Cancer Types
Common cancer types: symptoms, diagnostic methods and current treatment options.
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Oesophageal Cancer: Symptoms, Diagnosis and Treatment
Sources reviewed by: Assoc. Prof. Dr. Ali OğulLast updated: October 2026
Oesophageal cancer symptoms, diagnosis, staging, chemoradiotherapy, surgery and immunotherapy options. Medical oncology assessment in Mersin.
Key information
| Definition | A malignant tumour arising from the inner lining of the oesophagus |
|---|---|
| Main risks | Smoking, alcohol, long-standing reflux, Barrett’s oesophagus, obesity |
| Common symptoms | Difficulty swallowing, weight loss, pain behind the breastbone |
| Diagnosis | Endoscopy and biopsy, CT, PET-CT, EUS |
| Treatment | Chemoradiotherapy, surgery, chemotherapy, immunotherapy |
What is oesophageal cancer?
Oesophageal cancer develops from the inner lining of the oesophagus, the tube that carries food from the mouth to the stomach. There are two main types: squamous cell carcinoma, seen mostly in the upper and middle oesophagus, and adenocarcinoma, usually found at the lower end near the junction with the stomach. Type and location directly affect the choice of treatment [1][2].
Risk factors
Smoking and alcohol are the most important risk factors for the squamous cell type. Adenocarcinoma is associated with long-standing reflux disease, Barrett’s oesophagus and obesity. Very hot drinks and certain dietary habits have also been linked to the risk [2][3].
What are the symptoms?
The most common symptom is difficulty swallowing (dysphagia), first with solid and then with soft food. Unintentional weight loss, pain or burning behind the breastbone, hoarseness, cough and anaemia may occur. Anyone with difficulty swallowing is advised to be assessed with endoscopy [1][3].
Most of these complaints can also be caused by other conditions; complaints that persist or get worse need to be assessed by a doctor.
How is it diagnosed?
Diagnosis is made by endoscopy and biopsy. Contrast-enhanced chest-abdomen CT, PET-CT and, in suitable patients, endoscopic ultrasound (EUS) are used to assess spread. In adenocarcinoma HER2, PD-L1 (CPS) and MSI/MMR status, and in the squamous type PD-L1 status, may influence the choice of systemic treatment [1][2].
Staging
Staging follows the AJCC/UICC TNM system; the depth of the tumour in the wall (T), lymph node involvement (N) and distant spread (M) are assessed together. Very early tumours can be removed endoscopically, whereas locally advanced disease is treated with a multimodal approach [1][4].
Treatment options
- Early stage: Endoscopic resection for very superficial tumours, and surgery (oesophagectomy) for deeper tumours.
- Locally advanced disease: Preoperative chemoradiotherapy (e.g. radiotherapy with carboplatin + paclitaxel, the CROSS regimen) followed by surgery is a common approach. Perioperative FLOT chemotherapy is also an option in adenocarcinoma. In the squamous type, especially in patients not suitable for surgery, definitive chemoradiotherapy may be used.
- After surgery: In selected patients with residual tumour in the surgical specimen despite preoperative chemoradiotherapy, nivolumab for one year may be recommended.
- Advanced stage: Immunotherapies such as nivolumab, pembrolizumab or tislelizumab may be added to platinum and fluoropyrimidine-based chemotherapy depending on PD-L1 level; in HER2-positive adenocarcinoma there are options such as trastuzumab and, in later lines, trastuzumab deruxtecan [2][4][5].
- Nutrition and support: In swallowing difficulty, stents, feeding tubes and dietitian support are an important part of treatment.
Treatment is planned individually, taking into account the stage, tumour characteristics, general condition and the patient’s preferences. Not every option listed here is suitable for every patient.
Recent developments
Immunotherapy has broadened treatment options both after surgery (adjuvant) and in advanced disease. Studies continue on the optimal form of perioperative treatment in adenocarcinoma and on adding immunotherapy to this phase [4][5].
Support and follow-up during treatment
During treatment, not only the anti-cancer drugs but also the patient’s general condition is monitored. Nausea, fatigue, loss of appetite, pain, infection risk and changes in mood are asked about at every visit; when needed, preventive medication, nutritional support, physiotherapy and psychosocial support are planned. In situations such as fever, shortness of breath, uncontrollable diarrhoea or vomiting, or new severe pain, it is advisable to contact the treatment team without waiting for the scheduled visit. Herbal products and supplements can interact with some cancer drugs, so the treatment team should be consulted before using them.
In the first years after treatment, clinical assessment is carried out every 3–6 months, with endoscopy and imaging when needed. Nutrition, weight monitoring and reflux management after surgery are part of follow-up.
Frequently asked questions
No. Benign causes such as reflux, strictures or motility disorders can also cause difficulty swallowing; however, endoscopy is recommended to find the cause.
No. The decision depends on stage, tumour type, location and general condition; for some patients chemoradiotherapy without surgery is a suitable option.
Dietitian assessment, soft and high-calorie foods, nutritional supplements when needed, and stents or feeding tubes may be used.
Endoscopic surveillance is carried out at intervals recommended by a gastroenterologist; the aim is to detect possible changes early.
Call +90 530 250 54 85 or write to the same number via WhatsApp. The outpatient clinic is open Monday to Friday, 08:00–16:00.
At the medical oncology outpatient clinic of Mersin University Faculty of Medicine Oncology Hospital, Çiftlikköy Campus, 33110 Yenişehir/Mersin, Türkiye. The assessment is done in person.
When needed, yes. The multidisciplinary tumour board meets every Friday from 09:00 to 13:00, and the sequence of surgery, radiotherapy and drug treatment is planned jointly.
Yes. A second opinion is a common way to clarify a treatment plan. Bring your pathology, imaging and discharge reports to the clinic for the assessment.
Pathology report, imaging reports and, if possible, the image CDs, discharge summary, recent blood tests and a list of the medicines you take. Translated copies are helpful if your documents are not in Turkish or English.
Medical oncology consultation for oesophageal cancer in Mersin
If you have been diagnosed with oesophageal cancer, or your diagnostic work-up is ongoing, you can apply for a medical oncology consultation with Assoc. Prof. Dr. Ali Oğul at Mersin University Faculty of Medicine Oncology Hospital (Çiftlikköy Campus, 33110 Yenişehir/Mersin, Türkiye). Medical oncology covers the planning of drug treatments such as chemotherapy, targeted therapy, immunotherapy and hormone therapy, the monitoring of side effects and follow-up after treatment. The hospital has a day treatment unit where drug treatments are given.
Treatment decisions are made by a team. When needed, patient files are discussed at the multidisciplinary tumour board, which meets every Friday from 09:00 to 13:00 with specialists from the relevant departments.
For appointments, call +90 530 250 54 85 or send a WhatsApp message to the same number with your name, diagnosis and reason for the request; you can also send your reports. The outpatient clinic is open Monday to Friday, 08:00–16:00. No diagnosis or treatment recommendation is given via WhatsApp; the assessment takes place in person at the clinic. Consultations are held in Turkish.
Appointment
Evaluation and second opinion
If you have been diagnosed with oesophageal cancer or would like a second opinion on your current treatment plan, you can contact Assoc. Prof. Dr. Ali Oğul with your pathology report and imaging results.
This content is for information only; please consult your physician for diagnosis and treatment.
References
- ESMO Clinical Practice Guidelines – Oesophageal cancer. Accessed: October 2026. https://www.esmo.org/guidelines/esmo-clinical-practice-guidelines-gastrointestinal-cancers
- NCI – Esophageal Cancer (PDQ). Accessed: October 2026. https://www.cancer.gov/types/esophageal
- WHO/IARC – Global Cancer Observatory. Accessed: October 2026. https://gco.iarc.who.int/
- NCCN Guidelines – Esophageal and Esophagogastric Junction Cancers. Accessed: October 2026. https://www.nccn.org/guidelines/category_1
- ASCO Guideline – Treatment of Advanced Gastroesophageal Cancer. Accessed: October 2026. https://www.asco.org/practice-patients/guidelines
Links open external sources. The references were accessible as of October 2026.