Page last updated: April 2026
The information on this webpage was adapted from Understanding Oesophageal Cancer - A guide for people with cancer, their families and friends (2026 edition). This webpage was last updated in April 2026.
Expert content reviewers:
This information was developed with the help of a range of health professionals and people affected by oesophageal cancer:
- Prof David Watson, Matthew Flinders Distinguished Professor of Surgery, Flinders University, and Senior Consultant Surgeon, Oesophago-Gastric Surgery Unit, Flinders Medical Centre, SA
- Prof Bryan Burmeister, Senior Radiation Oncologist, GenesisCare Fraser Coast and Hervey Bay Hospital, QLD
- Dr Natalie Collier, Radiation Oncologist, Wollongong Hospital, NSW
- A/Prof Melissa Eastgate, A/Executive Director, Cancer Care Services, Royal Brisbane and Women’s Hospital, QLD
- Natalie Lalor, 13 11 20 Consultant, Cancer Council Victoria
- Chris Menzies, Upper GI Cancer Nurse Consultant, Flinders Medical Centre and Southern Adelaide Local Health Network, SA
- Tammy Milne, Consumer
- Stefanie Simnadis, Clinical Dietitian, St John of God Subiaco Hospital, WA
- Prof Rajvinder Singh, Professor of Medicine, University of Adelaide, and Director, Gastroenterology Department and Head of Endoscopy, Lyell McEwin Hospital, SA
What is oesophageal cancer?
Oesophageal cancer begins when abnormal cells develop in the innermost layer of the oesophagus, called the mucosa. A tumour can start anywhere along the oesophagus. There are two main types:
- Oesophageal adenocarcinoma – This type often starts near the gastro-oesophageal junction and is linked with Barretts oesophagus (see below). Adenocarcinomas are the most common form of oesophageal cancer in Australia.
- Oesophageal squamous cell carcinoma – This type starts in the thin, flat cells of the mucosa, which are called squamous cells. It often begins in the middle and upper part of the oesophagus.
Another type is gastro-oesophageal junction cancer. This starts where the oesophagus meets the stomach. It is usually treated like oesophageal cancer, but sometimes like stomach cancer.
If not found and treated early, oesophageal cancer can spread to nearby lymph nodes or to other parts of the body (e.g. liver and lungs). It can also grow through the oesophageal wall and into nearby organs.
About the oesophagus
The oesophagus (the food pipe) is a muscular tube that connects the throat to the stomach. In adults, it is about 25 cm long and lies behind the windpipe, which is used for breathing.
The oesophagus is part of the upper gastrointestinal (GI) tract, which is a section of the digestive system. It takes food and liquids (including saliva) from the mouth to the stomach.
A valve (sphincter) at the lower end of the oesophagus stops acid and food moving from the stomach back into the oesophagus.
Parts of the oesophagus
Layers of tissue in the oesophageal wall
- Mucosa (inner layer) made up of squamous cells (thin, flat cells)
- Submucosa contains glands that make fluid (mucus), this fluid helps to move food through the oesophagus
- Muscularis propria (muscle layer) produces contractions to help push food down the oesophagus and into the stomach
- Adventitia (outer layer) connective tissue that supports the oesophagus
Your guide to best cancer care
A lot can happen in a hurry when you’re diagnosed with cancer. The guide to best cancer care for oesophagogastric cancer can help you make sense of what should happen.
It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.
Read the guide
Symptoms
Oesophageal cancer may not cause any symptoms in the early stages. If there are symptoms, these can include:
- difficulty swallowing
- heartburn or reflux that is new
- reflux that doesn’t go away
- food or fluids “catching” in the throat, or episodes of bringing food back up (regurgitation)
- pain when swallowing
- unexplained weight loss or loss of appetite
- feeling uncomfortable in the upper abdomen, especially when eating
- unexplained tiredness that won’t go away
- vomit that has blood in it
- black or bloody stools (poo). Not everyone with these symptoms has oesophageal cancer. If you have symptoms that do not improve, see your general practitioner (GP).
How common is oesophageal cancer?
In Australia, about 1785 people are diagnosed with oesophageal cancer each year. Men are almost 3 times more likely than women to be diagnosed with this cancer.
It is more common in people over 60, but it can occur at any age.
Oesophageal cancer statistics
Risk factors
The exact causes of oesophageal cancer are not known. However, certain factors can increase the risk. Many people with these risk factors do not develop oesophageal cancer.
The risk factors are different for oesophageal adenocarcinoma and oesophageal squamous cell carcinoma.
For oesophageal adenocarcinoma:
- being overweight or obese
- medical conditions, including gastro-oesophageal reflux disease (GORD) and Barretts oesophagus
- smoking tobacco
- being over 60.
For oesophageal squamous cell carcinoma:
- drinking alcohol
- smoking tobacco
- being over 60
- damage to the oesophagus from swallowing very hot liquids or corrosive substances (e.g. acid).
GORD and Barretts oesophagus
Reflux occurs when stomach acid flows up into the oesophagus. When reflux happens over a long time, it can lead to gastro-oesophageal reflux disease (GORD).
Over time, acid and bile can damage the oesophagus lining, causing inflammation or ulcers (oesophagitis). This can lead to Barretts oesophagus, which affects about 1 in 10 people with GORD.
Rarely, Barretts oesophagus can develop into oesophageal adenocarcinoma (see above). If you have Barretts oesophagus, your doctor may recommend regular endoscopies.
Diagnosis
If your GP suspects oesophageal cancer, they will examine you, arrange initial tests and refer you to a specialist, such as a gastroenterologist. These are some of the tests you may have:
Endoscopy and biopsy
The main tests are endoscopy and biopsy, which are often done at the same time. An endoscopy (also called a gastroscopy or upper endoscopy) lets your doctor look inside your oesophagus and stomach.
It is usually done as day surgery. Before the test, you will probably need to fast (not eat or drink) for about 6 hours.
You could be offered a light sedation to make the procedure more comfortable. A general anaesthetic is only needed in a small number of cases.
Once the sedative takes effect, a long, flexible tube with a light and small camera on the end (endoscope) is passed into your mouth, down your throat and oesophagus, and into your stomach and small bowel.
If the doctor sees anything unusual during the endoscopy, they may take a small sample of tissue (biopsy). A specialist, called a pathologist, will check the tissue sample under a microscope to look for cancer.
The endoscopy takes about 10 minutes. You may feel sleepy afterwards, so someone will need to take you home. You may also have a sore throat or feel bloated for a short time.
Endoscopic ultrasound (EUS)
An EUS is often done at the same time as a standard endoscopy. Sometimes it is done shortly after if more information is needed or to help with staging (see below).
The doctor uses an endoscope with an ultrasound probe on the tip or with a built-in ultrasound device. The probe releases soundwaves that echo when they bounce off anything solid, such as an organ or tumour.
If you have cancer, this test can help to show whether the cancer has spread into the oesophageal or stomach wall, nearby tissues or lymph nodes.
During the EUS, your doctor may use the ultrasound to guide a needle into the area they want to look at and take tissue samples.
Further tests
If a biopsy shows you have oesophageal cancer, you may have more tests to see if the cancer has spread. Some tests may be repeated during or after treatment to check your health and how well treatment is working.
| Test |
What is it |
Why it's done
|
What to expect |
| blood tests |
A sample of your blood is checked.
|
Checks your general health, blood cell count and how your liver and kidneys are working.
|
Quick test, usually a small needle in your arm.
|
| imaging scans |
Pictures of the inside of your body using CT, MRI or PET–CT scans.
|
Checks if the cancer has spread to other parts of your body.
|
You’ll lie still on a table. For some scans, a liquid dye (contrast) is injected into a vein.
|
| laparoscopy |
Keyhole surgery using a thin tube with a camera.
|
Sometimes used to check if cancer has spread to the stomach’s outer layer or the lining of the abdomen.
|
Done under general anaesthetic. The tube is inserted through small cuts in your belly. Afterwards, you may feel bloated or have shoulder pain.
|
| genomic testing |
Special tests on tissue removed during surgery.
|
Finds gene changes (mutations) in cancer cells to help decide which treatments may work best.
|
No extra procedure is needed. Uses tissue already taken during surgery or biopsy.
|
Staging
Working out how far the cancer has spread is called staging. It helps your doctors recommend the best treatment for you. The TNM staging system is the method most often used to stage oesophageal cancers.
TNM stands for “tumour, node, metastasis”. The specialist gives numbers to the size of the tumour (T1–4), whether or not lymph nodes are affected (N0–N3), and whether the cancer has spread or metastasised (M0 or M1).
Lower numbers mean the cancer is less advanced. The TNM scores are combined to work out the overall stage of the cancer, from stage 1 to stage 4 (see below).
Ask your doctor to explain what the stage of the cancer means for you. You can also call Cancer Council 13 11 20.
Stages of oesophageal cancer
- stage 1 (early or limited cancer) – tumour is found only in the oesophageal wall lining
- stages 2–3 (locally advanced cancer) – tumour has spread deeper into the layers of the oesophageal wall and to nearby lymph nodes
- stage 4 (metastatic or advanced cancer) – tumour has spread beyond the oesophageal wall to nearby lymph nodes or parts of the body, or to distant lymph nodes and parts of the body
Understanding Oesophageal Cancer
Download our Understanding Oesophageal Cancer fact sheet to learn more.
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