If you have a sore throat or difficulty swallowing, it’s likely to be caused by a virus. Unless it doesn’t go away. If you have a persistent sore throat lasting three to four weeks, the NHS says you should see your GP because it could be a sign of something more serious.
And, rarely, it could be a symptom of oesophageal cancer. Speaking before February’s Oesophageal Cancer Awareness Month, Dr Jason Chow, a consultant medical oncologist at Cromwell Hospital in London, explains: “A sore throat tends to be something that goes away on its own.
“However, persistent pain in your throat, which feels as though it’s in the centre of your chest (or behind the breastbone), and difficulty swallowing, which is painful or a burning sensation, or food feeling as though it’s sticking in your throat, are common symptoms of oesophageal cancer and you should speak to your doctor, especially if these symptoms don’t go away.”
But this type of cancer is often not diagnosed until it’s in its later stages, as in the early stages it may have no symptoms. Julie Thompson, information manager at the digestive system charity Guts UK, says: “Oesophageal cancer can be difficult to spot, as it might not cause any symptoms until it causes an obstruction of food and drinks down the oesophagus, or until swallowing becomes painful.”
Indeed, Guts UK says NHS data shows 20% of oesophageal cancer cases were diagnosed at emergency settings such as A&E, indicating that people are being diagnosed at later stages when the cancer is harder to treat.
Chow says around 9,000 people in the UK are diagnosed with oesophageal cancer each year, and warns: “Unfortunately, there is no clear established screening programme, and symptoms of oesophageal cancer can sometimes mimic more common problems such as indigestion, or be nonspecific, such as weight loss. This means that more than half of patients present with more advanced cancer.”
What are the symptoms of oesophageal cancer?
Difficulty swallowing
This is one of the most common symptoms of oesophageal cancer, and Thompson says: “This symptom starts with solid foods and progresses to liquids as the cancer worsens. This is called dysphagia.”
Weight loss
This is weight loss without trying, stresses Thompson.
Indigestion or heartburn
Another symptom, says Chow, is “indigestion or heartburn that doesn’t go away,” and Thompson explains: “Some people report longstanding heartburn before developing symptoms, although most people who develop oesophageal cancer have no symptoms of this kind before they experience dysphagia.”
Indigestion and heartburn are very common though, and rarely a sign of cancer.
Pain
Pain in your throat or behind your breastbone could be linked to oesophageal cancer, says Chow.
Food coming back up
Chow says regurgitation is a less common symptom of oesophageal cancer, and Thompson explains there may be regurgitation of food or being sick after eating or drinking, and regurgitated food may contain blood.
Coughing and hoarseness
Other less common symptoms include choking, coughing or unexplained chest infections, and Chow says there may be “A cough that won’t go away, hoarseness of the voice, or coughing up blood.”
Dark poo
Another uncommon symptom of oesophageal cancer is “poo that may be darker or almost black”, says Chow. Cancer Research UK says this can happen if the cancer is making the oesophagus bleed, but stresses it’s not a common symptom, and it’s one you can get if you’re taking iron tablets, for example.
Tiredness
Being tired may be a symptom, and Thompson says this can sometimes happen when a person with oesophageal cancer develops anaemia, which can make you very tired, because of bleeding in the oesophagus.
Who’s at risk?
Chow says the risk of developing cancer generally depends on factors including your age – most people with oesophageal cancer are aged over 60, with rates in the UK peaking in people aged 85 to 89 – medical conditions, and lifestyle factors such as being overweight.
“For oesophageal cancer, smoking or chewing tobacco increases your risk, and smoking and drinking alcohol together increases the risk further,” he says.
If you have a history of chronic acid reflux or Barrett’s oesophagus (a condition where the cells lining the oesophagus have become abnormal due to long-term acid reflux), this can also increase your risk of oesophageal cancer, he says.
Thompson adds: “Most people will seek medical attention because of problems swallowing, but it’s important to see your GP if you experience persistent heartburn, reflux, or any of the other symptoms for three weeks or more. Going to the doctor early is important, as it can increase your chance of early diagnosis and effective treatment.”