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Introduction

St James’s Hospital is the National Centre for Oesophageal and Gastric Cancer and the National Centre for Management of Early Upper Gastrointestinal Mucosal Neoplasia.

The hospital manages approximately 65% of oesophageal surgical resections nationally.

Cure rates are improving, with overall survival at 35%, 65% for node negative disease, and 75% for Stage I/II disease, outcomes consistent with best international benchmarks.

  • The oesophagus is part of the digestive system.  It links the tube from your throat to your stomach.  When you eat, the muscles in your oesophagus push the food down into your stomach. 

    The wall of the oesophagus has several layers, the inner layer or lining, the submucosa, the muscle layer, and the outer layer.

    Oesophageal cancer happens when cells in the oesophagus change and grow in an abnormal way.  Usually the tumour does not cause symptoms at first but as it grows it can cause difficulty with swallowing. 

    The causes of oesophageal cancer include:

    Age, gender (more common in men than women), smoking, alcohol, acid reflux, Barrett’s oesophagus (inflamed cells due to acid reflex), Achalasia, Obesity and poor diet.

    Symptoms of oesophageal cancer are:

    • Difficulty swallowing
    • Indigestion or heartburn that doesn’t go away
    • Poor appetite
    • Pain in your throat, breastbone
    • Hoarse voice
    • Frequent hiccoughs or belching
    • Frequent coughing
    • Weight loss
  • The aim of treatment is to stop any spread of cancer and, if possible, to remove all the cancer from your body. 

    Treatments for oesophageal cancer are surgery, radiotherapy and chemotherapy.  They may be used on their own or together.

    In deciding the most suitable treatment, your doctor will consider:

    • The size of the tumour
    • Location of the tumour
    • If it has spread to your lymph nodes
    • Your symptoms, age and general state of health.

    In St James’s Hospital, treatment plans are discussed by a multidisciplinary team of consultant surgeons, consultant radiologists, consultant pathologists, consultant medical oncologist, consultant radiation oncologist and cancer nurse specialists.

  • The Upper Gastrointestinal Cancer Programme at St James’s Hospital consists of:

    • Rapid access oesophageal clinic.  All patients referred are seen within one week
    • Well-developed multidisciplinary team model
    • Specialist Medical gastroenterologist in endoscopic ultrasound, radiofrequency ablation and endoscopic mucosal resection
    • High-volume centre for all complex surgeries, including two and three stage resections, transhiatal oesophagectomy and minimally invasive approaches
    • Defined link with St Lukes’s hospital
    • Integrated perioperative care pathway defined and implemented
    • Audit data published internationally and consistent with benchmarks from leading centres in Europe and North America
    • Consultant medical oncologist
    • Consultant radiation oncologist
    • Upper gastrointestinal cancer nurse coordinator
    • Upper gastrointestinal data manager
    • Specialist pathologist
    • Specialist radiologist
    • Multidiciplinary team coordinator
    • High-percentage of patients in translational clinical trials or studies.
  • The following are contact details for oesophageal cancer support services:

    Irish Cancer Society

    43/45 Northumberland Road, Dublin 4.

    Phone: (01) 231 0500/ Fax: (01) 231 0555
    Email: info@irishcancer.ie
    Website: www.cancer.ie

    National Cancer Helpline

    Phone: 1800 200 700
    Email: helpline@irishcancer.ie

    The Oesophageal Cancer Fund or OCF are another organization that provides support to Oesophageal cancer patients.
    Website: https://www.ocf.ie/

    ARC House

    Located near the hospital, on the South Circular Road. It provides support, information and holistic therapies for men and women with cancer.

    Phone: (01) 707 8880
    Email: linda@arccancersupport.ie

  • This film is intended for patients and their families who have received a diagnosis of oesophageal cancer. It is intended to inform them of the key elements in their treatment path.