Stage 1 oesophageal cancer
The stage of your cancer tells the doctor how far it has grown and if it has spread.
Staging oesophageal cancer is very complicated. It depends on:
- what type of oesophageal cancer you have (squamous cell or adenocarcinoma)
- the grade of your cancer (how abnormal the cells look)
- whether doctors stage your cancer using tests and scans (clinical staging) or after surgery (pathological staging)
When you read the information on this page, it's helpful to know what type of oesophageal cancer you have and whether the doctor is using pathological or clinical staging. Talk to your specialist doctor or nurse if you are unsure. They can help you understand more about your cancer stage.
You can call the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.
Staging systems
Doctors use different systems to stage oesophageal cancer. This page is about stage 1 cancer, which is part of the number staging system. This system has 5 stages, stage 0 (high grade dysplasia) to stage 4.
This page also tells you what stage 1 means in the TNM system. This system describes:
- the size of the primary tumour (T)
- whether the cancer has spread to the lymph nodes (N)
- whether the cancer has spread to another part of the body (M)
Squamous cell cancer
Squamous cell cancers develop from squamous cells that make up the inner lining of your oesophagus.
Clinical staging means your doctor uses test and scan results to stage your cancer. This is different to pathological staging, which doctors use after surgery.
Your doctor might tell you your clinical stage to begin with. And if you go on to have surgery, your stage might change when the doctor finds out your pathological stage.
Stage 1 squamous cell cancer (clinical stage) can be any grade.
It means the cancer has grown no further than the supportive tissue (submucosa). But it might have spread to 1 or 2 nearby lymph nodes. It hasn’t spread to distant organs.
In TNM staging, stage 1 is:
- T1, N0 or N1, M0
Stage 1 squamous cell cancer (pathological stage) has not spread to nearby lymph nodes or distant organs.
It depends on the grade of your cancer.
It’s split into 2 groups - stage 1A and stage 1B.
Stage 1A means the cancer has grown no further than the thin muscle layer of the oesophagus.
In TNM staging, stage 1A is:
- T1a, N0, M0
Stage 1B means the cancer has grown into the thin muscle layer, supportive tissue (submucosa) or thick muscle wall of the oesophagus.
In TNM staging, stage 1B is:
- T1a, T1b or T2, N0, M0
Adenocarcinoma
Adenocarcinomas are cancers that develop in gland cells. These cells make mucus in the lining of the oesophagus.
Clinical staging means your doctor uses test and scan results to stage your cancer. This is different to pathological staging, which doctors use after surgery.
Your doctor might tell you your clinical stage to begin with. And if you go on to have surgery, your stage might change when the doctor finds out your pathological stage.
Stage 1 adenocarcinoma (clinical stage) can be any grade.
It means the cancer has grown no further than the supportive tissue (submucosa). It has not spread into lymph nodes or distant organs.
In TNM staging, stage 1 is:
- T1, N0, M0
Stage 1 adenocarcinoma (pathological stage) has not spread to nearby lymph nodes or distant organs.
It depends on the grade of your cancer.
It’s split into 3 stages - stage 1A, stage 1B and stage 1C.
Stage 1A means the cancer has grown no further than the thin muscle layer of the oesophagus.
In TNM staging, stage 1A is:
- T1a, N0, M0
Stage 1B means the cancer has grown no further than the supportive tissue (submucosa) of the oesophagus.
In TNM staging, stage 1B is:
- T1a or T1b, N0, M0
Stage 1C means the cancer has grown no further than the thick muscle wall of the oesophagus.
In TNM staging stage 1C is:
- T1 or T2, N0, M0
Treatment for stage 1 oesophageal cancer
Surgery is the main treatment. You don't usually need any other treatment before or after your operation.
You have surgery to remove part or all of your oesophagus. This is called an oesophagectomy.
For very small, early stage cancers you might be able to have surgery through a thin flexible tube (endoscope) to remove cancer from the lining of the oesophagus. You might have an endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD).
You might have chemoradiotherapy instead of surgery if you have squamous cell cancer or you are unable to have surgery.
