'A huge shock': Helen Reilly on oesophageal cancer diagnosis and recovery

Her GP had sent her for ultrasound because of the digestive discomfort — “he thought it might be gallstones” — but this showed up nothing. When her doctor later heard about her swallowing difficulties, he sent her for gastroscopy.

At this stage, the Dublin-based mother, now in her mid-50s, began to worry that something might be amiss. “I got sedation for the scope. I was half asleep, but I could hear them talking… saying things like, ‘It’s bleeding’. So I knew there was something. I was thinking maybe an ulcer.” 

Three days later, the mother of two grown-up sons met the surgeon. “I went by myself. The first thing she said was, ‘Are you alone?’ I knew then there was news. I said, ‘Is it cancer?’ And she said, ‘Yes, it is’.

“It was a huge shock, but I was straightaway on the defensive, saying, ‘Well, I feel fine’, because I did. And I said, ‘But you’ll be able to do something, won’t you?’ The
surgeon said we’d have to find out the stage it was; from what she’d seen she didn’t think it was stage one. I was very scared, just kept saying, ‘I actually feel fine’.”

Reilly had a PET scan to see if her oesophageal cancer had spread and also to help decide a treatment plan. “The worst part was waiting for those results…The specialist nurse in the surgeon’s department was very positive, saying, ‘We have you. You’re not the first person to walk this road and we’ll do what we can’.”

Thankfully, the PET scan showed no sign it had spread. “It was a great relief. I felt ready for anything then. And I always felt I was in good hands with the team at St James’s,” says Reilly.

Treatment to shrink the tumour — located in her gastric junction, between the oesophagus and stomach — involved radiotherapy five days a week for five weeks, with chemo one day a week. She finished this phase at the end of June 2023, just two months post-diagnosis.

For the next two months, Reilly built up her fitness and weight in preparation for surgery. “I did pre-op physio and I kept up aqua aerobics and walking as much as I could — I’d always done them. I had surgery in September — they removed part of my oesophagus and part of my stomach. It was a big surgery. I spent five days in the high dependency unit, but only two weeks in total in hospital. I went home with a feeding tube that I managed to get rid of in record time.

She then underwent preventive immunotherapy for a year. “I’m good now,” she says, while adding that she is still adjusting to life post-surgery. “I love eating. I’ve always been a very enthusiastic eater, and I sometimes struggle with being able to only now eat smaller amounts. Sometimes I overeat and then feel uncomfortable.”

Reilly recalls her surgeon saying she was an unlikely candidate for oesophageal cancer, “being a woman and the age I was”. 

Dr Claire Donohue, consultant general and upper GI surgeon in St James’s Hospital (at Trinity St James’s Cancer Institute), says cancer of the oesophagus usually strikes men in their 60s and 70s. 

“25% of patients would be female. Occasionally, we get younger patients, in their 40s and 50s.”

Approximately 70% of patients experience symptoms of oesophageal cancer for three months before contacting their doctor. It’s a hard-to-treat cancer, and Donohue says patients may have had the tumour for some time even before symptoms. 

It starts in the oesophagus and can spread to the lymph nodes beside the oesophagus, or anywhere else in the body. In most patients at diagnosis, it has spread beyond the oesophagus.

Symptoms include ongoing heartburn or acid reflux, persistent cough or unexplained weight loss, and difficulty swallowing. Donohue says swallowing difficulties can be subtle at the start.

“Initially, it can involve hard food: Bread or meat. Over a short period of time, they start struggling with soft foods; even with liquids. It’s often a few months before they realise there’s a significant problem. When we’re eating, we’re usually talking with others, so we don’t notice, and also swallowing happens unconsciously.”

A recent survey, commissioned by the Oesophageal Cancer Fund, found 10% of women are unaware of oesophageal cancer, a figure that rises markedly for men — 64% of males were unaware that prolonged chronic heartburn or acid reflux can increase oesophageal cancer risk.

Worldwide, it is the sixth-leading cause of cancer mortality. Donohue says risk factors for the most common type in Ireland (adenocarcinoma) include obesity, being male and having a family history. With a five-year survival rate of 25%, she says it is normal for patients, post-treatment, to have a different quality of life.

“They have to learn how to eat differently, and they can often feel very tired for months afterwards. It takes time to regain stamina and get back to activities and exercise you were doing.”

• The Oesophageal Cancer Fund is asking people to buy a lollipop (€3) from volunteers nationwide on February 28 and March 1 to show support and help fund research. The charity urges local businesses, schools and clubs to get involved by organising their own lollipop day and help fill the awareness-gap surrounding this cancer.
  
• More information on Lollipop Day, how to volunteer, or donate, at: lollipopday.ie and ocf.ie.