Prognosis and duration

Localised (early stage) oesophageal cancer

Those who have had treatment for Barrett’s oesophagus are expected to make a complete recovery and are unlikely to experience recurrent disease. Ongoing problems for them may include difficulty eating large meals and symptoms of dumping syndrome such as nausea, bloating, pain and diarrhoea.

Those who have had treatment of Oesophageal cancer with major surgery are likely to be self caring and mobile three months into recovery although full recovery is likely to take at least 1 year. If needs are identified during treatment these are likely to be much reduced at 3 months and in the typical case no needs would be anticipated at 1 year. The exception to this might be those who have developed enduring side effects of surgery. Ongoing problems for this group may include difficulty eating large meals and symptoms of dumping syndrome. Many patients remain underweight for a long time after surgery and will feel tired for a large part of the day.

Those who have had chemoradiation treatment for localised Oesophageal cancer may have identifiable needs during treatment which lasts for 3-4 months. It may take several months to recover from this treatment but needs are unlikely to persist unless the rare but enduring side effects of radiotherapy have developed.

Some people who have had either type of treatment for Oesophageal cancer may have a prolonged recovery period after treatment. This condition is particularly difficult and slow to recover from because of the profound weight loss and malnutrition that having difficulty swallowing causes. In addition many will develop recurrent disease within 5 years of successful treatment. 5 year survival rates after surgery are at best 30% and for chemoradiation therapy also around 30%. If disease recurs, needs are likely to occur and information relating to the advanced/recurrent disease stage is appropriate.

In cases where needs are identified during treatment of the primary tumour, awards should be time limited to cover the period of treatment and recovery. People affected are unlikely to regain their normal weight but a return to near normal function is expected in the typical case. If disease has recurred after successful treatment of any stage of oesophageal cancer, information relating to the advanced/recurrent disease stage is appropriate.

Life awards are recommended even if palliative treatment has appeared to significantly help with symptoms.

All information must be taken into account when considering the duration of disabling effects and the duration of disabling effects must be based on the particular circumstances of the individual claimant.

Amended November 2008