Oesophageal cancer. X-ray of the chest of a patient with cancer of the gullet (oesophagus). The cancer has led to the formation of an abnormal passage (fistula) between the oesophagus and the neighbouring bronchus. Oesophageal cancer may be caused by smoking, heavy alcohol consumption and the drinking of very hot drinks. It causes swallowing difficulties, which can lead to vomiting. This can lead to rapid weight loss, but the cancer is usually painless. If the cancer is diagnosed before it spreads, then removal of the affected part of the oesophagus may effect a cure. In most cases, however, the prognosis is poor.