The best treatment for a cancer of the oesophagus (the gullet) is an operation to remove the growth. But this is a big operation and before deciding to go ahead with surgery it is important to make sure that your father is fit enough for the surgery and to check that his cancer has not spread too far for an operation to be possible.
After the diagnosis has been made the first step is to arrange for him to be seen by a team of specialists who are expert in the treatment of oesophageal cancer. This may mean travelling to a recognised Cancer Centre which may be some way from where you live, but it is necessary in order to make sure your father gets the best treatment.
The operations needed to remove oesophageal cancers involve major surgery and so the first thing will be to make sure your father is fit enough for this. As well as a general health check there are likely to be a cardiogram (ECG), to check how healthy his heart is, and tests of respiratory function, to check the state of his lungs. These are fairly simple, painless, tests that can be done as an out-patient.
The first step in finding out whether or not the cancer has spread is usually a CT scan. This will look at the chest and upper abdomen. If this shows obvious seedlings (of tumour secondary cancers) in, say, the lungs or liver, then an operation will not be possible. Even if the scan shows that the cancer appears to be confined to the gullet this still isn't a guarantee that the growth has not spread further (CT scans are a very useful guide but they are not 100% accurate), so the next step would probably be a endoluminal ultrasound (EUS) examination.
The EUS involves swallowing a tube with a small ultrasound probe which sends out sound waves to build up a picture of the surrounding structures. The EUS can give useful information about the size of the cancer, how deeply it has penetrated into the wall of the gullet, and surrounding tissues, and whether or not any nearby lymph nodes seem to be affected by the growth.
If the combination of the CT scan and EUS show that an operation might be possible then there might be one further investigation required before making a decision. If the cancer is in the upper part of the gullet, nearer the throat, this will involve a bronchoscopy (using a flexible telescope to look at the throat and the airways into the lung).
If the growth is in the lower part of the oesophagus, nearer the stomach, then a laparoscopy is likely (a small operation where a flexible telescope is inserted into the upper part of the belly to look at the lymph nodes, liver and stomach).
If all these tests show an operation is possible, and your father is fit enough, then his specialists will probably recommend surgery.
But do remember that although these tests give valuable information they are not absolutely reliable, and sometimes when an operation is done the surgeons will find that the cancer has spread further than they thought, so that it might not be possible to remove it after all.