The difference between esophagitis and esophageal cancer.

Written by Zhai Guo Dong

Gastroenterology

Updated on September 24, 2024

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Esophagitis and esophageal cancer have essential differences. Esophagitis is merely an inflammatory disease, which is relatively common in clinical settings and often related to excessive stomach acid, acid reflux, or other physical and chemical irritants. Esophageal cancer, on the other hand, is a malignant tumor. The mechanisms of their development, as well as the differences in prognosis and treatment plans, are very significant.

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The difference between esophagitis and esophageal cancer

The differences between esophagitis and esophageal cancer are significant. Esophagitis is an inflammation and is benign, but esophageal cancer is malignant, marking a stark contrast between the two. However, both esophagitis and esophageal cancer can have similar clinical symptoms, such as acid reflux, hiccups, heartburn, pain behind the breastbone, discomfort, and a burning sensation behind the breastbone, so symptoms can be similar. However, a more typical symptom of esophageal cancer is a sensation of swallowing obstruction, since there is actually something in the esophagus. Inflammation, after all, is just that, and it does not involve a mass forming inside the esophagus that could block it, hindering the ability to drink water, eat food, or swallow.

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How is esophageal cancer treated if it has not spread?

If esophageal cancer is clinically assessed as not having spread, surgical treatment is the first choice for patients. Since esophageal cancer surgery is a major operation, it is recommended that patients undergo surgery in a specialized hospital. Of course, for some older patients with poor cardiopulmonary function, if the pathology is squamous cell carcinoma, it is advisable to consider radiotherapy, because this tumor is relatively sensitive to radiation and often achieves better clinical outcomes. However, compared to surgical resection, the effects might be less favorable. For patients in generally good condition, surgery combined with radiation therapy can reduce the likelihood of postoperative recurrence and metastasis.

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Are the symptoms of esophagitis the same as those of esophageal cancer?

The clinical manifestations of esophagitis and esophageal cancer are different. The main symptoms of esophagitis include upper abdominal pain, chest pain, belching, acid reflux, nausea, vomiting, and heartburn. In contrast, the primary symptom of esophageal cancer is choking and difficulty swallowing after eating. Therefore, these two diseases can be distinguished based on symptoms, and a definitive diagnosis can be made through gastroscopy. If gastroscopy reveals gastric mucosa with congestion, edema, erosion, or ulcers, it can be diagnosed as reflux esophagitis. If a tumor is found in the esophageal mucosa, and a biopsy is taken for pathological examination, it can confirm whether it is esophageal cancer. After a definitive diagnosis, treatment can be tailored according to the specific disease.

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What are the symptoms of esophageal cancer?

The symptoms of esophageal cancer generally include progressive difficulty in swallowing, because the esophagus itself is a tubular cavity, similar to a water pipe. Esophageal cancer typically forms a tumor within this tubular cavity, creating an obstruction. Consequently, the most common symptoms include difficulty swallowing and a sensation of blockage during eating, since food must pass through the esophagus. Other symptoms can include nausea, vomiting, acid reflux, heartburn, and pain below the breastbone. Moreover, the difficulty in swallowing generally worsens progressively, as the tumor grows from small to large, increasingly narrowing the esophagus and exacerbating the swallowing difficulties.

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Early symptoms of esophageal cancer

The early symptoms of esophageal cancer are not very typical. In the early stages, there may be discomfort, a sensation of blockage, or burning and pinching feelings during swallowing. There might also be pain behind the breastbone. Other atypical gastrointestinal symptoms can include acid reflux, heartburn, belching, hiccups, and vomiting. However, as esophageal cancer progresses, the most typical symptom becomes difficulty swallowing, obstruction, and the sensation that swallowed items cannot pass down, including severe cases where even drinking water feels obstructed and leads to vomiting.