How can esophageal cancer be diagnosed?

Written by Zhou Zi Hua
Oncology
Updated on September 22, 2024
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The diagnosis of esophageal cancer is primarily based on symptoms. In the early stages, symptoms are generally nonspecific or only mild and typically do not attract the patient's attention. In the mid to late stages, the most common symptom is progressive difficulty swallowing. Additional diagnostic methods include esophageal radiography, MRI, and CT scans. Moreover, cytological diagnosis, endoscopic ultrasound of the esophagus, direct endoscopic examination and pathological sampling under endoscopy are utilized. The gold standard for confirmation still requires pathological or cytological diagnosis.

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How long can one live with esophageal cancer?

The life expectancy of esophageal cancer patients depends on several factors such as the stage of the cancer at the time of diagnosis, the patient's sensitivity to treatments like radiotherapy and chemotherapy, the effectiveness of these treatments, the patient's general condition, and whether they have other underlying diseases. Patients who can undergo radical surgery, especially those diagnosed at an early stage, generally have a better prognosis. Patients who respond well to treatment can also expect a better outcome. Therefore, there is significant individual variation in prognosis.

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How to treat esophageal cancer metastasis?

The metastasis of esophageal cancer involves several aspects. The first aspect is the metastasis of lymph nodes, including those around the esophagus. If the number of metastatic lymph nodes is small and the tumor's location is suitable for surgical removal, then surgery can still be considered. The second issue involves cases where there is lymph node metastasis but with a higher number and wider spread, making surgical treatment unfeasible. In such cases, radical radiotherapy and chemotherapy can be considered to treat the esophageal cancer. Of course, there are also some new methods available now, such as immunotherapy, which can be considered along with others. Also, to improve symptoms of esophageal stricture, using an esophageal stent to control the difficulty of swallowing associated with esophageal cancer is also possible.

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Esophageal cancer screening methods

The screening methods for esophageal cancer primarily involve checks of the esophagus, including upper gastrointestinal barium meal and gastroscopy. Gastroscopy, in particular, is a relatively accurate method for examining patients. This is because during a gastroscopy, biopsy samples can be taken, and pathology can definitively determine whether cancer is present. There might be issues regarding whether a patient can undergo a gastroscopy as it requires significant patient tolerance. Therefore, depending on the patient's health condition, if a gastroscopy is not feasible, an upper gastrointestinal barium meal can be conducted first.

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How is esophageal cancer staged?

The staging of esophageal cancer includes a preoperative clinical staging and a postoperative pathological staging. Clinical staging involves completing various systemic examinations, determining the extent of the tumor, whether there are lymph node metastases, and whether there are distant metastases to organs such as the liver and lungs. This requires thorough assessments, including esophageal endoscopic ultrasound and whole-body examinations like PET-CT, to conduct clinical staging. Postoperative pathological staging, on the other hand, is determined based on the depth of tumor invasion reached during surgery and the status of lymph node metastasis, among other factors.

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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.