Esophageal cancer screening methods

Written by Luo Peng
Thoracic Surgery
Updated on September 17, 2024
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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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Written by Peng Li Bo
Oncology
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Esophageal cancer T3 belongs to which stage?

For the staging of esophageal cancer, it not only depends on the T stage, but also on the N and M stages. If we are just considering the T stage, it is T3. If there are no N0 and M0 stages, it is relatively early and surgery can be considered. However, if looking only at T3 and the N stage involves lymph node involvement (N1, N2, or N3), with regional or distant lymph node metastasis, then the staging of the esophageal cancer is relatively late. Furthermore, if there is an M stage, which indicates the presence of distant organ metastasis, then it is classified as advanced stage. Therefore, the T stage alone for esophageal cancer does not determine whether it is early, intermediate, or late stage. It is necessary to look in conjunction with the N and M stages to determine the overall staging.

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Written by Hu Zhong Dong
Medical Oncology
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Is esophageal cancer prone to bone metastasis?

Modes of spread and metastasis of esophageal cancer. In the early to mid-stages, the spread is mainly intramural, as the esophagus lacks a serosal layer, making it easy to directly invade adjacent organs. Lymphatic metastasis is also a major route of spread for esophageal cancer. In advanced stages, the cancer metastasizes through the bloodstream to the liver, lungs, kidneys, and even bones. In cases of bone metastasis, treatment options such as chemotherapy, radiotherapy, and anti-bone metastasis treatment can be chosen based on the patient's general condition. If the patient experiences significant pain, pain relief medication can be chosen according to the three-step ladder for cancer pain treatment to alleviate symptoms.

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Written by Hu Zhong Dong
Medical Oncology
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Late-stage symptoms of esophageal cancer

What are the symptoms of late-stage esophageal cancer? Because in the early stages of esophageal cancer, the symptoms are often not very obvious, which leads many people to overlook them. By the time they feel very uncomfortable and seek medical advice, the cancer is generally in the middle to late stages. One common symptom in the later stages is progressive difficulty swallowing, which is a main symptom presented by many patients at the time of consultation. However, this symptom generally occurs only when about two-thirds of the esophagus's circumference has been infiltrated by the tumor, making swallowing difficulties a late-stage symptom. Other symptoms of late-stage esophageal cancer include hoarseness if the tumor compresses the recurrent laryngeal nerve, belching if it invades the diaphragmatic nerves, and symptoms like breathing difficulties and coughing if it compresses the airway.

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Written by Si Li Li
Gastroenterology
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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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Written by Wang Kun
Surgical Oncology
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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.