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 Si Li Li
Gastroenterology
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The difference between esophagitis and esophageal cancer.

Esophagitis and esophageal cancer can be differentiated in the following aspects. First, in terms of symptoms, esophagitis generally presents with symptoms such as acid reflux, heartburn, pain behind the sternum, belching, and upper abdominal pain. The main symptoms of esophageal cancer, on the other hand, are generally difficulty swallowing or pain when swallowing, and this symptom progressively worsens. Second, regarding age, esophagitis can occur in any age group, while esophageal cancer is more common in elderly male patients. Third, the best method of differentiation is through gastroscopy. Under gastroscopy, esophagitis can be diagnosed with findings such as mucosal erosion, congestion, and edema of the esophagus. Esophageal cancer, however, generally appears in the middle or upper or lower segments of the esophagus, and a diagnosis can be confirmed by performing a biopsy.

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Written by Peng Li Bo
Oncology
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What are the precancerous lesions of esophageal cancer?

The most common precancerous lesion of esophageal cancer is Barret's esophagus, which is formed by the chronic stimulation of the esophageal epithelium by chronic reflux esophagitis. Of course, this includes some chronic esophageal ulcers and long-term leukoplakia of the esophagus. These recurrent esophageal ulcers could potentially transform into atypical hyperplasia and then further into carcinoma in situ. However, the progression from precancerous lesions to actual cancer can take a very long time, possibly many years or even over a decade. Therefore, having a precancerous lesion does not necessarily lead to esophageal cancer.

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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 early symptoms of esophageal cancer?

The esophagus is a tubular passage for food, extending from the patient's pharynx to the stomach, thus named the esophagus. Its function is to allow food to travel from the mouth through the esophagus to the stomach. If a tumor develops in the esophagus, early symptoms can include difficulty swallowing, a choking sensation, and inability to swallow food, which sometimes may lead to vomiting. These are early symptoms of esophageal cancer. If the condition progresses to a late stage, it can lead to a situation where not even liquids can pass, making swallowing impossible, resulting in extreme weight loss. In severe cases, the cancer may metastasize, including to lymph nodes and other organs, and may also compress surrounding organs, causing symptoms like chest tightness.

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How can esophageal cancer be diagnosed?

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.