What are the symptoms of esophageal cancer?

Written by Peng Li Bo
Oncology
Updated on September 13, 2024
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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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Written by Zhu Dan Hua
Gastroenterology
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Distinction between esophagitis and esophageal cancer

Esophagitis and esophageal cancer are different diseases. Esophagitis refers to inflammatory changes in the esophagus, characterized by mucosal congestion, edema, and even erosion, commonly seen in middle-aged patients. Patients most often seek medical attention for abdominal discomfort or chest pain, and some may also experience nausea, belching, and so on. Esophageal cancer is more common in older patients, primarily presenting with progressively worsening dysphagia, accompanied by nausea, vomiting, and so on. Some cancer symptoms may be similar to those of esophagitis. The main method for differential diagnosis includes a thorough gastroscopic examination to provide further clarification. Esophagitis mainly manifests as inflammatory changes in the esophageal mucosa; in the case of esophageal cancer, a gastroscopic examination can directly reveal esophageal tumors, thereby facilitating differentiation.

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Written by Peng Li Bo
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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.

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Symptoms of esophageal cancer spread

The most typical symptom of esophageal cancer, especially in its advanced stages, is difficulty swallowing. As esophageal cancer progresses, patients may further experience difficulty swallowing semi-liquid food, eventually leading to difficulty swallowing even water and saliva. Additionally, as the cancer develops, it might compress the trachea, resulting in symptoms like sticky sputum and difficulty in expectorating. Consequently, due to difficulties in eating, progressive severe weight loss and fatigue often occur. Furthermore, some patients may also experience chest or back pain, and in some cases, an esophageal-tracheal fistula might occur, leading to severe respiratory difficulties and intense choking. Moreover, after advanced esophageal cancer has spread, it may also cause jaundice, ascites, and can metastasize to other parts of the body, potentially resulting in various symptoms.

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Written by Liu Liang
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Esophageal cancer metastasis pathways

"In terms of the metastatic pathways of esophageal cancer, the first one is through the bloodstream, known as hematogenous spread. This primarily results in metastases to distant organs such as the lungs, liver, bones, etc. The second pathway is via the lymphatic system. Lymphatic spread leads to metastases in regional lymph nodes and distant lymph nodes. The third pathway is through local invasion by the tumor, where the esophageal cancer can invade nearby organs and spread. These are the pathways through which metastasis occurs."

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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.