What are the precancerous lesions of esophageal cancer?

Written by Peng Li Bo
Oncology
Updated on September 22, 2024
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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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Will esophageal cancer recur after resection?

This depends on the actual situation and the specific postoperative pathology of the patient. Generally, a comprehensive examination is conducted before esophageal cancer surgery, and surgery is only performed if there is no metastasis and the patient's physical condition permits it. Therefore, postoperatively, if it is very early-stage esophageal cancer, the likelihood of recurrence is generally small. However, if it involves mid-to-late stages, the possibility of recurrence must be considered. However, essentially, all cases of esophageal cancer are prone to recurrence after resection.

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Typical symptoms of esophageal cancer

The most typical symptom of esophageal cancer is progressive difficulty swallowing, and a progressive sensation of swallowing obstruction is the most typical symptom. It's actually quite simple; the esophagus is akin to a water pipe or a tubular cavity. Esophageal cancer is like having a tumor grow inside this cavity, similar to something blocking the pipe, which causes the flow of water to be impeded. However, not only water passes through this esophagus, but also food. Therefore, if there's something inside the cavity, both water and food cannot pass through, leading to this difficulty swallowing and discomfort while swallowing.

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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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Esophageal cancer symptoms

In fact, the early symptoms of esophageal cancer are not very obvious. Some people only experience a slight discomfort when swallowing, and others might feel mild pain behind the sternum. However, in the advanced stages, the symptoms become more noticeable, such as progressive difficulty swallowing. Additionally, if the tumor compresses the laryngeal nerve, it can cause hoarseness. If it compresses the trachea, symptoms like shortness of breath and dry cough can occur. If the tumor erodes into the aorta, it can lead to severe bleeding.

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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.