Will esophageal cancer recur after resection?

Written by Peng Li Bo
Oncology
Updated on September 02, 2024
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After the removal of esophageal cancer, there is indeed a possibility of recurrence. This is because not only are there tumors on the esophagus, but some mediastinal lymph nodes around the esophagus may also have metastasized. It must be acknowledged that thoracic surgeons will definitely remove the tumor completely during surgery, but they can only remove the tumors that are visible to the naked eye. Many tumor cells that cannot be seen by the naked eye are impossible to remove. If the cancer is at a relatively advanced stage, many of these invisible tumor cells cannot be eliminated, just like air is invisible but still exists. Therefore, invisible does not mean there are no cancer cells. Thus, if there is no follow-up auxiliary treatment to kill the cancer cells, the cancer may very likely recur.

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Written by Zhou Zi Hua
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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.

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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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Written by Peng Li Bo
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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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Written by Liu Liang
Oncology
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What are the symptoms of esophageal cancer recurrence?

The symptoms of recurrent esophageal cancer are similar to those at its initial onset, primarily characterized by difficulties in swallowing and eating obstructions. Some may also experience nausea, vomiting, and reflux symptoms of the digestive tract. Of course, when recurrence occurs, if there are metastases to other distant organs, then clinical manifestations corresponding to those metastatic locations will appear. For example, if esophageal cancer metastasizes to the lungs, it could lead to coughing, expectoration, shortness of breath, or chest pain, and even clinical symptoms related to coughing up blood. If there is liver metastasis from esophageal cancer, symptoms might include abdominal pain, fatigue, poor appetite, and even ascites among other clinical manifestations related to liver metastasis.

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Oncology
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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.