How to check for esophageal cancer?

Written by Liu Liang
Oncology
Updated on May 13, 2025
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One clinical symptom of esophageal cancer is primarily dysphagia, especially progressive aggravation of dysphagia and difficulty swallowing. When these symptoms occur, the possibility of esophageal cancer should be considered, and one should seek medical attention at a hospital. An esophagoscope examination, which is an endoscopy, should be performed. Usually, under endoscopy, morphological changes in the esophagus can be observed, and if a biopsy is taken and cancer cells are found, esophageal cancer can be diagnosed. Therefore, the primary diagnostic approach for esophageal cancer involves an endoscopic examination and biopsy of the esophageal mass, which is the gold standard for diagnosis. After diagnosis, it is also necessary to perform comprehensive examinations such as chest and full abdominal CT scans, superficial lymph node ultrasound of the whole body, barium meal tests for the esophagus, and other examinations like ultrasound and esophagoscopy to assess the stage of the cancer and decide upon further treatment plans.

Other Voices

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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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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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The difference between esophagitis and esophageal cancer

The differences between esophagitis and esophageal cancer are significant. Esophagitis is an inflammation and is benign, but esophageal cancer is malignant, marking a stark contrast between the two. However, both esophagitis and esophageal cancer can have similar clinical symptoms, such as acid reflux, hiccups, heartburn, pain behind the breastbone, discomfort, and a burning sensation behind the breastbone, so symptoms can be similar. However, a more typical symptom of esophageal cancer is a sensation of swallowing obstruction, since there is actually something in the esophagus. Inflammation, after all, is just that, and it does not involve a mass forming inside the esophagus that could block it, hindering the ability to drink water, eat food, or swallow.

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Esophageal cancer screening methods

The best and clearest method for screening esophageal cancer is still gastroscopy, which can also be referred to as esophagoscopy. Endoscopic examination is very significant for this type of luminal tumor. Of course, if some people truly cannot tolerate a gastroscopic exam, they might consider initially undergoing a barium meal for the esophagus or iodized oil radiography for diagnosis. Additionally, a chest CT scan can be performed to determine whether there is narrowing in the esophageal lumen or if there is metastasis in the surrounding lymph nodes, among other issues. However, the best and most important method is certainly the esophagoscopy, or taking a biopsy of the pathological tissue under gastroscopy, which is very important for the definitive diagnosis of esophageal cancer.

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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.