Esophageal cancer symptoms

Written by Hu Zhong Dong
Medical Oncology
Updated on December 14, 2024
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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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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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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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Esophageal cancer T3 belongs to which stage?

For the staging of esophageal cancer, it not only depends on the T stage, but also on the N and M stages. If we are just considering the T stage, it is T3. If there are no N0 and M0 stages, it is relatively early and surgery can be considered. However, if looking only at T3 and the N stage involves lymph node involvement (N1, N2, or N3), with regional or distant lymph node metastasis, then the staging of the esophageal cancer is relatively late. Furthermore, if there is an M stage, which indicates the presence of distant organ metastasis, then it is classified as advanced stage. Therefore, the T stage alone for esophageal cancer does not determine whether it is early, intermediate, or late stage. It is necessary to look in conjunction with the N and M stages to determine the overall staging.

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How to check for esophageal cancer?

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.

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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.