Are the symptoms of esophagitis the same as those of esophageal cancer?

Written by Si Li Li
Gastroenterology
Updated on April 10, 2025
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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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Is esophageal cancer prone to bone metastasis?

Modes of spread and metastasis of esophageal cancer. In the early to mid-stages, the spread is mainly intramural, as the esophagus lacks a serosal layer, making it easy to directly invade adjacent organs. Lymphatic metastasis is also a major route of spread for esophageal cancer. In advanced stages, the cancer metastasizes through the bloodstream to the liver, lungs, kidneys, and even bones. In cases of bone metastasis, treatment options such as chemotherapy, radiotherapy, and anti-bone metastasis treatment can be chosen based on the patient's general condition. If the patient experiences significant pain, pain relief medication can be chosen according to the three-step ladder for cancer pain treatment to alleviate symptoms.

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How is esophageal cancer treated if it has not spread?

If esophageal cancer is clinically assessed as not having spread, surgical treatment is the first choice for patients. Since esophageal cancer surgery is a major operation, it is recommended that patients undergo surgery in a specialized hospital. Of course, for some older patients with poor cardiopulmonary function, if the pathology is squamous cell carcinoma, it is advisable to consider radiotherapy, because this tumor is relatively sensitive to radiation and often achieves better clinical outcomes. However, compared to surgical resection, the effects might be less favorable. For patients in generally good condition, surgery combined with radiation therapy can reduce the likelihood of postoperative recurrence and metastasis.

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How is esophageal cancer staged?

The staging of esophageal cancer includes a preoperative clinical staging and a postoperative pathological staging. Clinical staging involves completing various systemic examinations, determining the extent of the tumor, whether there are lymph node metastases, and whether there are distant metastases to organs such as the liver and lungs. This requires thorough assessments, including esophageal endoscopic ultrasound and whole-body examinations like PET-CT, to conduct clinical staging. Postoperative pathological staging, on the other hand, is determined based on the depth of tumor invasion reached during surgery and the status of lymph node metastasis, among other factors.

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What are the early symptoms of esophageal cancer?

The esophagus is a tubular passage for food, extending from the patient's pharynx to the stomach, thus named the esophagus. Its function is to allow food to travel from the mouth through the esophagus to the stomach. If a tumor develops in the esophagus, early symptoms can include difficulty swallowing, a choking sensation, and inability to swallow food, which sometimes may lead to vomiting. These are early symptoms of esophageal cancer. If the condition progresses to a late stage, it can lead to a situation where not even liquids can pass, making swallowing impossible, resulting in extreme weight loss. In severe cases, the cancer may metastasize, including to lymph nodes and other organs, and may also compress surrounding organs, causing symptoms like chest tightness.

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What are the early signs of esophageal cancer?

The early symptoms of esophageal cancer are often nonspecific and intermittent, thus many patients do not take them seriously and delay the condition. Clinically, common early symptoms of esophageal cancer include a choking sensation when swallowing food, which is more noticeable in patients who swallow dry food or other foods that are not well chewed in large bites. Additionally, there is discomfort or a feeling of fullness behind the sternum. Thirdly, there is a sensation of a foreign body in the esophagus, with about 20% of patients experiencing this sensation when swallowing, as well as dryness and a feeling of tightness in the throat. Furthermore, there is a slow passage and a sense of retention of food.