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Esophageal cancer
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.
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.
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.
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.
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.
The main metastatic pathways of esophageal cancer
The main metastatic pathways of esophageal cancer include firstly, hematogenous spread, which can transfer to distant organs such as bones and the lungs or liver via the bloodstream. The second pathway is via the lymphatic system, which can lead to the metastasis of regional lymph nodes and other non-regional lymph nodes. For example, cervical esophageal cancer tends to metastasize to the supraclavicular and adjacent esophageal lymph nodes; in thoracic esophageal cancer, metastases may occur in the subcarinal, upper periesophageal, and lower periesophageal lymph nodes; metastasis can also be achieved through local spread and invasion of the tumor.
The difference between esophagitis and esophageal cancer.
Esophagitis and esophageal cancer have essential differences. Esophagitis is merely an inflammatory disease, which is relatively common in clinical settings and often related to excessive stomach acid, acid reflux, or other physical and chemical irritants. Esophageal cancer, on the other hand, is a malignant tumor. The mechanisms of their development, as well as the differences in prognosis and treatment plans, are very significant.
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."
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.
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.