How can esophageal cancer be diagnosed?

Written by Zhou Zi Hua
Oncology
Updated on September 22, 2024
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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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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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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.

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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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Written by Gong Chun
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What should I do about esophageal cancer?

Currently, effective treatments for esophageal cancer include surgical treatment, radiation therapy, and chemotherapy. Integrated treatment with surgery as the main approach is the primary method for treating esophageal cancer. This may include preoperative radiotherapy followed by surgery, preoperative chemoradiotherapy followed by surgery, preoperative chemotherapy followed by surgery, or direct surgery followed by adjuvant chemoradiotherapy. These are all major treatment methods for esophageal cancer. However, the choice of a personalized integrated treatment should be based on factors such as the stage of the disease, the location of the lesion, age, and physical condition.

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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.