What are the early signs of esophageal cancer?

Written by Zhou Zi Hua
Oncology
Updated on September 13, 2024
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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.

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Esophageal cancer screening methods

The screening methods for esophageal cancer primarily involve checks of the esophagus, including upper gastrointestinal barium meal and gastroscopy. Gastroscopy, in particular, is a relatively accurate method for examining patients. This is because during a gastroscopy, biopsy samples can be taken, and pathology can definitively determine whether cancer is present. There might be issues regarding whether a patient can undergo a gastroscopy as it requires significant patient tolerance. Therefore, depending on the patient's health condition, if a gastroscopy is not feasible, an upper gastrointestinal barium meal can be conducted first.

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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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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 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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What are the symptoms of esophageal cancer recurrence?

The symptoms of recurrent esophageal cancer are similar to those at its initial onset, primarily characterized by difficulties in swallowing and eating obstructions. Some may also experience nausea, vomiting, and reflux symptoms of the digestive tract. Of course, when recurrence occurs, if there are metastases to other distant organs, then clinical manifestations corresponding to those metastatic locations will appear. For example, if esophageal cancer metastasizes to the lungs, it could lead to coughing, expectoration, shortness of breath, or chest pain, and even clinical symptoms related to coughing up blood. If there is liver metastasis from esophageal cancer, symptoms might include abdominal pain, fatigue, poor appetite, and even ascites among other clinical manifestations related to liver metastasis.