The difference between esophagitis and esophageal cancer

Written by Peng Li Bo
Oncology
Updated on September 27, 2024
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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.

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Written by Hu Zhong Dong
Medical Oncology
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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 Peng Li Bo
Oncology
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What are the symptoms of esophageal cancer?

The symptoms of esophageal cancer generally include progressive difficulty in swallowing, because the esophagus itself is a tubular cavity, similar to a water pipe. Esophageal cancer typically forms a tumor within this tubular cavity, creating an obstruction. Consequently, the most common symptoms include difficulty swallowing and a sensation of blockage during eating, since food must pass through the esophagus. Other symptoms can include nausea, vomiting, acid reflux, heartburn, and pain below the breastbone. Moreover, the difficulty in swallowing generally worsens progressively, as the tumor grows from small to large, increasingly narrowing the esophagus and exacerbating the swallowing difficulties.

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Written by Liu Liang
Oncology
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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.

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Written by Peng Li Bo
Oncology
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Will esophageal cancer recur after resection?

After the removal of esophageal cancer, there is indeed a possibility of recurrence. This is because not only are there tumors on the esophagus, but some mediastinal lymph nodes around the esophagus may also have metastasized. It must be acknowledged that thoracic surgeons will definitely remove the tumor completely during surgery, but they can only remove the tumors that are visible to the naked eye. Many tumor cells that cannot be seen by the naked eye are impossible to remove. If the cancer is at a relatively advanced stage, many of these invisible tumor cells cannot be eliminated, just like air is invisible but still exists. Therefore, invisible does not mean there are no cancer cells. Thus, if there is no follow-up auxiliary treatment to kill the cancer cells, the cancer may very likely recur.

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Written by Hu Zhong Dong
Medical Oncology
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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.