What are the symptoms of esophageal cancer?

Written by Peng Li Bo
Oncology
Updated on September 13, 2024
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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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Distinction between esophagitis and esophageal cancer

Esophagitis and esophageal cancer are different diseases. Esophagitis refers to inflammatory changes in the esophagus, characterized by mucosal congestion, edema, and even erosion, commonly seen in middle-aged patients. Patients most often seek medical attention for abdominal discomfort or chest pain, and some may also experience nausea, belching, and so on. Esophageal cancer is more common in older patients, primarily presenting with progressively worsening dysphagia, accompanied by nausea, vomiting, and so on. Some cancer symptoms may be similar to those of esophagitis. The main method for differential diagnosis includes a thorough gastroscopic examination to provide further clarification. Esophagitis mainly manifests as inflammatory changes in the esophageal mucosa; in the case of esophageal cancer, a gastroscopic examination can directly reveal esophageal tumors, thereby facilitating differentiation.

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Late-stage symptoms of esophageal cancer

What are the symptoms of late-stage esophageal cancer? Because in the early stages of esophageal cancer, the symptoms are often not very obvious, which leads many people to overlook them. By the time they feel very uncomfortable and seek medical advice, the cancer is generally in the middle to late stages. One common symptom in the later stages is progressive difficulty swallowing, which is a main symptom presented by many patients at the time of consultation. However, this symptom generally occurs only when about two-thirds of the esophagus's circumference has been infiltrated by the tumor, making swallowing difficulties a late-stage symptom. Other symptoms of late-stage esophageal cancer include hoarseness if the tumor compresses the recurrent laryngeal nerve, belching if it invades the diaphragmatic nerves, and symptoms like breathing difficulties and coughing if it compresses the airway.

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How to treat esophageal cancer metastasis?

The metastasis of esophageal cancer involves several aspects. The first aspect is the metastasis of lymph nodes, including those around the esophagus. If the number of metastatic lymph nodes is small and the tumor's location is suitable for surgical removal, then surgery can still be considered. The second issue involves cases where there is lymph node metastasis but with a higher number and wider spread, making surgical treatment unfeasible. In such cases, radical radiotherapy and chemotherapy can be considered to treat the esophageal cancer. Of course, there are also some new methods available now, such as immunotherapy, which can be considered along with others. Also, to improve symptoms of esophageal stricture, using an esophageal stent to control the difficulty of swallowing associated with esophageal cancer is also possible.

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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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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.