Esophageal Cancer Symptoms : Detecting Malignant Growths

Symptoms of Esophageal Cancer: Types and Causes

Esophageal cancer is a life-threatening and often underestimated disease affecting the long, muscular tube connecting the throat and stomach. As per a 2022 report, almost 75% of such cases and deaths occurred in Asia, where China, Bangladesh, and India took the lead.

Since esophageal cancer often goes undetected until advanced stages, awareness beforehand is vital. Early identification of esophageal cancer symptoms can significantly influence survival rates.

Read ahead to learn about the key symptoms of esophageal cancer, particularly those occurring more frequently in women, and understand the importance of early detection.

What is Esophageal Cancer?

Esophageal cancer is a cancerous growth that arises in the lining tissues of the esophagus—the muscular tube connecting the throat and stomach and aiding the movement of food for digestion.

It is one of the most prevalent cancers in the world and among the top causes of cancer-related mortality because it is aggressive and tends to be diagnosed late. Esophageal cancer can arise anywhere on the esophagus and usually develops from the inner lining cells.

What are the Symptoms of Esophageal Cancer?

Listed below are the major symptoms that may indicate the presence of esophageal cancer:

Difficulty Swallowing (Dysphagia)

One of the first and most frequent symptoms of esophageal cancer is dysphagia, or difficulty swallowing. The initial stage typically involves difficulty swallowing solid foods, which may later extend to liquids as well.

Patients can feel the food getting stuck in their throat or chest, which often leads to changes in eating patterns, like taking smaller bites or bypassing certain foods.

Unexplained Weight Loss

A sudden drop in body weight without dietary or lifestyle changes can be a warning sign. Cancer cells consume the body’s energy and, combined with difficulty swallowing, can lead to rapid and unintentional weight loss. Malnutrition and fatigue often follow, making the condition challenging to treat.

Chest Pain or Discomfort

Chest pain or a burning feeling in the chest—particularly behind the breastbone—may result as the tumor advances. This pain is usually confused with heartburn or acid reflux and might become more constant and worsen over time, particularly after meals or after lying down.

Persistant Cough

A persistent, dry cough that lasts weeks or months. It might be due to irritation of the tumor or food that gets into the airway and is brought up from the stomach. The cough occurs worse at night or after eating and is usually unresponsive to the usual remedies for a cough.

Hoarseness or Voice Changes

The tumor can push against the recurrent laryngeal nerve, which can lead to voice changes or persistent hoarseness. This symptom is particularly worrisome if it persists for longer than several weeks and is not associated with a cold or vocal strain.

Persistent Heartburn or Indigestion (GERD)

Persistent acid reflux that fails to respond to customary medication can be a sign of esophageal damage or the initial development of cancer. Persistent GERD (gastroesophageal reflux disease) can cause Barrett's esophagus, a condition that is precancerous and increases the risk of malignancy.

Regurgitation or Vomiting Blood

With advancing disease, patients regurgitate undigested food or vomit blood. It is a sign of the growth of the tumor or internal bleeding, usually seen in advanced cancer.

Chronic Hiccups

Though uncommon, chronic hiccups might happen if the tumor puts pressure on the diaphragm or surrounding nerves. This symptom of esophageal cancer is usually neglected but can be an early indicator when accompanied by other signs.

Chronic Indigestion

Chronic pain or burning in the upper belly might resemble typical gastrointestinal symptoms but may be indicative of cancer, especially when paired with trouble swallowing and weight loss.

Fatigue and Weakness

General fatigue and lower energy levels can be caused by anemia due to internal chronic bleeding or malnutrition, which is prevalent in patients with esophageal cancer.

What are the Causes of Esophageal Cancer?

While the exact cause of esophageal cancer remains unknown, healthcare providers have identified causes that can significantly increase the likelihood of developing this disease. These include:

• Tobacco Use: Smoking cigarettes and chewing tobacco leaves can significantly raise the risk of esophageal cancer by injuring the cells that line the esophagus.
• Alcohol Use: Long-term heavy alcohol consumption has a strong association with increased risk, particularly with the use of tobacco.
• Obesity: Overweight status may cause chronic inflammation of the esophagus, which may be a factor in cancer development.
• Human Papillomavirus (HPV): The role of the Human Papillomavirus (HPV) in esophageal cancer is uncertain and has not been proven. The established major risk factors are tobacco, alcohol, chronic acid reflux, and obesity.
• Chronic Acid Reflux and Barrett's Esophagus: Long-term GERD can damage the esophagus's lining. Barrett's esophagus, an alteration in cells from acid exposure, substantially increases cancer risk.
• Inherited and Rare Conditions: Certain conditions, such as achalasia (swallowing difficulty because of nerve problems) and tylosis (extra skin on hands and feet) predispose to esophageal cancer.
• History of Head or Neck Cancer: Those who have had a history of cancer in the head or neck area are at higher risk of esophageal cancer.
• Occupational Exposure to Chemicals: Exposure to industrial solvents over a long period, for example, in dry cleaning, can raise the risk of esophageal cancer.

What are the Stages of Esophageal Cancer?

Staging of esophageal cancer ranges from 0 to 4, with increasing numbers representing increasing severity. The stages are as follows:

• Stage 0:Stage 0 is precancerous, with the abnormal cells being confined to the lining of the esophagus. Endoscopic treatments such as EMR (Endoscopic Mucosal Resection) or photodynamic therapy can be used.
• Stage 1: In this stage, cancer penetrates deeper levels of tissue but has not spread; stage 1esophageal cancer symptoms tend to be mild, like occasional chest pain or minor swallowing difficulty. For very early-stage cancers (Stage 0 and some Stage I), less invasive procedures like endoscopic resection (EMR or ESD) are often the first-line treatment.
• Stage 2:Stage 2 cancer extends into the exterior layers of the esophagus and can metastasize into a few lymph nodes. The symptoms can include chest discomfort, weight loss, and persistent coughing. The treatment is usually a mixture of chemotherapy, radiation, and surgery.
• Stage 3:Stage 3 has further lymph node or tissue spread, with more serious symptoms like anemia and bloody cough. Treatment regimens of chemoradiation and occasionally surgery are needed.
• Stage 4:Stage 4 cancer metastasizes to far-off organs such as the liver or bones. Symptoms are extreme, and treatment is concentrated on palliative care with chemotherapy, radiation, immunotherapy, and targeted therapy. Survival rates fall sharply in advanced stages, although progress is still enhancing results.

Esophageal cancer is a severe disease that tends to go unnoticed in its early stages because it has nonspecific and indistinctive symptoms. Knowing the spectrum of esophageal cancer symptoms can make it easier to diagnose and treat early.