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What are the symptoms and signs of esophageal cancer?

Esophageal cancer tends not to be associated with symptoms until it grows large enough to narrow the esophagus and make it difficult for food to pass. This also means there is time and opportunity for the cancer to grow beyond the esophagus and spread (metastasize) either to surrounding tissues or to distant parts of the body before it is discovered.

Esophageal cancer symptoms

The first symptom of esophageal cancer is almost always dysphagia (dys=abnormal + phagia=swallowing). Initially there may be difficulty swallowing solid foods, but symptoms worsen so there may also problems swallowing liquids.

Because adenocarcinoma of the esophagus may be related to chronic gastroesophageal reflux disease, symptoms of GERD may also be present, including heartburn and indigestion.

Patients with esophageal cancer also can present with unexplained weight loss which occurs in more than half of patients. Esophageal cancers bleed and may cause vomiting of blood or black, tarry stools. Sometimes the bleeding can be microscopic and not seen by the naked eye. The patient may experience weakness due to low red blood cell count, and because it is due to blood loss, it is most often an iron-deficiency anemia.

Pain from esophageal cancer can be felt in the lower chest or upper abdomen. If the cancer has spread there may be pain in other places around the chest or back.

Patients may experience voice hoarseness due to vocal cord damage caused by reflux of stomach acid into the throat. As the tumor grows, it may cause nerve damage. The cancer can affect the recurrent laryngeal nerve that helps control the vocal cords. The nerve runs close to the esophagus, so if cancer spreads to the nerve, it means the cancer has grown beyond the esophagus wall.

Esophageal cancer signs

Physical examination may not be helpful in making the diagnosis; the esophagus is hidden within the chest cavity and not easily evaluated by physical examination. That is the reason why patient history is so important in making the diagnosis and all complaints of difficulty swallowing should be taken seriously.

If the cancer has metastasized beyond the esophagus, there may be abnormal lymph nodes palpable in the neck below the jaw or above the clavicles (collarbones). If cancer has spread to the liver, the liver may become enlarged and may be palpated on examination of the abdomen.

Return to Esophageal Cancer

See what others are saying

Comment from: Joy, 0-2 Male (Caregiver) Published: July 27

My husband had lost some weight last fall (2016) but he had wanted to lose about 10 pounds. He was healthy otherwise and exercised and ate a healthy diet. No smoking, no excessive alcohol (wine with dinner or social occasions), not obese, no acid reflux. Thanksgiving and Christmas he ate normally but after Christmas he had lost some more weight. Sunday during President's Day weekend (February) 2017 we were having brunch and he had trouble swallowing. He went to the emergency room at the local hospital and they sent him by ambulance to the regional hospital. Diagnosis was Barrett's esophagus and esophageal cancer. We went to a cancer center hospital for a CT and PET scan. It was stage 4 and lymph nodes were affected. He had surgery to insert a J-tube for feeding. He started chemotherapy at the beginning of April. After the first treatment swallowing was better. Second treatment two weeks later, he could drink normally and not sip it. After the 3rd treatment white blood cell count was low and he had two injections. Two days later he was faint and could not walk very far when we went for our usual walk. The next week May 11 he had chemotherapy again but had to have a blood transfusion of platelets. He did not recover from the fatigue of the chemotherapy. May 17 during the night, bleeding occurred in the esophagus and blood was being digested and passed into the feces. He was sent to the regional hospital and given radiation treatments. May 24 the bleeding started again and an endoscopy was done to tie off the bleeding vein. May 27 he left ICU, bleeding stopped, oncologist was still pleased with progress. May 28 bleeding started again and could not be stopped. He passed away within a few hours. He did not even know he had Barrett's esophagus. The only issue that was a problem was foods with high fructose corn syrup. If he ate those then it caused some bloating and gas. So he avoided those foods and we checked nutrient labels avidly. There was such as increase of high fructose corn syrup in foods. Several oncologists said there was no link to that and Barrett's esophagus or the cancer. The cardiologist stated that chemotherapy can weaken the veins. How do you know you have cancer when the symptoms show up at a later stage! The oncologist thought the red blood count (low) was due to chemotherapy but there was a leaking vein in the esophagus around the tumor. According to the oncologist, bleeding veins is a complication of this type of cancer.

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Comment from: Daphne May, 55-64 Female (Patient) Published: October 13

I am a 56 year old female. About 2 years before I was diagnosed with esophageal carcinoma I noticed my hair was thinning fast. I also noticed an ache type pain in my chest that would go through to my back. At that time I thought it was anxiety. The following year I felt angry & depressed, not my usual self! Then September 2014 I started to have trouble swallowing food, especially bread! It was painful and got worse by Christmas. I was diagnosed with esophageal carcinoma on 16/1/15. They thought it was stage 1-2. I started chemotherapy and radiation for 6 weeks. Then I had a 3 stage esophagectomy and found out the cancer was stage 3 B. I have just finished 3 months of chemotherapy &and am due for a CT scan in a few weeks, fingers crossed! To anyone else who is going down the same path, you are not alone, there are others of us going through the same thing. Never give up hope, be brave and do your homework, find the best doctors!

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Comment from: Texmar63, 65-74 Female (Caregiver) Published: January 06

My sister who is 68 was diagnosed last April with esophageal cancer. Her symptoms started as shortness of breath and feeling like something was stuck in her throat. She was always a smoker but after having bypass surgery about 6 years ago, she tried to quit and then was using the e-cigarettes when she was diagnosed. She started chemotherapy last May and continued till about November. She couldn't do radiation because the doctor said it would affect the bypass grafts. She became so sick from chemotherapy that he decided to stop it right after Thanksgiving. She is still very weak and was admitted to hospital this last weekend because of fluid in her lungs causing one lung to nearly collapse. She now has to have oxygen to help her breathe. This is a horrible disease and just keep hoping for a miracle to cure her.

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