Esophageal Cancer: Symptoms, Causes, Treatment
سرطان المريء
Esophageal cancer may cause progressive swallowing difficulty, painful swallowing or weight loss. Endoscopy and biopsy establish the diagnosis, followed by staging and type assessment to guide treatment and early nutritional support.
What is Esophageal Cancer?
The esophagus carries food from throat to stomach. Common cancers are squamous cell carcinoma and adenocarcinoma, with different risk patterns and typical sites. Other conditions also impair swallowing, but dietary changes alone should not delay assessment.
Related reading: Does acid reflux increase the risk of oesophageal cancer?.
Symptoms
Food may feel stuck, with difficulty progressing from solids to liquids. Pain on swallowing, weight loss, hoarseness or inadequate intake can occur. Chest pain may have cardiac or other causes requiring separate assessment, especially when acute.
Causes
Cellular changes may be associated with tobacco and alcohol, particularly for squamous disease. Adenocarcinoma is associated with chronic reflux, Barrett esophagus and obesity. Reflux does not mean cancer will develop, and heartburn cannot determine tissue changes.
Risk factors
Factors include tobacco and alcohol for some types, and longstanding reflux, Barrett esophagus and obesity for adenocarcinoma, with age also relevant. Combined risks and symptoms guide testing; routine endoscopy is not appropriate for everyone with heartburn.
Diagnosis
Endoscopy with biopsy identifies the tumour type. CT and selected additional tests, such as endoscopic ultrasound, assess depth, nodes and spread. Nutritional status and general health are evaluated before choosing treatment.
Treatment
Selected early lesions may receive endoscopic treatment. Other options include surgery, chemotherapy and radiation in a stage- and type-dependent sequence, with immune or targeted medicines in suitable cases. Stenting or feeding support may relieve obstruction within the care plan.
Complications
Narrowing can cause malnutrition and dehydration; bleeding or spread may occur. Treatment can also affect swallowing. The team can plan nutrition, symptom control and rehabilitation around safe swallowing ability.
Prevention
Avoid tobacco and alcohol and discuss weight and reflux management. Barrett surveillance depends on biopsy findings; precancerous changes may need intervention. Do not self-start aspirin for cancer prevention. Relief of heartburn does not guarantee removal of risk.
When to see a doctor
Promptly seek assessment for new or worsening swallowing difficulty or unintended weight loss. Inability to swallow fluids or saliva, or impacted food, needs urgent evaluation. Significant bleeding, choking or severe chest pain requires emergency care.
Scientific references
- What is esophageal cancer? — National Cancer Institute
- Esophageal cancer symptoms — National Cancer Institute
- Esophageal cancer causes, risk factors and prevention — National Cancer Institute
- Esophageal cancer diagnosis and prognosis — National Cancer Institute
- Esophageal cancer treatment — National Cancer Institute