10 Symptoms of Esophageal Cancer: The esophagus is the tract or passage where food runs between the throat and stomach. Cancer in the esophagus can be divided into two sub-types: the squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma starts from the epithelial cells in the esophagus while adenocarcinoma starts from glandular cells that are only present in the lower third of the esophagus.
The squamous cell carcinoma is usually caused by alcohol, tobacco, very hot beverages, poor diet, and the chewing of betel nut. The most common causes of adenocarcinoma are obesity, acid reflux, and smoking tobacco.
1. Difficulty in Swallowing
Difficulty swallowing is also medically known as dysphagia. People with dysphagia have a higher risk of pulmonary aspiration and subsequently, aspiration pneumonia. Dysphagia can manifest as coughing, choking, wet voice, nasal regurgitation, and more.
2. Weight Loss
Unexplained weight loss that is not caused by a reduction in the intake of calories or exercise is known as cachexia and can be a symptom of a serious condition. In advanced cases of esophageal cancer, eventual weight loss is common due to poor appetite and undernutrition.
3. Voice Hoarseness
In esophageal cancer, one of the symptoms is having a hoarse voice. The tone of the voice is described as unusually raspy or husky. Coughing also sounds hoarse. This is due to a tumor that affects the recurrent laryngeal nerve. If the nerve is compressed by tumors, the result is hoarseness.
4. Enlarged lymph nodes:
Lymphadenopathy refers to abnormalities in consistency, size, or number of the lymph nodes. Lymphadenopathy is a non-specific inflammation and is commonly seen in various infections, cancers, and autoimmune diseases. In esophageal cancer, the lymphadenopathy can usually be seen in the supraclavicular lymph nodes on the left side, also known as Virchow’s nodes.
5. Superior Vena Cava syndrome:
Superior vena cava syndrome refers to the group of symptoms that occurs when there is obstruction of the vein which carries deoxygenated blood to the heart. Approximately 90% of obstructions are caused by cancers such as bronchogenic carcinoma, aortic aneurysm, or esophageal cancer. Individuals with superior vena cava syndrome usually have characteristic features such as swelling of the arms and face, swollen collateral veins on the chest wall, breathlessness, coughing, difficulty swallowing, headaches.
6. Upper airway obstruction
Upper airway obstruction manifests as stridor, which is a high-pitched sound that occurs when breathing due to the turbulent airflow in the larynx near the lower parts of the bronchial tree. In esophageal cancer, the growth of the tumor can cause compression of the airway, leading to upper airway obstruction.
Odynophagia refers to pain during swallowing. The pain is often felt in the throat or mouth. Individuals may describe a burning sensation, ache, or stabbing pain that radiates to the back. Odynophagia can be caused by ulcers, abscesses, upper respiratory tract infections, inflammation of the mouth, throat, or tongue, and immune disorders, oral or throat cancers.
8. Pain behind the breastbone
Cancer pain may be due to the compression from a growing tumor that is infiltrating the surrounding body parts. In most cases, chronic pain is caused by illness while short-term pain may be due to iatrogenic (treatment) causes. The pain usually depends on the location and stage of the disease. In cancer patients, this pain can affect their mood, sleep, relationships, and daily activities. With competent pain management, cancer pain can be well-controlled in 80 to 90% of cases.
9. Vomiting and nausea
Nausea refers to the unpleasant and uncomfortable sensation of wanting to vomit. Both nausea and vomiting are non-specific symptoms that can be seen in various conditions such as pregnancy, food poisoning, peptic ulcer disease, viral infections, bacterial infections, chemotherapy, and more. In esophageal cancer, the presence of a tumor can disrupt the contractions of the esophagus leading to regurgitation, nausea, and vomiting.
Hematemesis refers to the vomiting of blood. The source of the bleed is usually from the upper gastrointestinal tract. Hematemesis is always an important sign of a serious condition. Some of the causes of hematemesis include vomiting of ingested blood, Mallory-Weiss syndrome (a tear in the lining), tumors of the stomach or esophagus, viral hemorrhagic fevers, peptic ulcers, and more.