If you or someone dear to you are experiencing symptoms affecting your chest and throat, you might be concerned about a potential esophageal cancer diagnosis. But what are the symptoms of esophageal cancer, exactly, and how do you tell the difference between a benign discomfort with ailments associated with the condition?
Immunity Therapy Center is here to answer your questions about the condition and offer guidance for taking the next steps. Here’s what you should know about the signs and symptoms of esophageal cancer.
What Is Esophageal Cancer?
First things first, what is esophageal cancer? The esophagus is the long tube that runs between the mouth and the stomach. Every time you eat food, it travels down the esophagus and enters the stomach, where it will be digested.
Esophageal cancer is an abnormality in the cells lining the tube. There are two main types of esophageal cancer, which account for roughly 98% of all cases: adenocarcinoma and squamous cell carcinoma. While the effects can be similar, the conditions have different causes and early warning signs. Read along to learn more about this condition and what causes esophageal cancer.
Adenocarcinoma is the most common type of esophageal cancer in the United States, making up more than half of all diagnoses. The chronic condition starts in the lower esophagus and is closely related to gastroesophageal reflux disease (GERD), as well as a condition called Barrett’s esophagus.
Squamous Cell Carcinoma
Squamous cell carcinoma, the second most common form of esophageal cancer, generally originates higher up in the esophagus. The condition has been linked to smoking and heavy drinking. It occurs when mutated squamous cells are replaced by cancerous glandular cells that start to grow uncontrollably.
What Are the Early Warning Signs of Esophageal Cancer?
The early warning signs of esophageal cancer can be confused with otherwise benign conditions. It’s not uncommon for people developing esophageal cancer to feel some chest pain and some hoarseness in the chest and throat. And because these symptoms might also be associated with a simple chest cold, or because they may be relieved with over-the-counter medicines, people often ignore the early warning signs.
A common early warning sign of esophageal cancer is a persistent feeling of hoarseness in the throat or chest. That raw, scratchy sensation indicates that the lining of the tube is irritated and potentially undergoing cancerous mutations. However, in many cases, early esophageal cancer has no signs or symptoms.
Many doctors believe the persistent irritation of cells in the esophagus is the root cause of esophageal cancer, and there are several known irritants closely related to the condition. That said, an assessment of personal risk factors can help you determine if your symptoms are associated with a growing cancer.
Adenocarcinoma Risk Factors
As we mentioned, adenocarcinoma is closely associated with gastroesophageal reflux disease. The condition arises when stomach acids and bile escape and flow back up into the esophagus. These substances can irritate the cells in the lower esophagus and trigger mutations that lead to cancer.
Squamous Cell Carcinoma Risk Factors
The leading risk factors for squamous cell carcinoma include smoking tobacco products and drinking alcohol. Tobacco smoke is hot and contains numerous toxins and chemicals that can aggravate the esophagus lining. Likewise, alcohol can be irritating and potentially trigger unwanted changes to the cells in the esophagus that may eventually lead to cancer.
What Are the Signs and Symptoms of Esophageal Cancer?
People suffering from esophageal cancer may first notice the following signs of the disease. Hoarseness or pain in the chest is common, which can feel like pressure behind the breastbone or a burning sensation similar to acid reflux.
Worsening indigestion and heartburn are also indicative of esophageal cancer. Those who normally have acid reflux are at a higher risk of developing adenocarcinoma. It’s important for people suffering from acid reflux to take note if the symptoms become worse and stay worse.
Difficulty swallowing (also called dysphagia) is a common symptom in more developed esophageal cancers. As tumors grow in the esophagus, they can interrupt the normal function of the esophagus and make swallowing more difficult. Unexplained weight loss can also be a sign of esophageal cancer.
How Is Esophageal Cancer Diagnosed?
If you are experiencing any of the signs and symptoms of esophageal cancer, your healthcare provider can run a number of tests to confirm or deny a diagnosis. Doctors use many tests to identify cancerous tumors and determine whether they’ve spread.
For most types of cancer, a biopsy is the only sure way for a physician to know if a tumor is cancerous. With esophageal cancer, doctors typically perform an endoscopy, a procedure that involves inserting a thin, flexible tube into the patient’s throat and down into their esophagus.
During an endoscopy, a doctor can view the lining of the esophagus using a camera. They can also take biopsies of any abnormal-looking tissue and later perform lab tests to determine if the abnormal tissue is cancerous.
An endoscopic ultrasound is a procedure to take images of the esophagus using a probe that’s inserted endoscopically (through the mouth and throat). The ultrasound is used to determine if a tumor exists, and if so, whether it’s grown into the wall of the esophagus or nearby lymph nodes.
Physicians may also elect to employ a CT scan to use magnetic resonance imagining (MRI) to produce detailed images of the body. Using these methods, doctors can determine the extent to which a cancer has spread to distant organs within the body.
Is Esophageal Cancer Curable?
Is esophageal cancer curable? Esophageal cancer treatment depends on the stage of the disease when detected. With early-stage cancer, the tumors are localized to the esophagus and are generally easier to treat.
Stage zero or one esophageal cancer can often be cured through a minor surgery called an endoscopic mucosal resection. Larger tumors might be removed through an esophagectomy, a procedure involving the removal of a small portion of the esophagus.
Another option is a technique called radiofrequency ablation. Using radio waves, this non-invasive method essentially burns and kills cancer cells.
But for more advanced cancers, in which the tumors have started to grow through the lining of the esophagus into the surrounding tissue spread to distant organs, more traditional therapies are required in conjunction with surgery.
Late-Stage Esophageal Cancer Treatment
Chemotherapy and radiation therapy are commonly used to treat stage two, three, and four esophageal cancers. When combined, these treatments are called “chemoradiotherapy” or “chemoradiation.”
Doctors generally recommend chemoradiotherapy before surgery for people with locally advanced esophageal squamous cell cancer. The goal of this preoperative chemoradiation is to send the cancer into remission. In some cases, it eliminates the need for surgery entirely.
For adenocarcinoma, the most common treatment is chemoradiotherapy followed by surgery. Doctors typically recommend surgery after chemoradiotherapy when treating adenocarcinoma. Postoperative chemotherapy is also common when there is evidence that surgery did not remove all of the cancer.
For advanced or metastatic esophageal cancer, surgery is a less common approach. Stage four treatment usually involves radiation therapy, chemotherapy, and immunotherapy. The goal of treatment at this stage is to control the growth of the cancer, extend patient longevity, and improve quality of life.
But in addition to the cancer treatments aimed at curing the disease, many therapies exist to alleviate symptoms of the disease. For people who have pain, medications can be prescribed to offer relief.
For people who have trouble swallowing, numerous less-invasive techniques exist to help clear the patient’s esophagus of tumors or other blockages. In some cases, doctors can even bypass blockages in the esophagus.
The Emotional Social Effects of Cancer Treatments
Cancer treatments can have immense physical, emotional, social, and financial effects. A critical aspect of treatment is to manage these outcomes to improve how patients feel.
Palliative care focuses on improving how patients feel throughout the process by managing the symptoms of the disease and the negative effects of the treatments. Any person, regardless of age, cancer type, or stage, can receive this type of care.
Palliative treatments can include medication, nutritional changes, relaxation techniques, and the development and maintenance of social support networks. Those who receive this type of care early and in conjunction with their cancer treatments often experience less severe symptoms, a better quality of life, and an overall higher level of satisfaction with the process.
Learn More about Esophageal Cancer
Esophageal cancer is a complex disease, and every patient is unique. Here at Immunity Therapy Center, our goal is to be your partner on the path to recovery, and we’re here to answer any questions you may have along the way. Contact Immunity Therapy Center to find out more about what we do and how we can help you manage the symptoms of esophageal cancer.
At Immunity Therapy Center, our goal is to provide objective, updated, and research-based information on all health-related topics. This article is based on scientific research and/or other scientific articles. All information has been fact-checked and reviewed by Dr. Carlos Bautista, a Board Certified Medical Doctor at Immunity Therapy Center. All information published on the site must undergo an extensive review process to ensure accuracy. This article contains trusted sources with all references hyperlinked for the reader's visibility.