Late symptoms of esophageal cancer

The symptoms of mid- and late-stage esophageal cancer include:

(1) Dysphagia: It is a typical symptom of esophageal cancer. Since the esophageal wall has good elasticity and expansion ability, when obvious dysphagia occurs, the tumor has usually invaded more than 2/3 of the circumference of the esophagus, and is often accompanied by infiltration of the surrounding tissues of the esophagus and lymph node metastasis. Dysphagia is often intermittent at the beginning, and can be aggravated by food blockage or local inflammatory edema, or alleviated by tumor necrosis and shedding or the disappearance of inflammatory edema. However, as the disease progresses, the general trend is progressive and persistent, and its development is generally rapid. Most patients may die within 1 year after the onset of obstruction symptoms if not treated. The degree of dysphagia is related to the pathological type. Stenotic and medullary cases are more severe, while other types are milder. About 10% of patients do not have obvious dysphagia when they seek medical treatment. The severity of dysphagia has no definite relationship with tumor size, surgical resection rate, and survival rate.

(2) Obstruction: Severe cases are often accompanied by reflux and continuous vomiting of mucus. This is due to the infiltration and inflammation of esophageal cancer, which reflexively causes increased secretion of esophageal glands and salivary glands. Mucus accumulated in the esophagus can reflux, causing choking and even aspiration pneumonia.

(3) Pain: Continuous pain behind the sternum or between the shoulder blades on the back. This may be caused by esophageal cancer invading the esophagus, causing periesophagitis and mediastinitis, but it may also be caused by deep esophageal ulcers caused by tumors. Pain caused by tumors in the lower thoracic segment or cardia may occur in the upper abdomen. Patients with severe pain who cannot fall asleep or who are accompanied by fever are less likely to undergo surgical resection and should be aware of the possibility of tumor perforation.

(4) Bleeding: Patients with esophageal cancer may sometimes come to the hospital for treatment due to vomiting blood or black stools. The tumor can infiltrate large blood vessels, especially the thoracic aorta and ribs, causing fatal bleeding. For cases with penetrating ulcers, especially those with CT scans showing tumor invasion of the thoracic aorta, attention should be paid to the possibility of bleeding.

(5) Hoarseness: It is often caused by direct invasion of the tumor or metastatic lymph nodes compressing the recurrent laryngeal nerve, but sometimes it can also be caused by laryngitis caused by inhalation inflammation. Indirect laryngoscope can help to identify it.

(6) Weight loss and anorexia: Due to obstruction, the patient's food intake is reduced, and the nutritional status is gradually deteriorating. Weight loss and dehydration often occur one after another, but the patient generally still has an appetite. If the patient loses a lot of weight or develops anorexia in a short period of time, it often indicates that the tumor has spread widely.