Esophageal Cancer: Symptoms, Diagnosis and Treatment

Esophageal cancer develops in the esophagus — the muscular tube that connects your throat to your stomach. It is a serious condition but treatable, especially when detected early.

Common Symptoms of Esophageal Cancer

• Difficulty swallowing (dysphagia), initially with solids, then progressing to liquids
• Pain or burning sensation in the chest
• Unintentional weight loss
• Indigestion or heartburn that doesn't go away
• Chronic cough or hoarseness
• Vomiting blood or passing black stools

Many of these symptoms are mistaken for common digestive issues, leading to delayed diagnosis.

Diagnostic Methods

To confirm esophageal cancer, doctors use a combination of tests:

• Endoscopy: A thin, flexible tube with a camera is passed down the throat to examine the esophagus. Biopsies can be taken during this procedure.
• Barium Swallow: The patient drinks a barium solution, and X-rays are taken to visualize the esophagus.
• Imaging Scans: CT, PET, and endoscopic ultrasound help determine the extent of cancer spread.

Treatment Approach

Esophageal cancer treatment requires a multidisciplinary approach involving medical, surgical, and radiation oncology. The choice of treatment depends on the type (adenocarcinoma or squamous cell carcinoma), stage, location, overall health, and patient preference.

Early-Stage Treatment

For very early cancers confined to the inner lining, endoscopic resection may be sufficient.

Locally Advanced Disease

The standard approach includes:

• Neoadjuvant Chemoradiation: Chemotherapy and radiation before surgery to shrink the tumour.
• Surgery (Esophagectomy): Removal of part or all of the esophagus, followed by reconstruction.
• Adjuvant Therapy: Additional chemotherapy or radiation after surgery if needed.

Metastatic or Inoperable Disease

Treatment focuses on controlling symptoms and prolonging life using chemotherapy, immunotherapy (especially for PD-L1 positive or MSI-H tumours), targeted therapy, and palliative procedures like stent placement.

Improving Outcomes

Survival rates have improved due to better staging, multimodal therapy, and enhanced surgical techniques. Early detection remains key to successful treatment.