Esophageal cancer: Signs and Symptoms

Symptoms:
• Pain and difficulty in swallowing, hiccups with pain, food gets stuck in the esophagus, and food may come back up
o constricted to < 14 mm
o Swallowing may be painful when the cancer is large enough to block the esophagus. Pain may be felt a few seconds after swallowing, as food or liquid reaches the tumor and cannot get past it.
o often mild when it starts, and then gets worse over time. The opening of the esophagus is often narrowed to about half of its normal width. Dysphagia is commonly a late symptom caused by a large cancer.

• Thick mucus and more saliva
o To help pass food through the esophagus, the body makes more saliva. This causes some people to complain of bringing up lots of thick mucus or saliva.

• lose weight unintentionally

• Heartburn -reflux

• Pain at the back – nerve compression

• Persistent cough
o reflux
o tracheoesophageal fistula. This occurs when the tumor destroys the tissue between the esophagus and the trachea (windpipe) and creates a hole connecting them. With this connection, anything that is swallowed can pass from the esophagus into the windpipe and lungs. This leads to frequent coughing and gagging.

• Hiccups: damage or irritation of vagus and phrenic nerves, reflux

• Malaena
o Sometimes the cancer will bleed. If there is enough blood, stools may turn black.

• Vomit blood

• Hoarse voice
o Compression of the recurrent laryngeal nerve may lead to vocal cord paralysis and hoarseness.

Signs:
• Signs are often absent

• General inspection: weight loss, anorexia

• The hands: Inspect for palmer creases for pallor
o Anaemia- iron deficiency anaemia

• Neck: Palpate the supraclavicular nodes
o Lymphatic spread to internal jugular, cervical, supraclavicular, mediastinal, and celiac nodes is common.

• Examine for evidence of retrosternal thyroid enlargement.