What are the symptoms of esophageal cancer?
The symptoms of esophageal cancer occur very late and are usually very unspecific. Especially swallowing difficulties (dysphagia) are a quite typical symptom, but they occur only in a late stage of the disease. Since the esophagus is a very flexible hollow organ, swallowing difficulties only occur when the tumor has already narrowed more than half of the inner diameter of the esophagus.
In some cases, an increased salivation (hypersalivation) may be indicative. Patients rarely complain of pain when swallowing (odynophagia). The pain comes less from the tumor itself, but rather from an accompanying esophagitis, which is caused by the tumor irritating the surrounding mucous membrane.
If the tumor is large, the food may accumulate before the narrowing and cause a feeling of pressure. If the food vomits after some time, the feeling of pressure typically disappears. Especially tumors located high up in the mouth can cause food to flow back into the mouth (regurgitation).
Especially at night, there is a risk that food chunks are inhaled into the lungs, leading to dangerous pneumonia (aspiration pneumonia). There may also be dull pain behind the breastbone (retrosternal pain), which may radiate into the thorax and back. In the late stages, it is possible that food intake is no longer possible at all, so that patients lose a lot of weight.
To make matters worse, the tumor itself can cause weight loss (tumor cachexia), so that adequate nutrition of the patient is the most important goal of the therapy. If the tumor extends so far into the neighborhood in the late stage, it can attack the nearby recurrent nerve (nervus recurrens) that controls vocal cord function, leading to hoarseness. The nerve that controls diaphragm function (phrenic nerve) may also be damaged by the tumor, resulting in permanent hiccups (singultus).
If the tumor is already in its final stage, the tumor masses can cause considerable pain. In particular, bone metastases are known to cause particularly severe pain. These have to be treated particularly consistently with strong joke drugs.
