Excerpts from Wikipedia.org
Esophageal cancer (or oesophageal cancer; 食道癌) is malignancy of the esophagus. There are various subtypes, primarily squamous cell cancer (approx 90-95% of all esophageal cancer worldwide) and adenocarcinoma (approx. 50-80% of all esophageal cancer in the United States). Squamous cell cancer arises from the cells that line the upper part of the esophagus. Adenocarcinoma arises from glandular cells that are present at the junction of the esophagus and stomach.
Esophageal tumors usually lead to dysphagia (difficulty swallowing), pain and other symptoms, and are diagnosed with biopsy. Small and localized tumors are treated surgically with curative intent. Larger tumors tend not to be operable and hence are treated with palliative care; their growth can still be delayed with chemotherapy, radiotherapy or a combination of the two. In some cases chemo- and radiotherapy can render these larger tumors operable. Prognosis depends on the extent of the disease and other medical problems, but is fairly poor.
Signs and symptoms: Dysphagia (difficulty swallowing) and odynophagia (painful swallowing) are the most common symptoms of esophageal cancer. Dysphagia is the first symptom in most patients. Odynophagia may also be present. Fluids and soft foods are usually tolerated, while hard or bulky substances (such as bread or meat) cause much more difficulty. Substantial weight loss is characteristic as a result of reduced appetite and poor nutrition and the active cancer. Pain behind the sternum or in the epigastrium, often of a burning, heartburn-like nature, may be severe, present itself almost daily, and is worsened by swallowing any form of food. Another sign may be an unusually husky, raspy, or hoarse sounding cough, a result of the tumor affecting the recurrent laryngeal nerve.
The presence of the tumor may disrupt normal peristalsis (the organized swallowing reflex), leading to nausea and vomiting, regurgitation of food, coughing and an increased risk of aspiration pneumonia. The tumor surface may be fragile and bleed, causing hematemesis (vomiting up blood). Compression of local structures occurs in advanced disease, leading to such problems as upper airway obstruction and superior vena cava syndrome. Fistulas may develop between the esophagus and the trachea, increasing the pneumonia risk; this condition is usually heralded by cough, fever or aspiration.
Most of the people diagnosed with esophageal cancer have late-stage disease. This is because people usually do not have significant symptoms until half of the inside of the esophagus, called the lumen, is obstructed, by which point the tumor is fairly large.
If the disease has spread elsewhere, this may lead to symptoms related to this: liver metastasis could cause jaundice and ascites, lung metastasis could cause shortness of breath, pleural effusions, etc.
