Recognizing Early Signs of Esophageal Cancer: Throat Discomfort, Coughing, and Gastric Burning

Esophageal cancer is a type of cancer that affects the esophagus, the long muscular tube that connects the throat to the stomach. Esophageal cancer can cause difficulty swallowing, weight loss, chest pain, hoarseness, and indigestion. Esophageal cancer is more common in men than women, and in older people than younger people. Esophageal cancer is the sixth most common cause of cancer deaths worldwide.

Table of contents

What is esophageal cancer? What are the symptoms?

Esophageal cancer is a type of cancer that occurs in the esophagus, the tube that connects the mouth to the stomach. The esophagus helps move food and liquids from the mouth to the stomach for digestion. Esophageal cancer can affect any part of the esophagus, but it usually starts in the cells that line the inside of the lower part of the esophagus.

Esophageal cancer can cause various symptoms, depending on the location and size of the tumor. Some of the common symptoms include:

  1. Difficulty swallowing or experiencing pain. This is also called dysphagia. It may feel like food is stuck in the throat or chest, or that there is a lump in the throat. It may also cause choking, coughing, or regurgitation of food or liquids. Dysphagia can affect the quality of life and nutrition of people with esophageal cancer.
  2. Sudden weight loss of approximately 10-15% without specific dieting. This may be due to difficulty swallowing, reduced appetite, or malabsorption of nutrients. Weight loss can also be a sign of other serious conditions, so it should not be ignored.
  3. Persistent coughing, hoarseness. This may be caused by irritation or compression of the nerves that control the voice box (larynx) by the tumor. It may also be due to aspiration, which is when food or liquids enter the lungs instead of the stomach. Aspiration can lead to pneumonia, a lung infection that causes fever, chest pain, and breathing problems.
  4. Pain behind the sternum. This is also called retrosternal pain. It may feel like a burning or squeezing sensation in the chest. It may be worse when swallowing, lying down, or after eating. It may also radiate to the back, neck, or arms. Pain behind the sternum can be a symptom of other conditions, such as heartburn, angina, or heart attack, so it should be evaluated by a doctor.
  5. Indigestion, gastric burning. This may be due to reflux, which is when stomach acid flows back into the esophagus. Reflux can cause heartburn, a burning sensation in the chest or throat. It can also cause nausea, vomiting, bloating, burping, or sour taste in the mouth. Reflux can damage the lining of the esophagus and increase the risk of esophageal cancer.

If you have any of these symptoms, especially if they are persistent or severe, you should see your doctor as soon as possible. Early detection and treatment of esophageal cancer can improve your chances of survival and quality of life.

High-risk groups

Esophageal cancer can affect anyone, but some people are more likely to develop it than others. The following factors may increase the risk of esophageal cancer:

  1. Age. Esophageal cancer is more common in older adults, especially those over 60 years old. The average age of diagnosis is 68 years old.
  2. Smoking. Smoking tobacco damages the cells that line the esophagus and increases the risk of esophageal cancer. The longer and more often a person smokes, the higher the risk. Quitting smoking can lower the risk of esophageal cancer and other diseases.
  3. Alcohol consumption. Drinking alcohol can irritate the esophagus and increase the risk of esophageal cancer. The risk is higher for people who drink heavily and regularly. Limiting alcohol intake or avoiding it altogether can help prevent esophageal cancer and other health problems.
  4. Barrett's esophagus. This is a condition where the normal cells that line the lower part of the esophagus are replaced by abnormal cells that resemble those in the stomach or intestine. Barrett's esophagus is usually caused by chronic acid reflux, which is when stomach acid flows back into the esophagus and causes heartburn. People with Barrett's esophagus have a higher risk of developing a type of esophageal cancer called adenocarcinoma.
  5. Human papillomavirus (HPV). This is a common virus that can infect the skin and mucous membranes, including the mouth and throat. Some types of HPV can cause warts, while others can cause cancers, such as cervical cancer and oropharyngeal cancer. HPV can also infect the esophagus and increase the risk of a type of esophageal cancer called squamous cell carcinoma.
  6. History of cancer. People who have had certain types of cancer, such as head and neck cancer, lung cancer, or lymphoma, may have a higher risk of developing esophageal cancer. This may be due to shared risk factors, such as smoking or HPV infection, or to the effects of radiation therapy or chemotherapy on the esophagus.
  7. Obesity. Being overweight or obese can increase the risk of esophageal cancer in several ways. Obesity can cause chronic inflammation in the body, which can damage the cells and DNA. Obesity can also increase the pressure on the stomach and cause acid reflux, which can lead to Barrett's esophagus. Losing weight and maintaining a healthy body mass index (BMI) can reduce the risk of esophageal cancer and other diseases.

Knowing your risk factors for esophageal cancer can help you take steps to prevent it or detect it early. If you have any of these risk factors, talk to your doctor about screening tests and lifestyle changes that can lower your risk.

How is esophageal cancer diagnosed and treated?

Esophageal cancer is a serious condition that requires timely diagnosis and treatment. If you have any of the symptoms mentioned above, you should consult your doctor as soon as possible. Your doctor may perform some tests to confirm the diagnosis, such as:

  • Endoscopy: A thin, flexible tube with a camera and a light is inserted through your mouth and into your esophagus. This allows your doctor to see any abnormal areas or growths in your esophagus.
  • Biopsy: A small sample of tissue is taken from the suspicious area during the endoscopy and examined under a microscope for signs of cancer.
  • Barium swallow: You swallow a liquid that contains barium, a contrast agent that makes your esophagus visible on an X-ray. This can show any narrowing, blockage, or ulceration in your esophagus.
  • CT scan: A computerized tomography (CT) scan uses X-rays to create detailed images of your chest and abdomen. This can show the size and location of the tumor, and whether it has spread to nearby organs or lymph nodes.
  • PET scan: A positron emission tomography (PET) scan uses a radioactive substance that is injected into your vein and accumulates in cancer cells. This can show the extent of the cancer and whether it has spread to distant parts of your body.

The treatment of esophageal cancer depends on the stage, location, and type of the cancer, as well as your overall health and preferences. The main treatment options are:

  • Surgery: The goal of surgery is to remove the tumor and some surrounding healthy tissue. Depending on the extent of the cancer, this may involve removing part or all of your esophagus, and sometimes part of your stomach or other nearby organs. The remaining part of your esophagus is then reconnected to your stomach or a piece of intestine.
  • Radiation therapy: Radiation therapy uses high-energy rays or particles to kill cancer cells. It can be given externally, by a machine that directs the radiation to the tumor area, or internally, by placing radioactive seeds or wires near the tumor. Radiation therapy can be used before or after surgery, or as the main treatment for patients who cannot have surgery.
  • Chemotherapy: Chemotherapy uses drugs that kill cancer cells or stop them from growing. It can be given intravenously (through a vein) or orally (by mouth). Chemotherapy can be used before or after surgery, in combination with radiation therapy, or as the main treatment for patients who cannot have surgery or radiation therapy.
  • Targeted therapy: Targeted therapy uses drugs that target specific molecules that are involved in the growth and spread of cancer cells. These drugs can block the signals that tell cancer cells to grow and divide, or prevent them from getting nutrients or blood supply. Targeted therapy can be used alone or in combination with chemotherapy or radiation therapy.
  • Immunotherapy: Immunotherapy uses drugs that stimulate your immune system to recognize and attack cancer cells. These drugs can help your body fight off the cancer or prevent it from coming back after other treatments. 

Preventing esophageal cancer: 5 dietary principles

Esophageal cancer is a serious disease that can affect anyone, but some people are more at risk than others. Fortunately, there are some dietary habits that can help prevent or reduce the risk of developing this type of cancer. Here are five principles to follow:

  1. Avoiding tobacco and alcohol. Tobacco and alcohol are two of the most common causes of esophageal cancer, as they can damage the lining of the esophagus and increase the production of stomach acid. Smoking and drinking also impair the immune system and make it harder for the body to fight infections and inflammation. If you are a smoker or a drinker, try to quit or reduce your consumption as much as possible.
  2. Limiting hot tea and soup consumption. Drinking very hot liquids can also irritate and scald the esophagus, especially if you have a history of acid reflux or heartburn. Hot liquids can also increase the risk of esophageal ulcers and bleeding. It is recommended to wait until the liquids cool down to a comfortable temperature before drinking them.
  3. Avoiding foods containing nitrosamines. Nitrosamines are chemical compounds that can form when foods are cooked at high temperatures, such as frying, grilling, or smoking. They can also be found in processed meats, such as bacon, ham, sausages, and salami. Nitrosamines are known to be carcinogenic, meaning they can cause cancer in humans and animals. To avoid them, choose lean meats and cook them with low heat and moisture. You can also marinate them with vinegar, lemon juice, or herbs to reduce the formation of nitrosamines.
  4. Eating more natural fruits and vegetables. Fruits and vegetables are rich in antioxidants, vitamins, minerals, and fiber that can protect the esophagus from damage and inflammation. They can also help lower the acidity of the stomach and prevent acid reflux. Some fruits and vegetables that are especially beneficial for the esophagus include apples, bananas, berries, carrots, celery, cabbage, broccoli, cauliflower, kale, spinach, and tomatoes.
  5. Avoiding moldy foods. Moldy foods can contain toxins that can harm the esophagus and other organs. Some of these toxins include aflatoxins, which are produced by certain fungi that grow on peanuts, corn, grains, nuts, and dried fruits. Aflatoxins can cause liver cancer and weaken the immune system. Another toxin is ochratoxin A, which is produced by fungi that grow on coffee beans, cocoa beans, grapes, raisins, and wine. Ochratoxin A can cause kidney damage and neurological disorders. To avoid moldy foods, store them in a cool and dry place and discard them if they show any signs of spoilage.

By following these five dietary principles, you can lower your risk of developing esophageal cancer and improve your overall health. Remember to also consult your doctor regularly and get screened for any signs of esophageal abnormalities. Early detection and treatment can make a big difference in your prognosis and quality of life.

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