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How Do You Detect Esophageal Cancer? 9 Symptoms & Diagnosis

How Do You Detect Esophageal Cancer?
Esophageal cancer refers to the uncontrolled growth of abnormal cells that starts in the esophagus.

The diagnosis of esophageal cancer is done by the doctor based on:

  • Medical history: The doctor will take a detailed history concerning your symptoms, their severity, and onset, addictions (including smoking and alcohol consumption), previous history of cancers in your family or you, medications or underlying health conditions, dietary patterns, and potentially toxic environmental exposures.
  • Physical examination: After taking a detailed history, the doctor then performs a physical examination. They will assess your general health, examine your abdomen, and will look for any swellings or lumps in your body, including your neck and underarm region. They may do a chest examination to assess the health of the lungs and heart.
  • Investigations: A careful history and examination is followed by certain investigations to confirm the diagnosis and assess the person’s general health. Investigations help assess the type of cancer, how aggressive it is, and how far it has progressed in the body (staging and grading). The investigations generally include blood examination (such as blood counts, electrolytes, kidney, and liver function) and imaging studies, such as:
    • Barium swallow (also called esophagogram, the person swallows a solution containing a barium-based contrast material. X-rays are then used to produce images of the esophagus, stomach, and small intestine.)
    • Esophagoscopy (a long, thin, flexible tube with a camera and light source called an esophagoscope is used to view the inside of the esophagus)
    • Endoscopic ultrasound (a long, flexible tube called an endoscope is used along with ultrasound to get detailed images of the esophagus)
    • Chest X-ray
    • Chest computed tomography (CT) (an imaging study that uses X-rays to create multiple images of the inside of the body)
    • Positron emission tomography/computed tomography (here CT scan is used along with a radioactive compound called a tracer to look for the spread of cancerous cells)
    • Biopsy (a sample of the suspected tissue is collected via endoscopy and sent for lab examination to look for cancer cells)

What is esophageal cancer?

Esophageal cancer refers to the uncontrolled growth of abnormal cells that starts in the esophagus. The esophagus is a hollow, muscular tube that connects the throat to the stomach and acts as a channel for the movement of what you eat or drink. It measures about 10 to 13 inches in length and 3/4th of an inch in diameter in adults. The esophagus contains several tissue layers, forming its wall. The innermost layer is called mucosa, the middle muscle layer and the outermost is a connective tissue layer (fibrosa).

Esophageal cancer generally starts from the inner layer and spreads outward. Depending on the type of cells that form cancer, esophageal cancer is of two main types.

  • The most common esophageal cancer is called squamous cell carcinoma of the esophagus and begins in the upper part of the esophagus.
  • Adenocarcinoma is the other main type of esophageal cancer and typically arises from the lower two-thirds of the esophagus.

Certain conditions, such as smoking, alcohol, and acid reflux disease, may increase the risk of esophageal cancer.

9 symptoms of esophageal cancer

The symptoms of esophageal cancer mainly depend on the stage of cancer. Early disease may not exhibit any symptoms.

When present, the symptoms of esophageal cancer generally include:

  1. Dysphagia (difficulty swallowing)
  2. Blood in vomit
  3. Coughing
  4. Hoarseness
  5. Chest pain or pressure
  6. Indigestion
  7. Black, tarry stools
  8. Heartburn
  9. Unexplained loss of weight and appetite

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