Signs and Symptoms of Esophageal Cancer

Most people with esophageal (esophagus) cancer are diagnosed because they have symptoms. In a small number of people, the cancer is found by accident because of tests done for other medical problems.

Unfortunately, most esophageal cancers don’t cause symptoms until they have reached an advanced stage, when they are often harder to treat.

General symptoms

The most common symptoms of esophageal cancer are:

• Trouble swallowing
• Chest pain or heartburn
• Weight loss
• Hoarseness
• Chronic cough
• Vomiting after eating
• Feeling tired
• Bone pain (if cancer has spread to the bone)
• Blood in vomit, or black/tarry stool (if the cancer is bleeding)

Having one or more symptoms does not mean you have esophageal cancer. In fact, many of these symptoms are more likely to be caused by other conditions. Still, if you have any of these symptoms, especially if they don’t go away or get worse, have them checked by a doctor so that the cause can be found and treated, if needed.

Trouble swallowing or painful swallowing

The most common symptom of esophageal cancer is having trouble swallowing (dysphagia). It can feel like the food is stuck in the throat or chest, and it might even cause someone to choke on their food or vomit it back up.

This is often mild when it starts and then gets worse over time as the tumor grows and the opening inside the esophagus gets smaller.

When swallowing becomes harder, people often change their diet and eating habits without realizing it. They take smaller bites and chew their food more carefully and slowly. People then might start eating softer foods that can pass through the esophagus more easily. They might avoid bread and meat since these foods typically get stuck. The swallowing problem may even get bad enough that some people stop eating solid food completely and switch to a liquid diet. If the cancer keeps growing, at some point even liquids might be hard to swallow.

To help pass food through the esophagus, the body makes more saliva. This causes some people to bring up lots of thick mucus or saliva (spit).

Swallowing may become painful if the cancer is large enough to limit the passage of food through the esophagus. The medical term for painful swallowing is odynophagia. Pain may be felt a few seconds after swallowing, as food or liquid reaches the tumor and has trouble getting around it.

Chest pain

Sometimes, people have pain or discomfort in the middle part of their chest. Some people get a feeling of pressure or burning in the chest. These symptoms are more often caused by problems other than cancer, such as heartburn, so they are rarely seen as a signal that a person might have cancer.

Weight loss

Many people with esophageal cancer lose weight without trying to. This happens because their swallowing problems keep them from eating enough to maintain their weight. The cancer might also decrease their appetite and increase their metabolism.