Signs and Symptoms of Esophageal Cancer

Most people with esophageal cancer are diagnosed because they have symptoms. It's rare for people without symptoms to be diagnosed with this cancer. When it does happen, the cancer is usually found by accident because of tests done for other medical problems.

Unfortunately, most esophageal cancers do not cause symptoms until they have reached an advanced stage, when they are harder to treat.

The most common symptoms of esophageal cancer are:

  • Trouble swallowing
  • Chest pain
  • Weight loss
  • Hoarseness
  • Chronic cough
  • Vomiting
  • Bone pain (if cancer has spread to the bone)
  • Bleeding into the esophagus. This blood then passes through the digestive tract, which may turn the stool black. Over time, this blood loss can lead to anemia (low red blood cell levels), which can make a person feel tired.

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 trouble swallowing, it’s important to have them checked by a doctor so that the cause can be found and treated, if needed.

Trouble swallowing

The most common symptom of esophageal cancer is a problem swallowing (called dysphagia). It can feel like the food is stuck in the throat or chest, and can even cause someone to choke on their food. This is often mild when it starts, and then gets worse over time as the cancer 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. As the cancer grows larger, the problem can get worse. 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 complain of bringing up lots of thick mucus or saliva (spit).

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.

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.

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.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Ku GY and Ilson DH. Chapter 71 – Cancer of the Esophagus. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa. Elsevier: 2020.

PDQ® Adult Treatment Editorial Board. PDQ Esophageal Cancer Treatment (Adult). Bethesda, MD: National Cancer Institute. Updated 11/15/2019. Available at: https://www.cancer.gov/types/esophageal/patient/esophageal-treatment-pdq. Accessed 01/28/2020. [PMID: 26389463].

Posner MC, Goodman KA, and Ilson DH. Ch 52 - Cancer of the Esophagus. In: DeVita VT, Hellman S, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott-Williams & Wilkins; 2019.

Saltzman JR and Gibson MK. Clinical manifestations, diagnosis, and staging of esophageal cancer. Howell DA and Goldberg RM, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed on January 28, 2020).

References

Ku GY and Ilson DH. Chapter 71 – Cancer of the Esophagus. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa. Elsevier: 2020.

PDQ® Adult Treatment Editorial Board. PDQ Esophageal Cancer Treatment (Adult). Bethesda, MD: National Cancer Institute. Updated 11/15/2019. Available at: https://www.cancer.gov/types/esophageal/patient/esophageal-treatment-pdq. Accessed 01/28/2020. [PMID: 26389463].

Posner MC, Goodman KA, and Ilson DH. Ch 52 - Cancer of the Esophagus. In: DeVita VT, Hellman S, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott-Williams & Wilkins; 2019.

Saltzman JR and Gibson MK. Clinical manifestations, diagnosis, and staging of esophageal cancer. Howell DA and Goldberg RM, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed on January 28, 2020).

Last Medical Review: March 20, 2020 Last Revised: March 20, 2020

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