gastrointestinal disorders
Esophageal Cancer
Symptoms and Signs of Esophageal Cancer
Early-stage esophageal cancer tends to be asymptomatic. When the lumen of the esophagus becomes progressively constricted, Dysphagia commonly occurs. The patient first has difficulty swallowing solid food, then semisolid food, and finally liquids and saliva; this steady progression suggests a growing malignant process rather than a spasm, benign ring, or peptic stricture. Chest pain may be present, usually radiating to the back. Weight loss, even when the patient maintains a good appetite, is almost universal. Compression of the recurrent laryngeal nerve may lead to vocal cord paralysis and hoarseness. Nerve compression may cause spinal pain, hiccups, or paralysis of the diaphragm. Malignant pleural effusions or pulmonary metastasis may cause dyspnea. Intraluminal tumor involvement may cause odynophagia, vomiting, hematemesis, melena, iron deficiency anemia, aspiration, and cough. Fistulas between the esophagus and tracheobronchial tree may cause lung abscess and pneumonia. Other findings may include superior vena cava syndrome, malignant ascites, and bone pain. Lymphatic spread to internal jugular, cervical, supraclavicular, mediastinal, and celiac nodes is common. The tumor usually metastasizes to lung and liver; less common sites include bone, heart, brain, adrenal glands, kidneys, and peritoneum. 