Michael is 58 years old. He has been a smoker over 30 years, and heusually drinks several glasses of wine a day, in addition to a glass of gin or whiskey. A few weeks ago he has noticed that food getsstuck when he’s eating. At first this only happened with meat andbread, but even mashed potatoes are hard to swallow now Can this difficulty swallowing be caused byan esophageal cancer? John is 62 years old.
He has always been overweight, and he’staken antacids for years because he has gastroesophageal reflux. In the last few weeks he is losing weight,because he has stopped eating solid food as his chest hurts when he tries to swallow. This pain that appears when he swallows food,will have any relationship with an esophageal cancer? Watch the full video, and you’ll learn howto distinguish all the symptoms of esophageal cancer, so that if you or any of your relativessuffer from it, you can suspect it as soon as possible!
Esophageal cancer is a tumor that is diagnosedlate, because the person who has it usually consults very late. Let’s see what these symptoms are, to be onguard against their appearance. Let’s start with those who directly causesthe esophageal cancer located only in the esophagus. Situation 1: swallowing food is increasinglymore difficult The most common symptom of esophageal cancerthat has not spread outside of it, is the progressive difficulty swallowing foods. This symptom is called dysphagia. This difficulty swallowing appears gradually.
At first solid food is swallowed badly: drybread, meat too cooked … Progressively other solids also cause choking:vegetables, fish, fatty meats … After a while, when the person with esophagealcancer has replaced his normal diet with mashed food, even these are swallowed withdifficulty. If remedy is not put, even water will be swalloweddifficultly, although this only happens with very advanced tumors.
Situation 2: pain appears when swallowingfood In addition to the mechanical obstacle tothe passage of food, esophageal cancer can hurt when food rubs and shoves it in its transitto the stomach The early onset of the pain is typical ofthe ulcerated tumors, but in tumors that have not broken the esophageal mucosa will alsoeventually appear.
Situation 3: The person starts to lose weightgradually and inexorably When the esophageal cancer begins to obstructthe entry of food into the stomach, the person begins to eat less and less. That reduction in caloric intake can makehim gradually lose weight. If personal and family situation of the patientallows the replacement of solid food for balanced purees or soups, this weight loss will slowdown, but even eating enough, weight loss will eventually appear. This is called cachexia-anorexia syndrome,a metabolic syndrome in which the body begins to lose muscle proteins, regardless of anadequate calorie intake. Even eating properly, person gets thinnerand thinner.
Situation 4: Cancer breaks the esophagealmucosa and starts bleeding Because cancer can break the esophageal mucosaand thus a blood vessel, the person with esophageal cancer can start bleeding without noticingit. This is called “upper gastrointestinal bleeding”. When bleeding is minor, it causes no symptoms. But if bleeding is constant and of certainintensity, it can produce a microcytic anemia, with a progressive fatigue that this anemiawill entail. The person with a bleeding esophageal cancermay even begin to have black stools. We have seen the symptoms that cancerof the esophagus can cause. But what happens when the tumor escapes fromthe esophagus? Lets see it! When the tumor is already out of the esophagusit may be because it has followed three different ways: The tumor infiltrates organs near the esophagus The tumor escapes through the lymphatics Or the tumor enters the blood. Let’s see where each of these three ways leads!
Situation 1: Esophageal cancer invades neighboringorgans When the tumor grows forward, as esophagusis not separated from other organs by any mechanical barrier, esophageal cancer caninfiltrate neighboring organs, which will cause the appearance of symptoms in them. If the tumor compresses and infiltrates thebottom of the pharynx or trachea in its posterior side, it may cause difficulty for the passageof air to the lungs, resulting in the feeling of difficulty breathing, a symptom calleddyspnoea.
The air passing through the duct narrowedby the tumor can produce a characteristic noise, called respiratory stridor. Seldom, if the tumor grows backwards, it canreach and erode the bodies of the thoracic vertebrae. When this happens, a poorly defined back painwill appear. Less often is the situation in which the tumorpierces the wall of the thoracic great blood vessels, which could cause their breakage. This could be catastrophic because of themassive bleeding it would cause.
Situation 2: the tumor has escaped throughthe lymph vessels The cells of esophageal cancer, when choosingthe lymphatic route to escape the body, tend to accumulate first on the nodes of the esophagealwall, and those around the esophagus itself. Because of this accumulation of tumor cells,symptoms of difficulty swallowing and pain caused by the cancer itself are accentuated.
Situation 3: The tumor has escaped throughthe blood The esophageal cancer cells can enter theblood in two ways: The most common way is when cancer cells havereached the blood indirectly from the lymph vessels that go towards the thoracic duct. This duct empties its contents directly intothe superior vena cava. The less frequent way is when inside the esophagealcancer itself, cells enter a blood vessel, breaking its wall. Once in the blood, these cells of esophagealcancer can travel to live anywhere in the body: lungs, liver, bones, brain … causing different symptoms depending on its location. Metastasis into the bones: If the tumor cells grow inside bone, whenmetastasis become very large they can break the lining of bone, a membrane that has greatsensitivity: the periosteum.
When this happens, pain occurs. This growth compromises bone strength and,especially if a bone has to bear weight, it may break. If the affected bone is a vertebrae, breakingit can cause neurological symptoms that fall into spinal cord compression syndrome, whichis an oncologic emergency. Metastasis in the lungs: When tumor cells get to live within the lungs,they usually build separate groups, appearing with time multiple metastasis. If they cancel enough lung function, thiscan cause difficulty breathing (a symptom called dyspnoea). If they touch a breathing tube (bronchus ortheir branches), they will irritate them, producing a very troublesome dry cough.
If metastases are placed near a blood vessel,this vessel may break, pouring a little blood with cough. Metastasis in the brain: When groups of cancer cells get to live withinthe brain, they also make metastasis bigger and bigger. As they push neighboring neurons, these neuronsbegin to function in an altered way, so two types of symptoms may occur: Irritative symptoms, in which neurons firepushed uncontrolled flashes. The person can have seizures Or deficit symptoms, in which neurons stopworking and their work is not done. The person can have loss of mobility, canexperience the lost of vision for an eye, or loses sensitivity. In both cases, if there is much tumor in thehead, as there is not enough room for so many cells, because the skull is a closed cavitywith a single large outlet, we can start having headaches that gradually build up in intensityand frequency.
Metastases in the liver: When tumor cells are located in the liverand begin to grow, they can crush normal liver cells. When broken, the contents of these liver cells,which are transaminases, are put into the blood, thus increasing their levels (as detectedin a blood test). If cancer cells compress small channels withinthe liver, channels that carry bile, this bile may accumulate and the person gets ayellow tint on his skin (a phenomenon called jaundice). As you can see, esophageal cancer can causethe appearance of many signs and symptoms.
Let’s summarize them! Symptoms that esophageal cancer can causeare: In the esophagus itself: most often dysphagiaappears, which is the progressive difficulty swallowing food. At some point this process will produce painfulswallowing. When the person with esophageal cancer eatsless and less amount of food, he begins to lose weight. That loss is accentuated even if the personeats enough calories. Anorexia-cachexia syndrome appears If the esophageal mucosa is broken, bleedingappears, which tints stool black. If bleeding is important, anemia will appear.
In regions of lymphatic drainage: Most often, the difficulty swallowing andpain are accentuated when we eat food, solid initially, and then all kinds of food. In the rest of the body: If esophageal cancer infiltrates neighboringorgans, it may occur: Shortness of breath, sound when breathingor stridor, or dyspnea, if it grows forward. Pain in the upper back if it grows backwards,affecting the dorsal vertebrae. If it spreads through the blood, the mostcommon symptoms are: Bone pain or fractures if bone is involved. Cough, hemoptysis or dyspnea if metastasisare located in the lungs Epileptic seizures or neurological deficitsif the brain is affected Increased transaminases or jaundice if metastasisare located in the liver It is very important knowing the symptomsof esophageal cancer. Do not forget to carry out the early diagnostictests of this tumor prescribed by your doctor. Early detection of esophageal cancer is thebest way to beat it!