Esophageal (Food Pipe) Cancer — Symptoms, Diagnosis & Treatment Options

Esophageal cancer is a cancer that begins in the esophagus, the tube that carries food from the throat to the stomach. It is more common in older adults and is often linked to smoking, alcohol, and long-standing acidity (reflux).


Types of Esophageal Cancer (Simple Explanation)


There are two major types:




  1. Squamous Cell Carcinoma




    • Upper & middle esophagus




    • Related to smoking & alcohol






  2. Adenocarcinoma




    • Lower esophagus (near stomach)




    • Related to long-standing acidity, reflux, Barrett’s esophagus, and obesity






These types matter for deciding treatment.


 


Common Symptoms of Esophageal Cancer


Symptoms often appear late and may be ignored initially.


1. Difficulty Swallowing (Dysphagia)




  • Most common symptom




  • First with solids, later with liquids




2. Unintentional Weight Loss




  • Very common presentation




3. Food Sticking Sensation in Chest




  • Patients describe “food not going down”




4. Chest Pain or Burning




  • Mimics gastritis or heartburn




5. Persistent Acid Reflux or Regurgitation


6. Hoarseness or Cough




  • If tumor irritates vocal cords or airway




7. Vomiting of Undigested Food


 


What Tests & Investigations Are Needed?


For accurate diagnosis and staging:


1. Upper GI Endoscopy (OGD)




  • Most important test




  • Shows tumor




  • Biopsy confirms cancer




2. CT Scan (Chest/Abdomen/Pelvis)




  • Checks spread & staging




3. PET Scan




  • Useful to detect distant metastasis




 


Treatment Options for Esophageal Cancer (Explained Simply)


Treatment depends on:




  • Stage




  • Tumor location (upper/middle/lower)




  • Patient’s nutritional status




Early-stage


Treatment options include:




  • Endoscopic resection (EMR/ESD) for very early tumors




  • Surgery (Esophagectomy) for operable disease




 


Locally Advanced (Stage II–III)


These tumors often need combined treatment:


Step 1: Chemoradiotherapy (Neoadjuvant)




  • Shrinks tumor




  • Improves surgical outcomes




Step 2: Surgery


Surgical options include:




  • Ivor Lewis esophagectomy




  • Transhiatal esophagectomy




  • Minimally invasive or robotic esophagectomy (in modern centers)




Step 3: Adjuvant therapy




  • Depending on pathology




 


Metastatic Stage (Stage IV)


Treatment goals are to control symptoms & improve quality of life:




  • Chemotherapy




  • Targeted therapy (HER2 positive cases)




  • Immunotherapy (checkpoint inhibitors)




  • Radiotherapy for pain or obstruction




  • Feeding support (stenting or PEG tube if needed)




Role of Stenting


 


 


An esophageal stent may be placed to help improve swallowing when surgery is not possible. This significantly improves nutrition and quality of life.