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First Sign of Esophageal Cancer: A Guide for Cancer Patients

Esophageal cancer is a relatively rare but aggressive form of cancer that can be life-altering if not detected and treated early. Particularly for individuals who have already faced the trials of cancer, understanding the first signs of oesophagal cancer is crucial. This comprehensive guide is tailored to cancer patients, equipping you with knowledge on what to look for and when to seek medical advice. By staying informed and vigilant, you can proactively address any red flags and improve your chances of early detection and successful treatment.

Understanding Esophageal Cancer

Before discussing the first signs of esophageal cancer, it’s essential to grasp what this cancer is and what factors are known to increase the risk of developing it.

What is Esophageal Cancer?

Esophageal cancer occurs in the esophagus—a long, hollow tube that connects the throat with the stomach. The esophagus is responsible for moving food and liquid to the digestive system. The two most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma, each developing in different cells lining the esophagus. Esophageal cancer typically begins in the cells that line the inside of the esophagus and can spread to other parts of the body, such as the liver and lungs.

Risk Factors Associated with Esophageal Cancer

Various factors can increase an individual’s risk of developing esophageal cancer. These include:

  • Age: The risk of esophageal cancer increases with age, with most people being diagnosed in their 60s and 70s.
  • Gender: Men are three to four times more likely than women to develop esophageal cancer.
  • Tobacco and Alcohol Use: Both smoking and heavy alcohol use are significant risk factors.
  • Gastroesophageal Reflux Disease (GERD): The risk of adenocarcinoma is increased in individuals with chronic GERD.
  • Obesity: Excess body weight can lead to GERD, which increases the risk of adenocarcinoma.
  • Diet: Diets low in fruits and vegetables, and certain minerals may increase the risk.

What Does Esophageal Cancer Feel Like in the Beginning? Identifying the First Sign

Recognising the early symptoms of esophageal cancer is crucial. While these symptoms may vary from person to person, the following indicators could signal the early stages of the disease.

Difficulty Swallowing (Dysphagia)

One of the most common early signs of esophageal cancer is dysphagia, or difficulty swallowing. This may occur when eating solid foods at first but can progress to difficulty with swallowing liquids as the cancer grows and the esophagus narrows.

Unexplained Weight Loss

Weight loss is often a symptom of cancer, particularly when unexplained by diet or exercise. Esophageal cancer can lead to a decrease in appetite and difficulty eating, which may result in significant weight loss over a relatively short period.

Chest Pain

Esophageal cancer can cause a sensation of pressure, burning, or a tight band around the chest—commonly mistaken for heartburn. This pain can occur behind the breastbone or in the throat and often occurs during or after eating.

Persistent Cough or Hoarseness

A cough or changes to the voice that do not improve and persist over time could indicate esophageal cancer. Coughing may be accompanied by bloody phlegm, a clear indicator to seek medical advice.

Other Possible Symptoms

In addition to the above, patients with esophageal cancer might experience:

  • Indigestion or heartburn that doesn’t go away.
  • Frequent choking on food.
  • Bone pain or weakness in the back or neck, which can occur when the cancer spreads.
  • Vomiting.
  • Unexpected hiccups.

Determining the first sign for each patient can greatly vary, which is why it’s crucial to listen to your body and note any persistent symptoms.

How Do You Confirm Esophageal Cancer?

Confirming esophageal cancer involves several steps. If symptoms suggest esophageal cancer, a cancer specialist may recommend one or more of the following diagnostic procedures:


During an endoscopy, a thin, flexible tube with a camera at the end (endoscope) is passed down the throat to examine the esophagus. Biopsies can be taken during an endoscopy to test for cancer cells.


A biopsy involves taking a small sample of tissue from the esophagus to be examined under a microscope by a pathologist to look for cancer cells.

Imaging Tests

Imaging tests, such as CT scans and PET scans, can provide a clearer picture of the esophagus and surrounding areas, helping to determine the size and spread of the tumour.


Once cancer is confirmed, staging procedures help determine how advanced the cancer is and if it has spread. Staging can involve additional endoscopies with ultrasound, CT scans, PET scans, and sometimes other tests.

How Long Can You Have Esophageal Cancer and Not Know?

It is possible to have esophageal cancer and not know for a long time, as symptoms may not appear until the cancer has reached an advanced stage. This is why it’s important to pay attention to any persistent symptoms and seek medical advice if necessary. If diagnosed early, treatment options and chances of recovery are improved. However, some people may also experience symptoms but not associate them with esophageal cancer. This is why it’s crucial to let your doctor know about any unusual changes in your body, even if they seem insignificant.

Why and When to Consult an Oncologist?

When to consult an oncologist depends on your specific symptoms and risk factors. If you’re at a higher risk for esophageal cancer, such as a history of smoking or GERD, or if you’re experiencing persistent or concerning symptoms, seeing an oncologist can be a proactive step.

An oncologist can conduct a detailed evaluation to determine whether your symptoms are linked to esophageal cancer and create a personalized care plan.

Oncologists play a crucial role in cancer detection and treatment. They are highly skilled in recognizing the nuances of various types of cancer, including esophageal cancer. If you have any concerns about your health, an oncologist’s expertise is your best bet for a thorough assessment and the next best steps in your healthcare.


For any patient esophageal cancer can be daunting. However, education, awareness, and timely intervention are key. By staying informed about the potential signs and symptoms and not dismissing any unusual bodily changes, you empower yourself in the fight against cancer. If you’re experiencing any of the symptoms discussed in this guide, don’t wait. Take action and consult your doctor about your concerns. Early detection of esophageal cancer significantly improves the chances of successful treatment.

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