This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on May 19, 2022.
Esophageal cancer may not cause symptoms until the tumor is big enough to disrupt common functions like swallowing or eating. These symptoms may start out as mild or irritating and then increasingly worsen.
Difficulty swallowing is typically the first symptom of cancer that develops in the esophagus. Patients may feel as if food is stuck in the throat or chest, which may lead to choking. Although this symptom is often mild to start, as the tumor grows, it generally worsens and may eventually lead to an inability to swallow liquid.
In addition to difficulty swallowing, the patient may experience other esophageal cancer symptoms, either alone or in combination with other signs.
Some patients with difficulty swallowing alter their food intake to prevent feelings of discomfort. When swallowing is painful, patients may eat less, take smaller bites or switch to liquid foods. Cancer may also cause metabolic changes or decreased appetite.
A tumor may cause a pressure or burning sensation in the middle of the chest. With cancer, the chest pain is usually chronic, meaning it doesn’t go away. Sharp, temporary pains may also occur when swallowing food or liquid. Doctors generally use tests to determine whether chest pain is from cancer or something else.
Heartburn is another way patients may describe chest pain. A tumor in the esophagus may cause discomfort in the upper abdomen.
An esophageal tumor may squeeze up against the vocal cords, causing changes in the patient's voice. In some cases, the vocal cord nerves stop working completely, a result of a condition called laryngeal nerve palsy.
An esophageal tumor may cause excess mucus or bleeding, which may lead to a persistent cough. In rare cases, the tumor may create a connection between the esophagus and the trachea (the tube that takes air to the lungs). Called a tracheoesophageal fistula (TEF), this abnormal airway may also present as a cough.
A tumor may cause bleeding in the throat, which makes its way into the stomach. If the patient vomits, he or she may notice some blood. The blood may also cause stool to turn black. Heavy bleeding may cause anemia, or low red blood cell counts, and fatigue due to blood loss.
Esophageal cancer may spread to nearby tissue or even distant parts of the body (metastasis). If cancer metastasizes into areas such as the bones, lungs or liver, different symptoms may develop.
Although these symptoms may indicate a tumor in the esophagus, they also may be caused by other, less serious health issues. Some esophageal cancer patients experience none of these signs, and others experience different symptoms entirely.
Patients who notice any of the above symptoms should schedule an appointment with a doctor. Even if the cause isn’t cancer, a doctor may recommend treatments to control these symptoms.
Several tests are used to look for tumors in the esophagus. The most common way to check for esophageal cancer is with an upper endoscopy. With this technique, a flexible tube with a camera on the end, called an endoscope, is carefully inserted down the esophagus to search for tumors. Medications are used to sedate the patient before this exam. If a tumor is found, a small section is removed to determine whether it’s cancerous. The removal of a small section of a suspected cancerous area is called a biopsy. Only a biopsy determines for certain the presence of cancer.