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 is not commonly diagnosed until a patient experiences symptoms. If a doctor suspects an esophageal tumor based on symptoms or other factors, he or she may order diagnostic tests, including an endoscopy, an endoscopic ultrasound, imaging tests, a biopsy and/or lab tests.
Factors that may increase the risk for developing esophageal cancer include obesity, tobacco and alcohol use, as well as certain disorders such as gastroesophageal reflux disease (GERD) and Barrett’s esophagus, a condition caused by chronic acid reflux.
Typically, the first symptom of cancer that develops in the esophagus is difficulty swallowing, which may feel as if food is stuck in the throat and 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.
Other common signs of cancer of the esophagus include:
Trouble swallowing, or dysphagia, that generally worsens over time: Some patients with difficulty swallowing alter their food intake to prevent feelings of discomfort. When swallowing is painful, you might eat less, take smaller bites or switch to liquid foods. Cancer may also cause metabolic changes or decreased appetite.
Chest pain or discomfort: 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.
Indigestion and heartburn: Heartburn is another way you may describe chest pain. A tumor in the esophagus may cause discomfort in the upper abdomen.
Hoarseness: An esophageal tumor may squeeze up against the vocal cords, causing changes in your voice. In some cases, the vocal cord nerves stop working completely, a result of a condition called laryngeal nerve palsy.
Chronic cough: 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.
Vomiting blood: 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.
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.
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.
These are just a few of the many symptoms cancer may cause in other parts of the body.
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.