Symptoms of Esophageal Cancer You Shouldn’t Ignore

It is the sixth most common cause of cancer death worldwide, yet many people do not realize they have the disease.

It is because cancer of the esophagus – the long tube that carries food from the throat to the stomach – does not cause symptoms at the beginning of the disease.

That’s what happened to former Scottish football player Andy Goram, who played as a goalkeeper and played for several clubs in Scotland and England; he recently revealed to have cancer of the esophagus.

The news shocked his followers when Goram, 58, announced in May that he had been told he had just six months to live.

In an interview, the former football player explained that he felt unwell about seven weeks ago, when he had trouble eating and drinking.

Goram says he ignored the heartburn he initially suffered after failing to get an appointment with his doctor.

Like him, many patients treated for esophageal cancer talk about how this disease initially presents itself without symptoms, or with symptoms that are often easily ignored.

In 2020, according to data from the Ministry of Health, this type of cancer was the fifth highest mortality in men in Brazil, after which it affects the airways (trachea, bronchi and lungs), prostate, colon and rectum and stomach.

‘I ignored like everyone else’

Paul Sinclair, from Fife, Scotland’s east coast, told the BBC he started feeling what felt like gas in his lower rib cage in September 2020. Sinclair also felt like he had eaten too much after just a few bites.

“I ignored it, like everyone else,” he says. “I felt gassy. But I was eating well, no pain.”

“It was just a nuisance under my ribs. It lasted about a week and a half and then I thought, ‘I’m going to see someone about this.’

“I went to the doctor and he sent me straight for an endoscopy. The scan confirmed that I had a tumor in my upper stomach.”

Sinclair underwent four rounds of chemotherapy over an eight-week period before taking a six-week break.

After that, he underwent an 11-hour surgery, which also included the removal of his spleen – the small organ located in the upper left part of the abdomen, which participates in the process of filtering blood.

Sinclair subsequently underwent “very aggressive chemotherapy” again.

“I got really sick from the chemotherapy sessions,” he explains. “The second session was worse because the body is already weak after the surgery.”

“As you recover, you need to start learning to eat again, chew your food well, eat small portions, and eat lots of meals throughout the day.”

Now, three years later, Sinclair can return to the gym for light exercise, but “nothing will ever be the same.”

“You have to remain optimistic and be grateful for every day you wake up,” he says.

“Most importantly, I haven’t had any particularly severe symptoms, but it’s important not to ignore them and see a doctor.”

What are the symptoms of esophageal cancer?

The esophagus is the long tube that carries food from the throat to the stomach. The main symptoms of cancer are:

• Problems swallowing (dysphagia)
• nausea
• heartburn or reflux
• Indigestion symptoms, such as burping a lot

Other symptoms include:

• Cough that doesn’t get better
• Hoarse voice
• Loss of appetite or weight loss without trying to lose it
• Tiredness or lack of energy
• Pain in the throat or in the middle of the chest, especially when swallowing

Source: NHS (UK National Health Service)

‘You never fully recover’

Linda Moffat, who also lives in Scotland, considered herself a fit woman at age 48 and rode a horse every day.

But in December 2014, he began to feel “that the food wouldn’t go down, as if it was sticking to me”, he recalls. “The pain would increase and the food would get stuck.”

“I had to throw up to feel good. I thought it was an ulcer. And it wasn’t anything serious.”

After a while, Moffat says he “got up the courage to talk to the doctor” and was prescribed antacids. But the symptoms continued and she was referred for an endoscopy.

The examination revealed a “very advanced tumor” in the esophagus and this was “the beginning of a very long and difficult journey”, he explains.

“It’s a very aggressive cancer and the surgery is really brutal: eight hours,” he says. “You go through chemotherapy before and after. You need to learn to eat again.”

“And you end up having a lot of problems with vomiting and diarrhea and pain. I don’t think anyone ever fully recovers.”

“I’m very lucky. My cancer was very advanced and I only had a 20% chance of survival,” he says.

“It’s been almost seven years and I’m so happy to be alive and so grateful to everyone who helped me get here.”

“This disease is often called the ‘silent killer’ because the symptoms vary so much,” he adds. “You just pray people get to the doctor fast enough”

‘The sooner the better’

Caroline Geraghty, a specialist nurse at Cancer Research UK, says the risk of esophageal cancer is increased by “typical factors” such as smoking, drinking alcohol, gaining weight and chewing tobacco.

“But having a higher risk doesn’t mean you will definitely get cancer,” he says. “Most people don’t know why they have esophageal cancer.”

Geraghty recommends anyone experiencing symptoms to see their doctor “to be sure”.

“As we know, the earlier the cancer is identified, the greater the chance of survival for the patient,” he added.

But she notes that for most people who complain of symptoms like heartburn and dysphagia, the diagnosis is not esophageal cancer.

“We can understand why some GPs don’t send the patient directly for endoscopy to find out what’s wrong; some people just really need antacids,” he says.

“But there will be other people who will need a deeper investigation.”

This text was originally published at https://www.bbc.com/portuguese/geral-61806403