The most important symptoms of oesophageal cancer are difficulty or pain when swallowing and weight loss; pain behind the breastbone, hoarseness, cough, indigestion and heartburn may also occur [5]. Because the oesophagus stretches, symptoms often appear only when the disease is more advanced [1]. These symptoms also have harmless causes [5], but take swallowing difficulty that is getting worse seriously, and see your doctor for assessment and an endoscopy.
Key points
- Oesophageal cancer has two main types: squamous cell carcinoma and adenocarcinoma [1].
- Some regions have very high rates, such as north-eastern Iran (Golestan Province), where opium use and drinking very hot tea are known risk factors [2] (Does opium cause cancer?).
Symptoms of oesophageal cancer
| Symptom | Explanation | What to do |
|---|---|---|
| Difficulty or pain when swallowing | The most important symptom; usually first with solid foods [1, 5] | If it is getting worse, get checked now |
| Unintended weight loss | One of the main symptoms [1, 5] | See your doctor as soon as possible |
| Pain behind the breastbone | One of the symptoms [5] | Severe chest pain always needs urgent assessment |
| Hoarseness and cough | One of the symptoms [1, 5] | If it lasts several weeks, see your doctor |
| Indigestion and heartburn | One of the symptoms; but very common and often unrelated to cancer [5] | If it is new or does not get better with medicine, see your doctor |
| Vomiting blood or black stools; tiredness from anaemia | Sometimes happens [1] | Vomiting blood or black stools: get help straight away |
| A lump under the skin | One of the symptoms [5] | See your doctor to have it checked |
This table does not replace an examination by a doctor; in most people these symptoms have a benign cause.
The path to diagnosis
- 1
Endoscopy and biopsy
The main test; several samples are taken to find out the type of tumour [1].
- 2
CT scan
For everyone, to see whether the disease has spread elsewhere [1].
- 3
Ultrasound from inside the oesophagus and PET
They show the depth of the tumour more precisely and sometimes find hidden spread [1].
- 4
Tumour tests
HER2, MSI and PD-L1 in advanced disease to choose medicines [6].
When should I call my doctor?
If you feel that food gets stuck in your chest, you have to wash food down with water, or swallowing solid food is getting harder day by day — especially if you have lost weight — do not wait; see your doctor for assessment and probably an endoscopy.
Being unable to swallow even water or saliva, vomiting blood or black stools need urgent care.
Related questions
I have reflux; will I get oesophageal cancer?
Frequent reflux is a risk factor for one type of oesophageal cancer [4], but a risk factor means a higher chance, not certainty. If you have long-standing reflux, your symptoms have changed or you have developed difficulty swallowing, talk to your doctor about treatment and an endoscopy.
Is hot tea really a risk?
Yes; in the Golestan study, tea at 60 °C or hotter raised the risk of oesophageal cancer [3]. Wait a few minutes for tea to cool a little. Read more: Oesophageal cancer
Related cancer types
References
6 referencesShow all references, 5 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2Individual and Combined Effects of Environmental Risk Factors for Esophageal Cancer Based on Results From the Golestan Cohort Study
- 3A prospective study of tea drinking temperature and risk of esophageal squamous cell carcinoma
- 4Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma
- 5
- 6Esophageal and Esophagogastric Junction Cancers, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/questions/symptoms-of-esophageal-cancer/