By the early signs of esophageal cancer should include progressive deterioration of general condition of patients, decreased appetite, increase overall weakness, decreased performance, loss of body weight. Swelled slowly and gradually, these phenomena for a long time to go unnoticed by patients.

First, but, unfortunately, is not an early symptom of esophageal cancer is dysphagia - swallowing difficulties food. This symptom is observed in more than 75% of patients with esophageal cancer. Approximately 2% of patients with delayed passage of food from esophagus occurs imperceptibly. Rather, patients do not fix this attention, though, and refuse to accept rough and dry food. Patients better swallow the food, reception of which causes excessive salivation (roasted meat, sausage, herring), and worse - black bread, boiled potatoes, boiled meat. First, a thorough chewing of food and water zapivaniem it possible to remove the painful effects of dysphagia, which allows patients to eat without restrictions. In these cases, dysphagia is periodic and is observed only in cases of a hasty meal ingestion of large, poorly chewed pieces. As the disease progresses dysphagia becomes permanent.

In some patients the first symptom of the disease is profuse salivation. Usually it appears at sharp degrees of narrowing of the esophagus. By the classification of AI Savitsky dysphagia taken to distinguish between grade 4 its severity:

• I degree - difficulty passing the solid food in the esophagus (bread, meat);
• II degree - difficulty arising from the admission mushy and semi-liquid foods (cereals, mashed potatoes);
• III degree - difficulty in swallowing liquids;
• IV degree - complete obstruction of the esophagus.

Approximately 17-20% of cases the disease is manifested by pain behind the breastbone or in the epigastric area in the back. Patients often note the dull, pulling pain behind the breastbone, at least - a sense of compression or compression of the heart, extending up to the neck. The pain may occur at the time of swallowing and disappear after a certain time after the esophagus is freed from food. Less pain is permanent and increases with the passage of food from esophagus. The pain in cancer of the esophagus can be felt during stimulation of nerve endings in izyazvivsheysya and decaying food undergoing tumor masses. In such cases, patients feel like a lump of food, passing through a certain place of the esophagus, «scratch», «burn» him. Pain can occur when reinforced by reductions in spastic esophagus to push food bolus through the narrowed portion of the esophagus, as well as during germination of the tumor into surrounding tissues and organs of the esophagus by compression of blood vessels and nerves of the mediastinum. In this case, it is not connected with the act of swallowing and is permanent.

It is important to note that patients with esophageal cancer are often not accurately characterize the level of delay of food and level of pain. Approximately 5% patients before the development of persistent dysphagia mark only vague nature discomfort behind the breastbone, not only when swallowing food, and outside thereof. All this complicates the clinical interpretation of the first signs of cancer of the esophagus.

When considering the clinical manifestations of esophageal cancer incidence should pay special attention to the general condition of the patient. Typically, patients with cancer of the esophagus deficiency of body weight. Weight loss is primarily concerned with a limited intake of food the patient, rather than the toxic effect of widespread tumor process. Especially significant weight loss observed at extreme degrees of dysphagia, the patient loses the ability to accept even a liquid, bringing the total of his condition was rapidly deteriorating from dehydration. Therefore, in esophageal cancer should distinguish between the general plight of the patient, which arose as a result of intoxication at far come malignancy (cancerous intoxication and cachexia), and malnutrition and dehydration.

The smell from the mouth, unpleasant taste in the mouth, coated tongue, nausea, vomiting - all of these features usually have little expressed in the early stages of esophageal cancer, is well manifested in the common forms of the disease and can be explained not only the narrowing of the esophagus, but also metabolic , qualitative deficiency of oxidative processes, enhanced dissolution of proteins, leading to accumulation in the body of unoxidized products and excess lactic acid.

With widespread cancer of the esophagus can be seen voice hoarseness, which is a consequence of compression of metastatic or recurrent tumor sprouting nerve. With widespread cervical cancer of the esophagus, as well as tumors of the breast it is often a choke and cough when swallowing liquid food due to dysfunction of the lock apparatus of the larynx or the formation of esophageal-tracheal, bronchial-esophageal fistula. In these patients develop signs of aspiration pneumonia.

Differential diagnosis of esophageal cancer should be conducted with the following groups of diseases of the esophagus:

• Anomalies of the esophagus (congenital narrowing of the esophagus)
• Diverticula (diverticulitis), esophagus
• Functional disorders of the esophagus (hyperkinesia and hypokinesia)
• Achalasia cardia
• Hiatal hernia
• Esophagitis and esophageal ulcers
• Allergic and specific lesions of the esophagus
• Injuries (burns) of the esophagus and their implications
• Diseases of the operated esophagus