Red Flag: Difficulty in Swallowing Solids

Difficulty in swallowing solids is the most common symptom that leads to
a diagnosis of esophageal cancer. Dr. Vasileios Tentzeris and colleagues
at Princess Royal Hospital and Donnigan Medical Practice, UK, reported
that better public awareness could lead to detection at an earlier
stage, when the chance for cure is higher.

Most people know they need medical care for a breast lump, chest pain,
exceptional weight loss, or coughing up blood, Tentzeris noted. Public

health campaigns have successfully educated most of us to recognize
these symptoms as indications of serious conditions including cancer or
heart attack. Dysphagia, the medical term for difficulty in swallowing
solids, is just as serious but much less widely recognized.

Tentzeris' research group investigated patient perceptions of serious
symptoms with a questionnaire administered to patients at a general
hospital in England. The results showed that 82 percent of the
respondents would seek medical care within 24 hours if they experienced
severe chest pain or coughing up blood. Breast lumps would send 71
percent to a doctor within 24 hours, but only 29 percent of respondents
would seek immediate care for difficulty in swallowing. The survey also
covered patient perceptions of the likely cause for serious symptoms.
While 57 percent recognized that a breast lump may be due to cancer,
only 10 percent expected difficulty in swallowing to be caused by
cancer. The patients who filled out the questionnaire were waiting to
see a doctor, so Tentzeris explained that these numbers are probably
higher what we should expect from the general population.

Dr. John C. Layke of the University of Illinois Metropolitan Group
Hospitals and Dr. Peter P. Lopez of the University of Miami, Florida,
reported that 90 percent of patients who are diagnosed with advanced
esophageal cancer have vague symptoms for two to four months before they
seek medical care. The first warning symptom is typically pain or
difficulty in swallowing dry foods or breads. Later the patient may
experience chest or back pain when swallowing, bad breath, and hoarseness.

Both papers encourage earlier medical evaluation of esophageal cancer
symptoms. If all of us are aware that swallowing difficulty can be a
symptom of cancer, then we should be able to catch more of these
malignancies in an early stage when treatment is more likely to produce
a cure.

References:

Tentzeris V et al, “Poor awareness of symptoms of oesophageal cancer”,
Interactive CardioVascular and Thoracic Surgery 2011; 12: 32-34.
http://www.ncbi.nlm.nih.gov/pubmed/20926460

Layke JC et al, “Esophageal cancer: A review and update”, American
Family Physician 2006; 73: 2187-94.
http://www.ncbi.nlm.nih.gov/pubmed/16836035

Reviewed June 1, 2011
Edited by Alison Stanton

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D.
in Physics and an M.S. in Macromolecular Science and Engineering. Her
background includes academic and industrial research in materials
science. She currently writes song lyrics and health articles.

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• Esophageal Cancer