When a person has stage 4 esophageal cancer, the tumor has spread to nearby tissues or lymph nodes. This is also referred to as advanced stage esophageal cancer or metastatic disease. If a person is diagnosed with this type of cancer, it may still be treatable, but the prognosis is poorer.
In stage 4, a person’s esophagus is no longer able to fully stretch or open to allow food and liquid to pass through. As a result, eating becomes difficult. People often feel like they are choking when trying to swallow. This symptom is called dysphagia. It typically gets worse over time, reaching a point where a person can no longer consume any foods and must stick to a liquid-only diet.
At this stage, a person may begin to lose weight because they are not eating any solid foods. A doctor might suggest a feeding tube to help pass nutrients and liquids through the mouth and into the stomach. This can reduce the need for a person to go to the hospital for nutrition assistance.
A person who is in stage 4 might also experience chest pain, which can be very painful if it affects the entire area of the lungs. It might be hard to breathe or cough, and it can cause a person to become tired quickly.
To diagnose esophageal cancer in its later stages, doctors perform blood tests and take a biopsy to analyze part of the tissue. They also use imaging tests such as an endoscopy and a barium swallow test to look for a tumor or any other abnormalities in the esophagus.
The goal of treatment in stage 4 esophageal cancer is to keep a person comfortable and prevent the cancer from spreading to other parts of the body. Doctors usually recommend a combination of treatments. Depending on the location of the tumor, the doctor might use chemotherapy, targeted therapy, radiation therapy, or immunotherapy.
Chemotherapy uses powerful medications that are taken by mouth or injected into a vein. These drugs enter the bloodstream and can kill cancer cells throughout the body, including those that have spread to other tissues and lymph nodes.
Targeted therapy is a type of chemotherapy that targets specific proteins found in the cancer cells. This type of treatment can be more effective than standard chemotherapy for esophageal cancer in some cases.
Radiation is a common treatment for esophageal cancer. It can kill cancer cells that have spread to other areas of the body and improve survival by limiting how much the cancer spreads.
For people with stage 3 esophageal cancer that has spread to lymph nodes, doctors might combine chemotherapy and radiation. This can be done because the cancer might be more likely to spread when it is in a larger area of the esophagus and because chemotherapy helps kill any remaining cancer cells in the esophagus that have not yet spread.
