Ask a doctor on the topic of Internal medicine

Fear of esophageal cancer

January 7, 2014 | 30,00 EUR | answered by Dr. med. Frauke Gehring

Good day,

I ask for an assessment of my health situation.

For months now, I have been experiencing discomfort in my esophagus. It all started with a stabbing pain when swallowing carbonated drinks. Later on, I also felt it with certain foods. What stood out to me was that the pain was not in the middle of the chest, but rather on the right side of the center. Over time, it also radiated partly to my back or shoulder. Additionally, I have been experiencing a frequent bad taste in my mouth, as well as mucus formation and a lump sensation in my throat.

I underwent a barium swallow test, which came back with no abnormal findings. Following that, I took proton pump inhibitors (my doctor suspected reflux esophagitis) for two weeks. There was improvement afterwards, but then a worsening of symptoms. I then had another course of proton pump inhibitors, this time for four weeks, but this time without much improvement.

The symptoms have changed slightly, with less pain and more of a feeling that food is not going down well. Bad breath, mucus formation, and lump sensation are remaining consistent. It seems very odd to me that the symptoms sometimes spontaneously improve, meaning there are almost symptom-free days. However, this is rare, and the symptoms never completely disappear.

I have an esophageal endoscopy scheduled in a few days, which is already causing me concern. But what I fear even more is a possible serious diagnosis like esophageal cancer. Although my doctor still suspects "only" reflux esophagitis, I do not feel any signs of reflux, nor do I have heartburn or anything like that.

I know that esophageal cancer is very rare and unlikely at my age (35), but the symptoms are making me anxious.

Dr. med. Frauke Gehring

Good day,

There is absolutely no reason to be afraid of esophageal cancer! The symptoms you described are very typical for reflux, which is not always the same (since people eat different acidic foods) and does not always feel like typical heartburn. In fact, you are much too young for esophageal cancer; you would have had to smoke, drink strong alcohol, or eat spicy foods for many more years.

"Almost symptom-free days" do not exist with esophageal cancer. Also, it is important to consider if you have taken the proton pump inhibitors in a sufficient dose and on an empty stomach in the morning. Otherwise, they may not work optimally, and it's not surprising that you didn't see improvement.

Therefore, you can approach the endoscopy with calmness!

I wish you all the best.

Warm regards, Dr. Höllering, specialist in internal and general medicine