Esophageal cancer is one of the common tumors and one of the diseases that seriously threaten people’s health and life. About 209,000 people die of esophageal cancer every year in China. The treatment results of esophageal cancer vary greatly depending on the stage of the disease. Taking surgical treatment as an example, the 5-year survival rate of early-stage cancer is about 90%, while the 5-year survival rate of middle and late-stage cancer drops to 20%-30%. Esophageal cancer is formed when normal epithelial cells of the esophageal mucosa are stimulated by various factors inside and outside the body and gradually become cancerous. It is still unclear how long it takes for normal epithelial cells to develop into cancer. Generally speaking, it takes several years to develop from severe hyperplasia of esophageal epithelial cells into cancer, and it takes about one year for the early stage cancer to develop into middle or late stage cancer. Early signals of esophageal cancer It is wrong to think that there are no symptoms and signals of early esophageal cancer. Because these signals and symptoms are mild, appearing and disappearing automatically without treatment, they are neglected by patients and doctors, failing to be further examined and diagnosed, and then losing the best time for treatment. In fact, most of early esophageal cancer patients have experienced different types and degrees of symptoms, and they should be alerted if they find the following symptoms. This is the most common symptom. Patients can remember clearly the time of the first occurrence and the cause of the choking sensation, which is mostly caused by eating food that is not easy to be chewed and perfected. After the first choking sensation, it disappears on its own without treatment and reappears after a few days or months. Patients describe this symptom as a blockage of gas in the esophagus when swallowing food, so they complain of “choking”. Because the esophagus is highly elastic and expandable, when the lesion is limited to the esophageal epithelium and does not involve the muscular layer of the esophageal wall, there is only a choking sensation, which does not affect the swallowing of food. This symptom often occurs with the patient’s mood fluctuations, so patients often link the occurrence of this symptom with “anger”. 2.Post sternal pain This is also the most common symptom. Patients often complain of a slight pain behind the sternum when swallowing food, and can explain the location of the pain. The nature of the pain can be burning pain, pins and needles pain or pulling and rubbing pain. The severity of the pain is related to the nature of the food: the pain is more severe when swallowing rough, hot or irritating food; the pain is less severe with fluid and warm food. The pain is worse when swallowing hot or irritating food, and less severe with liquid or warm food. There are also a few patients with heavier pain, or even persistent pain. The site of pain is not completely consistent with the site of the lesion in the esophagus. Most of the post-sternal pain can be temporarily relieved by medication, and then occur again after a few days or months when the patient encounters emotional fluctuations or improper eating, and often recur for a long period of time. 3.Foreign body sensation in the esophagus Patients often complained that the esophagus was bruised due to eating rough food or suspected of accidentally swallowing a foreign body stored in the esophagus, and they often felt that there were fragments such as grains of rice or vegetables adhering to the esophagus wall, which could not be swallowed without pain and had nothing to do with eating, and even if they didn’t do swallowing, they still had a foreign body sensation, which was mostly in line with the site of the lesion. Patients often complain that the esophageal opening becomes small and tight, and the food travels down slowly, and there is a feeling of stagnation. This symptom only appears when swallowing food and disappears after eating, and has nothing to do with the nature of the food, and the same feeling can be seen with drinking water. Patients often feel that when swallowing food, there seems to be a ladder in the esophagus, and the food slowly “stumbles” downward. 5.Pain under the raphe Most patients complain of burning-like pain, varying in severity, mostly occurring when swallowing food, alleviated or disappeared after eating, or persistent hidden pain, which has little relationship with eating. 6.Dryness and tightness in the throat Patients often complain of dryness and tightness in the throat, or described as “neck” tightness, swallowing food is unfavorable, and there is a slight pain, obvious when swallowing dry and rough food. The occurrence of this symptom is also often associated with the patient’s mood swings. Tightness and discomfort behind the sternum: Patients often cannot describe this symptom specifically, but only complain that they feel uncomfortable in the chest. The above are the common symptoms of early esophageal cancer. Besides, a few patients may have symptoms such as back heaviness, belching and earache, and even a very few patients may not have any symptoms. Patients with early esophageal cancer may have multiple symptoms coexisting or only one symptom, some of them last for a long time, some of them occur intermittently. In daily life, these uncomfortable symptoms may appear at the same time or successively, so we have to be especially alert and go to the hospital for timely consultation and examination after experiencing the above uncomfortable symptoms. How to prevent esophageal cancer? Although the causes of esophageal cancer are not clear yet, as far as we know, prevention should start from the following aspects. Changing dietary habits Do not eat too hot food, do not eat hot and too rough food. Too hot and rough food in the esophagus, contact with the mucosal epithelium, will burn the esophageal mucosal epithelium, so that the mucosal epithelium breakage, ulceration, bleeding and other lesions. Don’t eat too fast, don’t gobble, don’t eat food too fast. 2, do not smoke, drink less alcohol Do not drink excessive alcohol to reduce the stimulation of the esophageal mucosa, due to the high content of alcohol or due to the other harmful chemicals contained in the wine may make the smoking-induced cancer of the oral cavity, pharynx, larynx, and esophagus parts of the incidence of the factors increased exponentially. 3.Not squatting food Because squatting food and drink increased intra-abdominal pressure, food through the cardia into the stomach is bound to be blocked, the esophagus to increase peristalsis and pressure to transport food masses. The friction between food and esophagus aggravates the damage of esophageal wall. Loss of mucosal epithelium will quickly proliferate to repair the mucosal epithelium that has been broken and inflamed. If the mucosal epithelium is subjected to this kind of undesirable stimulation frequently and repeatedly, the mucosal epithelium will appear some abnormal “heteromorphic” cells in morphology and function during the process of repeated proliferation and repair, and if more of these abnormal cells are accumulated, they will develop in a bad direction and gradually develop into a “heteromorphous” cell. When these abnormal cells accumulate, they will develop in a bad direction, gradually undergo malignant changes, and finally form cancer cells that keep expanding. Don’t eat moldy food and eat less sauerkraut: moldy food can produce toxins. Sauerkraut contains a large amount of nitrosamines, which have strong cancer-causing effect. Reduce or avoid the intake of nitrosamine chemicals, nitrosamines are a class of highly carcinogenic chemical carcinogens. Therefore, as far as possible, do not eat long-stored spoiled food, cured meat food and pickled vegetables. Do not eat moldy food, moldy food is also one of the factors that induce esophageal cancer. Don’t ignore the early signs of esophageal cancer As the saying goes, “three feet of ice is not cold in one day”, the development of esophageal cancer is not a matter of overnight. Therefore, middle-aged and old people over 40 years old, especially those who come from or live in areas with high incidence of esophageal cancer (more so for men), and those who usually consume sauerkraut and drink alcohol, should not take it lightly when they have one or more precursor symptoms, such as difficulty in swallowing, retrosternal pain or discomfort, etc., and they should seek medical treatment in time for esophageal exfoliative cytology examination, X-ray barium meal examination, esophageal microscopy and biopsy so that the disease can be detected in the early stage. The condition should be detected early. As long as three early detection, early diagnosis and early treatment are achieved, the survival rate of patients can be greatly improved.