Esophageal cancer tumor 4.9cm large belongs to the more serious one, which usually belongs to the middle stage of esophageal cancer. Patients will have symptoms such as choking on food, difficulty in drinking water, etc. Patients should take medication, surgery and radiotherapy in time. When esophageal cancer patients have tumor 4.5cm in size, it is more serious, and the main symptoms of patients are choking on food, difficulty in drinking water, chest pain, pain in scapular area, etc. Some patients also have severe weight loss, vomiting blood, blood in stool, etc., which is a serious situation. It is suggested that patients with esophageal cancer should seek medical treatment in time, and they can use chemotherapeutic drugs such as 5-fluorouracil injection, cisplatin injection, paclitaxel injection, irinotecan hydrochloride for injection and other chemotherapeutic drugs according to doctor’s instruction. In addition, patients can also take surgical treatment, such as endoscopic mucosal resection, endoscopic submucosal dissection and other surgical methods. For patients who cannot be operated, local radiotherapy can be taken. The phenomenon of esophageal cancer with tumor size of 4.9cm is serious, it is suggested that patients should go to hospital in time and take treatment measures according to doctor’s prescription, so as to avoid aggravating the condition by delaying the treatment.