Esophageal cancer, also called esophageal cancer, is a malignant tumor occurring in the epithelial tissue of esophagus, accounting for 2% of all malignant tumors. About 220,000 people die of esophageal cancer worldwide every year, and China is a high incidence area for esophageal cancer, which is the second most common cause of death after gastric cancer, with the age of onset mostly above 40 years old and more men than women, but there is a growing trend of onset below 40 years old in recent years. The occurrence of esophageal cancer is related to the chronic stimulation of nitrosamines, inflammation and trauma, genetic factors and the content of trace elements in drinking water, food and vegetables. Early symptoms of esophageal cancer 1.Choking sensation in the throat is the most common, which can disappear or recur spontaneously and does not affect eating. It often occurs when the patient’s mood fluctuates, so it is easily mistaken for functional symptoms. 2.Posterior sternal and subxiphoid pain is more common. When swallowing food, there is pain behind the sternum or subsynovial pain, the nature of which can be burning-like, pinprick-like or pulling-like, with the swallowing of rough, burning or irritating food as the focus. Initially, it is intermittent, but when the cancer invades the nearby tissues or penetrates, there can be severe and continuous pain. The site of pain often does not exactly correspond to the site of lesion in the esophagus. The pain can be temporarily relieved by antispasmodics. When swallowing food or water, there is a sensation of slow movement and retention of food, as well as a feeling of tightness behind the sternum or food adhering to the esophageal wall. The site of the symptoms is mostly the same as the site of the lesion in the esophagus. 4. Dryness and constriction in the throat is especially obvious when swallowing dry and rough food, and the occurrence of this symptom is often related to the patient’s mood swings. 5.Other symptoms A few patients may have post-sternal stuffiness and discomfort, chest pain and Coelom (19) 2.Middle and late stage symptoms of esophageal cancer Typical symptoms of esophageal cancer: progressive dysphagia. It can have pain behind the sternum and mucus-like secretion when swallowing. Progressive dysphagia is the main symptom of most patients when they visit the clinic, but it is the late manifestation of the disease. Because the esophageal wall is elastic and expandable, dysphagia only appears when about 2/3 of the circumference of the esophagus is infiltrated by cancer. Therefore, after the appearance of early symptoms mentioned above, the disease gradually worsens within a few months, from inability to swallow solid food to inability to swallow liquid food as well. If the cancer is accompanied by inflammation, edema and spasm of the esophageal wall, the difficulty in swallowing may be aggravated. The location of the obstruction is often in line with the site of cancer. 2.Spitting mucus-like secretion: the more advanced the disease is, the more patients are likely to spit mucus-like secretion, foam-like and sticky. 3.Food reaction often appears when the difficulty in swallowing is aggravated, and the reflux volume is not large, containing food and mucus, but also blood and pus. 4.Other symptoms may cause hoarseness when the cancer presses the recurrent laryngeal nerve; invasion of phrenic nerve may cause eruption or phrenic nerve paralysis; compression of trachea or bronchus may cause shortness of breath and dry cough; erosion of aorta may produce fatal bleeding. If the cancer is located in the upper part of esophagus or esophagobronchial fistula, cervical sympathetic nerve palsy can be produced when swallowing liquid. Physical signs Early signs should be absent. In the late stage, eructation and difficulty in swallowing may appear. And due to the difficulty in eating, the patient may suffer from malnutrition and show signs such as wasting, anemia, water loss or cachexia. When the cancer metastasizes, enlarged and hard superficial lymph nodes or enlarged and nodular liver can be palpated. Jaundice and ascites may also be present. Other rare signs include nodules at the skin and abdominal white line, and enlarged inguinal lymph nodes. Esophageal cancer belongs to the category of “choking and hiccup”, “regurgitation”, “Guange” and “Y accumulation” in Chinese medicine, and it is believed that it occurs mostly because of worry and anger, emotional and mental disorders, depression of the seven emotions. It is believed that the disease occurs mostly because of depression and anger, emotional and mental disorders, depression of the seven emotions, or excessive alcohol consumption, spicy, dry and spicy food, damage to the spleen and stomach, so that the gas does not distribute the fluid, and the fluid gathers and becomes phlegm, and the phlegm is blocked in the esophagus. Therefore, its subtypes are qi stagnation, blood stasis, phlegm coagulation, heat toxicity, yin deficiency and yang deficiency, which are treated by draining liver and qi, activating blood and moistening dryness, softening phlegm and firmness, cooling blood and detoxifying toxins, nourishing yin and moistening dryness, and warming and tonifying yang. V. Treatment Early treatment of esophageal cancer should be a combination of surgery, radiotherapy, chemotherapy and Chinese medicine, while middle and late stage should be conservative treatment with Chinese medicine.