Dawaa Reference

chronic

Oesophageal Cancer

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD28.02 - condition scope only, no dose · NICE NG12: Suspected cancer: recognition and referral (recommendation 1.2.1) - https://www.ncbi.nlm.nih.gov/books/NBK555330/ · No dose - referral pathway, no medicine given in primary care

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Oesophageal Cancer - disease-level clinical article (oesophageal-cancer-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (7)

  • Progressive difficulty swallowing solids that later includes liquids as the tumor narrows the lumen [difficulty swallowing]
  • Unplanned weight loss from reduced oral intake and the tumor's higher metabolic demand [weight loss]
  • Painful swallowing that patients find quite distressing [painful swallowing]
  • Chest discomfort when the tumor sits in the mid or lower esophagus [chest pain]
  • Hoarseness signals invasion of the recurrent laryngeal nerve and more advanced disease [hoarseness]
  • Adenocarcinoma of the lower oesophagus and of the junction with the stomach is rising, and Barrett oesophagus is why
  • Carcinomatosis produces ascites and abdominal pain first, then severe loss of appetite, a bowel that stops working, and partial or complete obstruction [abdominal pain · ascites · poor appetite]

Signs — what you find (7)

  • Cachexia or visible malnutrition from significant weight loss [weight loss]
  • Tachycardia or pallor reflecting chronic blood loss anemia [anaemia · pallor · tachycardia]
  • Enlarged cervical or supraclavicular nodes suggesting metastatic spread [metastasis]
  • Hepatomegaly or a mass in the left upper quadrant pointing to liver spread or a large advanced tumor [hepatomegaly]
  • A weak or hoarse voice from vocal cord paralysis when the tumor involves the recurrent laryngeal nerve [hoarseness · vocal cord paralysis]
  • It spreads to the liver, the lungs, distant lymph nodes, bone and the peritoneum
  • Red flag: carcinomatosis reaches 10% to 15% of these adenocarcinomas, above all the diffuse or mixed types and the ones with signet-ring features

Tests (6)

  • Diagnosis is confirmed on biopsy taken at upper endoscopy
  • CT of the chest, abdomen and pelvis maps disease extent and possible metastases
  • Endoscopic ultrasound assesses depth of tumor invasion and samples suspicious nodes
  • PET scanning checks lymph node involvement and finds occult metastatic disease
  • Diagnostic laparoscopy looks for hidden peritoneal spread in advanced junctional or gastric tumors
  • Bloodwork commonly shows iron deficiency anemia from ongoing tumor blood loss

If not this — what else fits (8)

  • GERD produces similar heartburn and dysphagia; endoscopy with biopsy distinguishes it from cancer
  • Eosinophilic esophagitis causes similar dysphagia and chest pain; biopsy confirms it and excludes malignancy
  • Esophageal motility disorders such as achalasia cause similar dysphagia and chest pain; manometry with endoscopy tells them apart
  • Benign strictures from longstanding GERD, radiation, or caustic injury mimic the dysphagia and weight loss; biopsy on endoscopy separates them from cancer
  • Infectious esophagitis (viral, fungal, or bacterial) causes similar odynophagia and dysphagia; endoscopy with biopsy and microbiology pin down the cause
  • Esophageal tuberculosis is a rare mimic; biopsy with acid-fast staining and culture confirms it
  • Esophageal leiomyoma, a benign smooth-muscle tumor, can cause similar dysphagia and chest pain; EUS characterizes it and biopsy confirms it
  • Esophageal diverticula cause similar dysphagia, regurgitation, and halitosis; barium swallow and endoscopy rule out malignancy

SourceStatPearls "Esophageal Cancer" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Presents with progressive difficulty swallowing. GP recognises this red-flag symptom, supports nutrition and acid suppression, and refers urgently for endoscopy. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Presents with progressive difficulty swallowing. GP recognises this red-flag symptom, supports nutrition and acid suppression, and refers urgently for endoscopy.

Cautions
  • RED FLAG - Hematemesis, melena, or profound iron deficiency anemia: assess urgently and refer.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Warning signs requiring prompt evaluation include odynophagia (painful swallowing) and weight loss in addition to dysphagia.
  • RED FLAG - Progressive difficulty swallowing, solids first and then liquids.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.