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Stage 4 esophageal cancer is the most advanced of five stages of the disease, which are ranked numerically from zero. At this stage, the tumor in the esophagus is large enough to impede comfortable eating, drinking, and breathing. By stage 4 of the disease, tumors have also usually spread to several other parts of the body.
It is common for esophageal cancer to be first diagnosed in its later stages as its symptoms are difficult to detect earlier. For this reason, esophageal cancer is often fatal. Once the cancer has progressed to stage 4, the chances of the patient surviving more than a few years are extremely unlikely.
Symptoms of stage 4 esophageal cancer include hoarseness, swallowing difficulties, and abnormally high incidents of hiccuping. Some patients also vomit blood. Most symptoms are the result of physical discomfort caused by the tumor.
A patient with stage 4 esophageal cancer will usually experience pain while eating. Dramatic weight loss in patients with the disease is often as much the result of this physical pain as it is of other factors of the disease. It may also be difficult for food to move around a larger tumor.
Once a patient has advanced to stage 4 esophageal cancer, the tumor is usually too large to be removed via surgery. Most doctors will resort to palliative care, in which the disease is slowed and treated as much as possible, with very little anticipation of cure. At this point, increasing the patient’s comfort is the priority.
About half of most patients with advanced esophageal cancer will be eligible for palliative treatments. Radiation and chemotherapy are commonly administered at this stage of the disease. Some doctors will attempt to break down the tumor by sending an electrical current into the tissue via a wire in a process called electrocoagulation. Another common treatment is the placement of stents via endoscopy in order to open more breathing space for the patient. Many doctors will also prescribe a special diet in order to ensure that the patient receives proper nutrition despite the physical difficulties of eating and drinking.
In most cases, electrocoagulation, radiation, and chemotherapy, whether combined or used separately, will only slow the growth of the tumor. Though it is rare, occasionally treatment will shrink a tumor enough so that an attempt can be made to remove it. This procedure may still not be sufficient to sustain life as the cancer will have often spread to other parts of the body by this stage.