Oesophageal cancer
A 58-year-old man presents with difficulty swallowing (dysphagia) that has progressively worsened over the past three months. Initially, he had trouble swallowing solid foods, but now even liquids cause discomfort. He reports significant unintentional weight loss of about 10 kg during this period. The patient describes a sensation of food getting "stuck" in his chest and occasional chest pain. He has also experienced episodes of regurgitation, and a persistent cough, especially at night.
His medical history includes a long-term habit of smoking (30 years) and regular alcohol consumption. He denies any history of acid reflux or prior gastrointestinal issues. On physical examination, the patient appears thin and slightly dehydrated but otherwise has no significant abnormal findings.
An upper gastrointestinal endoscopy reveals a partially obstructing lesion in the lower third of the oesophagus. Biopsies taken from the lesion confirm the presence of oesophageal squamous cell carcinoma. Further imaging, including a CT scan of the chest and abdomen, shows local invasion but no distant metastasis.
The patient is referred to an oncologist for further evaluation and treatment planning, which includes considerations for a combination of surgery, chemotherapy, and radiation therapy based on the stage of the disease.
a). Chest pain
b). Difficulty swallowing
c). Persistent cough
d). Weight loss
a). Smoking and alcohol consumption
b). High-fat diet and sedentary lifestyle
c). Obesity and acid reflux
d). Family history of gastrointestinal issues
a). Adenocarcinoma
b). Squamous cell carcinoma
c). Small cell carcinoma
d). Large cell carcinoma
a). Chest X-ray
b). CT scan
c). Endoscopy with biopsy
d). Barium swallow
