Stage 4 esophageal cancer means that cancer has spread from the esophagus to the surrounding organs, or other parts of the body, and the nearby lymph nodes. Treatment usually focuses on therapies rather than surgery.

There are different types of esophageal cancer. These include squamous cell carcinoma and adenocarcinoma. Doctors can determine the stage based on the type of cancer, its location, and other factors.

This article looks at stage 4 esophageal cancer, its symptoms, treatment options, method of diagnosis, and survival rates.

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Typically, esophageal cancer in its earlier stages (stage 1 and stage 2) remains localized in one area of the esophagus and does not usually produce any symptoms.

When esophageal cancer reaches stage 3, cancer has spread to the nearby lymph nodes but not to other organs.

Stage 4 is the end stage of esophageal cancer.

By stage 4, the cancer may have spread to other parts of the body, including:

Learn more about what happens when cancer spreads to the lymph nodes.

Stage 4 esophageal cancer symptoms may include:

If a person experiences one or more of these symptoms, it does not mean they have stage 4 esophageal cancer. These symptoms have links with many other conditions. However, people might want to talk with their doctor for advice or a diagnosis.

Learn more about the symptoms of esophageal cancer.

When esophageal cancer reaches stage 4, it has likely spread to nearby lymph nodes and other areas of the body. Surgery is not usually a suitable option for treating this stage of cancer.

For this reason, the treatment options for stage 4 esophageal cancer may include the following:

Talking with their doctor about their treatment options can help a person make an informed decision about their treatment plan.

Learn about the difference between chemotherapy and immunotherapy.

Doctors typically perform blood tests and a biopsy so they can analyze part of the suspected cancerous tissue.

If the results of these tests suggest cancer, doctors may also perform imaging tests to diagnose stage 4 esophageal cancer.

These tests may include:

  • Barium swallow test: During this test, a person swallows a thick liquid called barium and has an X-ray exam. This exam can outline any atypical formation in the esophagus, but it cannot determine if cancer has spread elsewhere.
  • CT scan: This exam can produce a picture of the human body and determine if cancer may have spread to other areas of the body.
  • MRI scan: This test can examine the soft tissues of the body. Doctors may use an MRI scan to investigate if cancer has reached the spinal cord or the brain.
  • PET scan: A person often has this test in combination with a CT scan. Doctors typically inject radioactive material into the cancerous cells inside the person’s body. This can help determine if cancer has spread.
  • Endoscopy: During this test, the doctor will insert a tube with a camera into the esophagus and in other areas where cancer may have spread. An endoscopy can help diagnose esophageal cancer and identify how far it has spread.

Learn whether a blood test can diagnose cancer.

Survival rates for stage 4 esophageal cancer vary from person to person.

The following table shows the survival rate of esophageal cancer in its different stages, according to the National Cancer Institute’s SEER program.

Stage of cancer5-year survival rate
Stage 1–2 (localized)47.3%
Stage 3 (regional)26.3%
Stage 4 (distant)5.7%

Survival rate

The survival rate refers to the proportion of people who are still alive for a length of time after receiving a particular diagnosis. For example, a 5-year survival rate of 50% means that 50%, or half, of the people are still alive 5 years after receiving the diagnosis.

It is important to remember that these figures are estimates and are based on the results of previous studies or treatments. A person can consult a healthcare professional about how their condition is going to affect them.

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Learn more about stage 4 cancer survival rates.

Stage 3 esophageal cancer does not always progress to stage 4. An early diagnosis and prompt treatment can help improve the outcomes of this condition.

If a person notices any potential symptoms of esophageal cancer or other unusual changes in their health, it might be a good idea to talk with their doctor.

The doctor can determine whether they require cancer screening based on their symptoms and medical history.

Learn more about the stages of cancer.

Stage 4 is the last stage of esophageal cancer, when cancer has spread to the lymph nodes and other organs, such as the lungs or liver.

People with stage 4 cancer may experience various symptoms, such as difficulty swallowing and chest pain. If a person notices any changes in their health or experience any potential signs of esophageal cancer, it is a good idea to talk with their doctor.

Treatment for stage 4 esophageal cancer usually includes chemotherapy and radiation therapy. A prompt diagnosis and treatment may help improve the outcome of esophageal cancer.

Learn more about all types of cancer in our dedicated hub here.