7) Hoarseness
This is not an early sign of esophageal cancer. Instead, it usually appears when the tumor has grown big enough and already caused alterations to the normal transit of food through the esophagus and the nerve reflexes in this part of the gastrointestinal tract. Hoarseness has to do with an alteration to the vocal cords or the structures directly in contact with them. Acid reflux is one of the possible explanations, which triggers both esophageal cancer in the long term and hoarseness as well. However, in more advanced cases of cancer, hoarseness is not caused by acid reflux but a spread of cancer cells to the nearby tissue.
When the tumor becomes large enough and starts spreading all over the area, they may also take the recurrent laryngeal nerve, a particular structure that is responsible for maintaining the muscular tone of the larynx. With an alteration to this nerve structure, the vocal cords would behave differently and patients would start having a hoarse voice.
