Esophageal Cancer Stage 4B - no symptoms

My husband has stage 4B esophageal cancer.   Tumour is in the lower third of the esophagus and has broken through the wall.  There is lymph node involvement in the abdomen and bone mets to the arm.  The bone mets is the only symptom of cancer and it took 2 months after diagnosis of the bone cancer to find the esophageal cancer.  Now we are told 3 - 5 months without treatment; 8 - 10 with chemo.  My question is how can this be that he has such a short time yet he has absolutely no symptoms from the esophagus?  Is there going to be a sudden onset of those symptoms or what?  It is just a little confusing.  My mother passed 6 months ago with PC and she was symptomatic immediately before the diagnosis and very quickly after.  We are not experiencing any symptoms other than the bone mets.  Please advise.

[Fernando Roque, MD]

Hi. When your doctor told you that your husband had 3-5 months to live without treatment, and 8-10 months with chemotherapy, he is merely talking about the average duration of survival for the population of patients who have Stage 4 esophageal cancer.  Whether these statistics are going to apply to your husband or if he's going to prove to be one of the exceptions is something that's not easy to predict.  I've had patients with stage 4 esophageal cancer who have lived well beyond 10 months, and maybe with luck, and prayers, your husband will do the same.  What I can tell you is that his present "asymptomatic" state is no indication that he's going to survive longer.  Sometimes, cancer symptoms start occurring only when a certain "threshold" is reached. For example, once the tumor reaches a certain size, only then does it begin metastasizing to other body parts and causing symptoms which can develop rapidly. Your husband's present state may be deceiving.

[Dennis MD]

Hi.
I'm sorry to hear about your husband's condition.
Esophageal cancer typically presents with symptoms of dysphagia (difficulty in swallowing) and weight loss.  Other symptoms of esophageal cancer are painful swallowing, dull chest pain, cough, hoarseness, bone pains from bone metastasis. However, there are times when patients will not report any symptoms unless the disease is in the advanced stage.  
For now, it would be best to weigh all your options, particularly the risks and benefits of treatment.  A thorough discussion with your husband's oncologist is warranted.
Good luck.

[Juhi692]

There are a number of symptoms of esophageal cancer: Difficulty swallowing, feeling as if food gets stuck in your throat, sudden weight loss, and pain in the chest or throat are all common. These symptoms are caused by tumor growth in the esophagus, which can block the movement of food into the stomach, leading to pain and discomfort while eating. These symptoms often do not arise until the tumor has become large and the disease has advanced.
http://www.justcancer.org/esophageal-cancer-symptoms.html