Esophageal cancer (EC) is one of the most lethal cancers of the digestive tract, characterized by rapid progression, high recurrence, and poor survival rates despite advancements in treatment. Its tendency to metastasize to bone increases the disease burden by causing severe pain, disability, and psychological distress. The psychological distress, which frequently remains unrecognized, is a dimension that extends beyond the physical complications of bone metastasis. A recent study published in t