In addition to diagnosing the type of esophageal cancer you have, physicians will also examine you and your cancer’s cells to determine your cancer’s stage, which will help guide which treatment options are best for you. This takes the expertise of physicians from several subspecialties, including pathology, diagnostic radiology, gastroenterology and oncology.
Esophageal cancer staging
Adenocarcinoma and squamous cell carcinoma types are each staged differently, but both use the TNM staging system devised by the American Joint Committee on Cancer. This system classifies your cancer based on information about:
- The size of the tumor
- How many lymph nodes contain cancer
- Whether your cancer has spread to distant body areas, called metastasis
The pathologist will examine your tumor’s cells to determine how different they look from normal esophageal cells, and assign it a grade:
- GX means that the grade of the cancer cannot be determined from the sample
- Grade 1 means the cells still look similar to normal cells
- Grade 2 means the cells are somewhat different from normal cells
- Grade 3 means the cells are very different
Low-grade cancer cells (grade 1) tend to grow more slowly, whereas high-grade (grade 3) cancer cells are expected to grow faster.
Your cancer may be staged twice. Initially, before you begin treatment, your physician will assign the cancer a clinical or baseline stage. After you have surgery (and your surgeon and pathologist are able to learn more information about the tumor), your cancer is assessed again, called a pathological stage.
Adenocarcimoma esophageal cancer stages
This type of esophageal cancer is classified into five general stages, with substages identifying certain characteristics, such as the grade of the tumor:
- Stage 0 or adenocarcinoma means that abnormal cells (high-grade dysplasia) are found in the lining of the esophagus.
- Stage 1 adenocarcinoma means that the cancer is found in the first and possibly second or third layer of the esophageal wall, but no cancer is found in any nearby lymph nodes or distant body areas.
- Stage 2 adenocarcinoma means that the tumor may have grown further to the third or fourth layer of the esophageal wall, cancer may be found in up to one lymph node, but not an any distant sites.
- Stage 3 adenocarcinoma means that the tumor may be in any layer of the esophageal wall and possibly into the lining of nearby organs, the cells could be any grade, and cancer may be found in up to two nearby lymph nodes, but not in any distant sites.
- Stage 4 adenocarcinoma means the tumor has grown through the esophageal wall, and into nearby organs. The cells are any grade, may be found in nearby lymph nodes and possibly in distant body areas, such as the liver or lung.
Squamous cell esophageal cancer stages
This type of esophageal cancer is classified into five general stages, with substages identifying certain cell grades and location of the tumor at the top, middle or bottom of the esophagus:
- Stage 0 squamous cell carcinoma means that abnormal cells (high-grade dysplasia) are found in the lining of the esophagus.
- Stage 1 squamous cell carcinoma means that the cancer is found in the first and possibly second and third layer of the esophageal wall, but no cancer is found in any nearby lymph nodes or distant body areas.
- Stage 2 squamous cell carcinoma means that the tumor may have grown further to the third or fourth layer of the esophageal wall, cancer may be found in up to one lymph node, but not an any distant sites.
- Stage 3 squamous cell carcinoma means that the tumor may have spread through any layer of the esophageal wall and possibly into the lining of nearby organs, the cells could be any grade, and cancer may be found in up to two nearby lymph nodes, but not in any distant sites.
- Stage 4 squamous cell carcinoma means the tumor has grown through the esophageal wall, and into nearby organs. The cells are any grade, may be found in nearby lymph nodes and possibly in distant body areas, such as the liver or lung.