Diagnosis of Esophageal Cancer

  • Andrew Bain, MD, Chief of Endoscopy, discusses diagnostic testing with a esophageal cancer patient.

Diagnostic and Staging Tests

Esophageal cancer is fairly aggressive. Dr. Hochwald explains the importance of collaborative care when diagnosing and treating this disease.

The best treatment decisions for patients with esophageal tumors are contingent on state-of-the art imaging and diagnostics such as:

  • Upper endoscopy: After numbing your throat with an anesthetic spray, a thin, lighted tube (endoscope) is passed through your mouth or nose into the esophagus.
  • Barium swallow: After drinking a barium solution, x-rays are taken of your esophagus and stomach. The solution highlights the esophagus on the x-rays. This test is also called an upper GI series.
  • Endoscopic ultrasound (EUS): Performed only at specialized centers, this procedure uses a tool similar to the endoscope, but with a small ultrasound device at the tip. EUS provides high-quality and detailed images useful for diagnosing and staging upper GI cancers. A needle may be used to tissue samples of lymph nodes.
  • Computed Tomography (CT) scan: An x-ray machine linked to a computer takes a series of detailed pictures of your chest and abdomen to learn whether the cancer has spread to lymph nodes and other areas. You may receive contrast material by mouth or by injection into a blood vessel, to highlight any abnormal areas.
  • Image-guided biopsy: Performed with the assistance of an ultrasound machine or CT scan.
  • Magnetic Resonance Imaging (MRI) scan: A powerful magnet linked to a computer is used to make detailed pictures of areas inside your body to show whether cancer has spread to lymph nodes or other areas. Sometimes contrast material is given by injection into a blood vessel. The contrast material makes abnormal areas easier to see.
  • Positron Emission Tomography (PET) scan: You receive an injection of a small amount of radioactive sugar. The sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they use energy (sugar) faster than normal cells do. A PET scan shows whether esophageal cancer may have spread.
  • Laparoscopy: After you are given general anesthesia, the surgeon makes small incisions (cuts) in your abdomen. The surgeon inserts a thin, lighted tube (laparoscope) into the abdomen. Lymph nodes or other tissue samples may be removed to check for cancer cells. Sometimes staging tests are not complete until after surgery to remove the cancer and nearby lymph nodes.