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Diagnosis of Esophageal Cancer

The esophagus is a muscular portion of the digestive tract in which food passes through from the mouth to the stomach. The esophagus is about 10" long. Esophageal cancer is an abnormal growth of cells in the esophagus. Abnormal cells can clump together and form tumors that can be cancerous or non-cancerous. Metastasis happens when the cancer spreads from its original site and damages other organs and tissues. Esophageal cancer is diagnosed by a variety of tests and procedures, but not all tests will be indicated for everyone.

  1. Physician Exam

    • Your physician will assess you for risk factors, perform a physical exam, order blood work, and examine you for signs and symptoms of esophageal cancer. Signs and symptoms of esophageal cancer include a sensation that food is stuck in your throat, inability to swallow solid foods, pain or chest discomfort, painful swallowing, weight loss, hoarseness, hiccups and the presence of black stools. Your physician will order lab work to check for high blood calcium levels which can also be a sign of possible esophageal cancer.

    X-ray Tests

    • Your physician may order a barium swallow or a computed tomography (CT) scan. The barium swallow is usually the initial test used to diagnose cancer, but cannot be used to see if the cancer has spread beyond the esophagus. During a barium swallow test, the barium outlines the esophagus on an X-ray allowing your physician to see any irregularities in the esophagus surface.

      The CT scan is a more detailed X-ray that can allow your physician to see if the cancer has spread to other parts of body and help determine if surgery is an option for your situation. If your physician orders a CT scan with contrast you will have to drink one to two pints of a liquid contrast solution which will outline the esophagus and intestines.

    MRI Test

    • A magnetic resonance imaging (MRI) test uses radio waves and strong magnets to produce a detailed image of body tissues. In this type of test, you will be placed in a tube-like machine for as long as an hour--which may be a problem for someone who suffers from claustrophobia. Before this test, your physician may give you a medication to help you relax.

    Radioactive Particle Test

    • A positron emission tomography (PET) test is used to tell if cancer treatment is working, to see if the cancer is spreading and to find small deposits of cancer cells that may have been missed on other tests. A radioactive sugar is injected into a vein and, since cancer cells use sugar faster than normal tissues, the radioactive sugar will concentrate in areas of cancer.

    Endoscopy Test

    • An endoscopy is the visualization of body structures using a flexible, narrow tube with a light and video camera on the end. The camera is connected to a television set. An upper endoscopy is done under sedation. In this procedure, your physician passes the endoscope through your mouth and into your esophagus and stomach and is able to see abnormalities on a television screen.

    Biopsy

    • A biopsy is the only test to confirm that cancer cells are present in the esophagus. A biopsy is the removal of a small piece of questionable esophageal tissue. The tissue is sent to a laboratory for analysis. A tissue sample can be obtained by a fine-needle biopsy or a core needle biopsy. Certain tests like a CT scan or endoscopy may be performed along with a biopsy to ensure the correct area is sampled.

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