Making the Diagnosis
If other causes for the symptoms have been ruled out and esophageal cancer is suspected, your doctor may review your medical history, perform a physical exam, and do some of the following tests:
- barium swallow - this involves swallowing barium, which is then tracked by an X-ray
- endoscopy - this involves inserting an endoscope (a tube with a light and camera) into the throat so that your doctor can see the lining of the esophagus
- biopsy - while using the endoscope, your doctor may take some tissue from inside the esophagus to send it for microscopic evaluation
If a diagnosis of cancer has been made, the next step is to discover the stage (i.e., how far the cancer has progressed). This will involve:
- blood tests
- a chest X-ray
- computed tomography (CT) imaging scans of the chest and liver, which will show any tumors or other abnormalities
- ultrasounds of both the liver and chest, including an endoscopic ultrasound to help determine treatment options
The stages are:
- Stage 0 – very early cancer, found only in the first layer of the lining
- Stage I – cancer is still early in development, is in a small part of the esophagus but hasn't spread
- Stage II – cancer has spread deeper into the esophagus and may have invaded the lymph nodes near the esophagus
- Stage III – cancer has spread even deeper in the esophagus wall or has spread to nearby tissues and lymph nodes
- Stage IV – cancer has spread to other parts of the body (usually the lungs or liver, although it may spread to other body areas as well)
- Recurrent – cancer that has returned after treatment