Diagnosis
If you have symptoms of esophageal cancer, your doctor will conduct a physical exam and ask about your risk factors. If he or she thinks esophageal cancer might be present, your doctor will order additional diagnostic tests and biopsies. Here are some tests commonly used in diagnosing esophageal cancer.
Barium swallow
For this test, you will drink a chalky liquid called barium and undergo a series of X-rays. The barium coats the lining of your esophagus and clearly outlines it on the X-rays, making it easy for your doctor to identify any abnormalities.
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Computed tomography (CT) scan
For a CT scan, you will lie flat on a table while a machine rotates around your body and takes pictures. It produces detailed cross-sectional images of your body and allows doctors to study specific areas. Doctors commonly use CT scans to assess cancer spread and find its exact location in the esophagus.
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Magnetic Resonance Imaging (MRI) Scan
Magnetic resonance imaging (MRI) uses radio waves and a strong magnet to create clear and detailed images of body parts. Radio waves are absorbed by your body and then released in a certain pattern, which is translated by a computer in order to show "slices" of your body. An MRI is only obtained if the patient cannot undergo CT scan.
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Positron emission tomography (PET) scan
Doctors use PET scans when they think the cancer might have spread but do not know where. The picture is not as detailed as a CT or MRI scan but can show the whole body and help spot areas of cancer spread.
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Upper Endoscopy (EGD)
An endoscope is a thin tube with a camera and light on the end. In this procedure, the doctor inserts an endoscope through the nose or mouth and guides it into the esophagus. The endoscope is used to examine the esophagus and remove any suspicious tissue samples. Your doctor may also perform a bronchoscopy or laryngoscopy to check for cancer spread. In these procedures, the doctor uses an endoscope to visualize the lungs, windpipe, larynx, or lymph nodes.
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Endoscopic ultrasound (EUS)
For this procedure, your doctor will use an endoscope with an ultrasound device at the end of the tube. This device sends out high-energy sound waves to make images of the esophagus, like a bat or dolphin using echolocation to navigate in hard to see areas. This technology allows the doctor to see into the wall of the esophagus to determine how deep the tumor has grown and whether it has invaded the lymph nodes.
Biopsy
If any of these diagnostic tests indicate that you might have cancer, your doctor will conduct a biopsy to be certain. Your doctor will remove a tissue sample and have a pathologist examine it under a microscope to determine if it contains cancer cells. A biopsy is the only way to know for sure whether or not you have cancer. Your doctor will most likely take a biopsy sample while performing an endoscopy. If your doctor notices an abnormality during the procedure, he will pass a special tool through the endoscope and use it to take a tissue sample.
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Endoscopic Mucosal Resection(EMR)
This is a method of completely removing the tumor area using an endoscope. It is typically an outpatient procedure and requires no incisions on your body. This technique is only utilized in very early staged tumors, and it helps to determine the aggressiveness of the tumor and treat the tumor as well. Often this information will allow your doctor to make more precise recommendations pertaining to the treatment of your tumor.
