Diagnosis

The best diagnosis is based on findings from an endoscopic examination of the esophagus.

• This study may be carried out either in a hospital or in a doctor's office.



• The doctor administers a topical anesthetic to the throat to suppress the gag reflex. Doctors frequently give intravenous (IV) sedation just before the procedure.



• The doctor then inserts an endoscope into the esophagus. An endoscope is a thin, flexible plastic tube that contains fiberoptic bundles.
  
  
  • Using a tiny camera in the endoscope, the doctor searches the surface of the esophagus for areas of concern.
  
  
  
  • Doctors define esophageal tumors in terms of their size and location.
    
    
    • Stage I - Tumor limited to the top layers of the cell lining
    
    
    
    • Stage II - Tumor extending deeper into muscle layers of the esophagus or into adjacent lymph nodes
    
    
    
    • Stage III - Tumor extensively involving the wall of the esophagus, adjacent tissues, or lymph nodes
    
    
    
    • Stage IV - Tumor involving distant parts of the body (metastases) and may involve the liver, lungs, brain, or bones
  
  
  • These factors are important in determining the stage of the cancer and treatment options.
  
  
  
  • The doctor can take biopsies to confirm whether the abnormality is a cancer and to determine its type.


• Upper gastrointestinal (GI) barium contrast studies help the doctor to detect cancers but may fail to detect small tumors more easily seen through endoscopy.



• Once the presence of cancer has been confirmed, the doctor tries to determine the spread of the malignancy beyond the esophagus. Doctors may use the following imagery:
  
  
  • CT scan of the chest and abdomen
  
  
  
  • Chest x-ray film
  
  
  
  • Nuclear bone scans

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Esophageal Cancer - Symptoms and Signs

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