Cancer of the Esophagus (cont.)
Esophageal Cancer 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.
- Endoscopic ultrasound: Pictures created with sound waves passed through
the endoscope can help to determine the depth of invasion of the cancer and
the status of the surrounding tissues, including lymph nodes.
- 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
- PET scan in combination with CT scan
- Nuclear bone scans
Medically Reviewed by a Doctor on 7/28/2014
Robert J Fingerote, MD, MSc, BSc
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
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