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Medical Author:

Robert J Fingerote, MD, MSc, BSc

Medical Editor:

Scott H Plantz, MD, FAAEM

Medical Editor:

Francisco Talavera, PharmD, PhD

Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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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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