How We Diagnose and Stage Esophageal Cancer

Esophageal Cancer Diagnosis
A timely and accurate detection of esophageal cancer is essential to planning the best course of treatment. In addition to a routine physical examination, City of Hope doctors may also use the following tests to diagnose esophageal cancer, as well as pre-cancerous conditions such as Barrett’s esophagus:
  • Endoscopic ultrasound: City of Hope is a leader in the use of this highly sensitive detection method, which uses a probe in combination with sound waves to obtain detailed internal images of the esophagus. If a suspicious growth is found, it can then be biopsied for further evaluation.
  • Esophagoscopy: In this procedure, a thin, flexible camera is inserted into the esophagus. It is equipped with a tool to obtain tissue samples for further evaluation.
  • Biopsy: Abnormal-looking cells of the esophagus are removed and checked by a pathologist for cancerous signs. In addition to detecting esophageal cancer, this test can also spot pre-cancerous changes in the esophagus cells.
Other tests that may be used for diagnosis or further evaluation include chest X-rays, computed tomography (CT/CAT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans.
Staging Esophageal Cancer
To properly plan for treatment, esophageal cancer patients are staged in accordance to how advanced the disorder is. This is primarily done by taking a number of factors into consideration, including:
  • Size of the tumor
  • Grade of the tumor, which predicts how slow or fast it is growing
  • If the tumor have grown into or through the muscle and connective tissue layers of the esophagus
  • Whether the cancer has spread to nearby lymph nodes and how many lymph nodes are affected
  • If the cancer has spread to adjacent organs and tissues, such as the diaphragm, lungs, spine, aorta or membrane surrounding the heart
  • If the cancer has metastasized to distant organs, such as the bone or kidney
Based on these factors, patients are staged according to their risk level, with higher risk patients typically requiring more intensive treatments.
More information on esophageal cancer staging criteria is available on the National Cancer Institute’s website.
If you have been diagnosed with esophageal cancer or are looking for a  second opinion consultation about your treatment, find out more about  becoming a patient or contact us at 800-826-HOPE.