How We Diagnose Esophageal Cancer

Diagnostic tests are needed to determine whether symptoms are, in fact, esophageal cancer. If cancer is found, additional tests may be used to assess the stage of the disease, specifically, how advanced the cancer is, and whether it has metastasized (spread outside the esophagus).

City of Hope diagnostic and staging tests include:
  • Chest X-ray:  Rays of energy that can pass through organs and bones inside the chest are used to expose film, making an image of areas within the body.
  • Barium swallow/Upper GI series: A series of X-rays is taken after the patient drinks a liquid to improve the visualization of the inside of the upper gastrointestinal tract.
  • Esophagoscopy: Doctors examine the esophagus directly using an esophagoscope (a thin, lighted tube). Sometimes, tissue samples are taken for a biopsy.
  • Bronchoscopy: A thin, lighted tube called a bronchoscope is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for a biopsy.
  • Laryngoscopy: The larynx (voice box) is examined using a mirror or a thin, lighted tube called a laryngoscope.
  • Endoscopic ultrasound: A thin, lighted tube called an endoscope is guided into the esophagus. The device emits ultrasound waves that create images of structures inside the esophagus.
  • Thoracoscopy: This procedure is used in staging. An incision is made between two ribs, and a thin, lighted tube called a thoracoscope is inserted into the chest. Tissue samples and lymph nodes may be removed for biopsy.
  • Laparoscopy: This surgical staging procedure is used to examine internal organs. An incision is made in the abdominal wall and a thin, lighted tube called laparoscope is inserted into the abdomen. Tissue samples and lymph nodes may be removed for biopsy.
  • CT or CAT (computerized axial tomography) scan: This procedure uses a computer connected to an X-ray machine to obtain detailed pictures of areas inside the body. A dye may be used to help visualize organs or tissues more clearly.
  • PET (positron emission tomography) scan: PET is used to identify malignant cells. First, a small amount of radionuclide glucose (sugar) is injected into a vein, and then the scan begins. Cancer cells take up more glucose than normal cells and appear brighter in the scan.