Esophageal Cancer Tests

How We Diagnose And Stage Esophageal Cancer

Timely and accurate detection of esophageal cancer is essential to planning the best course of treatment. After a thorough physical examination, City of Hope doctors may also use the following tests to diagnose esophageal cancer and precancerous conditions such as Barrett’s esophagus:

  • Endoscopic ultrasound: A highly sensitive detection method, using a probe in combination with sound waves to obtain detailed internal images of the esophagus. If a suspicious growth is identified, it can be biopsied for further evaluation.
  • Barium swallow/upper GI series: For this test, a patient swallows a liquid that contains barium, a silver-white compound that covers the inner lining of the esophagus. X-rays are then taken and examined for suspicious growths.
  • Esophagoscopy: In this procedure, a thin tubed instrument called an esophagoscope is inserted into the esophagus. It is equipped with a lighted lens used to examine the esophageal lining, along 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 precancerous changes in the esophagus cells.
  • Other tests that may be used for diagnosis or further evaluation include chest X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) or positron emission tomography (PET) scans.

Staging Esophageal Cancer

To properly plan for treatment, esophageal cancer patients are staged according to how advanced the disorder is. This is done while taking into consideration a number of factors, including:

  • Size of the tumor
  • Grade of the tumor (with grade 1 being the slowest growing and grade 3 being the fastest)
  • Whether 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, if so, the number of lymph nodes affected
  • If the cancer has spread to adjacent organs and tissues such as the diaphragm, lungs, spine, aorta or the membrane surrounding the heart
  • If the cancer has metastasized to distant organs such as the bone, liver or kidney

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.