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Diagnosis of Esophageal Cancer
Suspicion of Esophageal Cancer
- Blood tests—Certain substances are released into the blood when a tumor develops. These tumor markers may be elevated in the presence of cancer.
- Barium swallow —Contrast material is swallowed and x-rayed. The barium makes it easier to see abnormalities.
- Imaging tests—To assess internal structures for the presence and location of tumors. Imaging tests may include:
- Upper GI endoscopy —A tube with a lighted tip and camera is inserted through the mouth and throat. The scope is threaded down the esophagus and into the stomach and first part of the small intestine to look for any abnormalities. Any abnormal tissue will be removed and examined under a microscope.
Diagnosis of Esoghageal Cancer
Staging of Esophageal Cancer
- Blood tests
- Microscopic evaluation of tissue samples—To look for genetic characteristics.
- Imaging tests—To help determine how deep the tumor has moved into the layers of the esophagus or nearby structures. They may also help to determine if there are any metastatic growths in other areas of the body. Imaging tests may include:
- Endoscopic ultrasound
- CT scan
- PET scan
- MRI scan
- Chest x-rays
- Endoscopy, bronchoscopy (to examine lungs), and thoracoscopy (to examine chest cavity)—To carefully look for and remove any suspicious tissue for closer examination under a microscope.
- Stage 0—High grade dysplasia—Abnormal cells are found only in the innermost 2 linings of the esophagus, the mucosa and submucosa.
- Stage IA—Grade 1 (less aggressive) cancer cells are found in the mucosa OR submucosa.
- Stage IB—Grade 2 and 3 cancer cells (more aggressive) are found in the mucosa or submucosa OR grade 1 cancer cells are found in the mucosa or submucosa AND have spread TO the muscle layer or adventitia. The tumor location may be unknown or in the lower esophagus.
- Stage IIA—Grade 1 cancer cells have spread TO the muscle layer or adventitia. The tumor is in the middle or upper esophagus OR Grade 2 and 3 cancer cells have spread TO the muscle layer or adventitia. The tumor location may be unknown or in the lower esophagus.
- Stage IIB—Cancer has spread TO the muscle layer or adventitia. The tumor is in the middle or upper esophagus OR cancer from the mucosa or submucosa has spread TO the muscle layer AND to 1-2 nearby lymph nodes.
- Stage IIIA—Cancer in the mucosa or submucosa MAY spread into the muscle layer AND to 3-6 nearby lymph nodes OR has spread TO the adventitia AND to 3-6 nearby lymph nodes OR has spread TO the diaphragm (separates the abdominal and chest cavities), pleura (tissue that lines the lungs), or the pericardium (the sac that surrounds the heart).
- Stage IIIB—Cancer has spread INTO the adventitia AND to 3-6 nearby lymph nodes.
- Stage IIIC—Cancer has spread INTO the diaphragm, pleura, or pericardium AND to 1-6 nearby lymph nodes OR nearby organs OR to 7 or more nearby lymph nodes.
- Stage IV—Cancer has spread to other parts of the body through the lymph and blood streams. The most common sites for metastatic esophageal cancer are lymph nodes in other parts of the body, the lungs, liver, kidney, and bones.
- Reviewer: Mohei Abouzied, MD
- Review Date: 12/2016
- Update Date: 12/16/2015