How is esophageal cancer diagnosed?

The doctor will ask you about your medical history, including your current symptoms. After a physical examination, the doctor might order certain tests that can help in diagnosing and assessing esophageal cancer.

  • Barium swallow uses a special series of X-rays to visualize the esophagus. The patient drinks a liquid containing barium, which makes the esophagus easier to see on the X-ray.
  • Esophagoscopy is a procedure that allows the doctor to look at the inside of the esophagus using a thin, lighted tube called an endoscope. For the test, the endoscope is passed through the mouth and down the throat into the esophagus while you are asleep. The endoscopy can also be used to relieve obstruction. The doctor can insert a balloon to dilate an obstructed esophagus. Looking at the esophagus and the upper part of the stomach is called an upper endoscopy.
  • Biopsy: During the esophagoscopy, the doctor may remove a small piece of tissue to examine under a microscope to see if there are any cancer cells.
  • Esophageal endoscopic ultrasound uses sound waves to create images of internal structures. In this procedure, the ultrasound is performed through the esophagoscope.
  • Computed tomography (CT) is often used to evaluate the extent of the tumor spread to the chest and abdomen.

How is esophageal cancer classified?

Most cancers are grouped by stage, a description of the cancer that aids in planning treatment. The stage of a cancer is based on the location and depth of the tumor; the involvement, if any, of the lymph nodes; and the degree that the cancer has spread, if at all, to other tissue and organs.

In addition to staging the cancer, tumors may also be graded. Grading is a way of rating a tumor based on how much its cells look and act like normal cells. Tumor grading can also tell the doctor how fast the tumor is growing. Tumors with almost normal-looking cells that grow slowly are called low-grade tumors. Tumors with very abnormal-looking cells that divide rapidly are called high-grade tumors. High-grade tumors are more likely to spread than low-grade tumors.

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