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Home >> Mercy Cancer Institute >> Esophageal Cancer >> Diagnosing Esophageal Cancer

Diagnosing Esophageal Cancer
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In many cases, symptoms of esophageal cancer do not appear until the disease is in a more advanced stage, making early diagnosis difficult. In addition, like with most diseases, individuals may experience different symptoms. The following are some common symptoms of esophageal cancer:
  • Difficult or painful swallowing: A condition known as dysphagia is the most common symptom of esophageal cancer and gives a sensation of having food lodged in the chest. Individuals with dysphagia often modify their diet to include softer foods to help with swallowing
  • Pain in the throat or back, behind the breastbone or between the shoulder blades
  • Severe weight loss
  • Hoarseness or chronic cough that does not go away within two weeks
  • Vomiting
  • Coughing up blood
  • Persistent heartburn
The symptoms of esophageal cancer may resemble other medical conditions or problems, so it is important to talk to your doctor to ensure a proper diagnosis.
 
There is no routine screening examination for esophageal cancer; however, persons with Barrett's esophagus should be examined often because they are at greater risk for developing the disease.
 
How is esophageal cancer diagnosed?  In addition to a complete medical history and physical examination, diagnostic procedures for esophageal cancer may include the following:
  • Chest X-ray: a diagnostic test using invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film
  • Upper GI (gastrointestinal) series (also called barium swallow): a diagnostic test that examines the organs of the upper part of the digestive system; the esophagus, stomach and duodenum (the first section of the small intestine). Barium fluid (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray) is swallowed. X-rays are then taken to evaluate the digestive organs
  • Esophagogastroduodenoscopy (also called EGD or upper endoscopy): a procedure that allows your physician to examine the inside of the esophagus, stomach and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach and duodenum. The endoscope allows your physician to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy
  • Computed Tomography scan (CT or CAT scan): a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images, both horizontally and vertically, of the body.
  • Endoscopic ultrasound: this imaging technique uses sound waves to create a computer image of the inside of the esophagus and stomach. The endoscope is guided into the mouth and throat, then into the esophagus and the stomach. As in standard endoscopy, this allows your physician to view the inside of this area of the body, as well as insert instruments to remove a sample of tissue
  • Thoracoscopy and laparoscopy: these methods allow your physician to examine the lymph nodes inside the chest or abdomen with a hollow, lighted tube and remove these nodes for further testing
  • Fiberoptic Bronchoscopy: a flexible fiberoptic bronchoscopy may be performed to assess whether the airway is affected by esophageal cancer. A flexible camera is inserted into the larger airways, projecting back an image for your physician to view on a large screen. Lesions or compression of the airway from the cancer may be seen on the screen. If the esophageal cancer goes in to the airways, surgery may not be the recommended treatment
  • PET Scan (Positron Emission Tomography): an imaging study used to evaluate whether the tumor has spread and if there are enlarged lymph nodes that may potentially have cancer. A PET scan shows areas in the body where high levels of glucose (sugar) are being used. A PET scan does not show the esophageal walls very well so it is not used to determine the size and position of a lesion in the esophagus
ESOPHAGEAL CANCER