Diagnosing Esophageal Cancer

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The first signs of esophageal cancer are usually its symptoms, which could range from difficulty swallowing and hoarseness to pain in the middle of the chest and unexpected weight loss. Unfortunately, these symptoms usually only show up once the cancer has entered its more advanced stages. Routine checkups are the best way to identify cancer of the esophagus early, when treatments are most effective.

Tests for esophageal cancer include:

• Chest x-ray: An ordinary x-ray can usually identify cancerous tissue in the esophagus. The cancer shows up as darker spots on the film.
• Barium swallow: The patient is asked to drink a liquid that contains barium, a silver-white metallic compound. The liquid coats the esophagus and stomach, which helps the x-ray identify abnormalities. This procedure is often referred to as a GI procedure.
• Biopsy: Once sample tissue is removed from the esophagus, it is checked by a pathologist for cancer. This is known as a biopsy. Even if cancer isn't present yet, a biopsy can show changes in the esophagus that may lead to cancer.
• Endoscopic Ultrasound (EUS): Increasingly, FHCI is using endoscopic ultrasound to assess certain esophageal diseases in a cost effective, nonsurgical manner. A highly trained endoscopist guides a thin, flexible tube down the mouth. A transducer on the end emits ultrasound waves that create a highly detailed image of the surrounding tissue. When combined with fine-needle aspiration, EUS is also a highly advanced method of performing exploratory surgery to remove tissue samples as well for further testing.
• Esophagoscopy: To view potential cancerous regions visually, an esophagoscope is inserted through the mouth or nose into the esophagus. The scope may have special tools attached that allow tissue to be removed so it can be checked under a microscope for the presence of cancer.

Esophageal Cancer Staging

If these tests show that cancerous cells are indeed present in the esophagus, your doctor will stage the cancer. This staging is based on the location of the cancer and how much it has spread. Staging helps the FHCI medical team determine the ideal course of treatment.

Stage 0: In Stage 0 of esophageal cancer, abnormal cells are found in the innermost layer of tissue lining the esophagus. The cells are not yet cancerous, but could become cancer in the future and spread into nearby tissue. This stage is often referred to as carcinoma in situ.

Stage I: In this stage cancer has actually formed and has spread beyond the innermost layer of tissue into the next layer of tissue in the wall of the esophagus.

Stage II-A: In Stage II-A, the cancer has spread to the muscle layer of the esophagus or to the outer wall.

Stage II-B: Cancer has spread to any of the first three layers of the esophagus in Stage II-B as well as the nearby lymph nodes.

Stage III: In this stage, cancer has spread into the outer wall of the esophagus. It ma have also spread into the tissues or lymph nodes near the esophagus as well.

Stage IV-A: When cancer has spread to nearby or distant lymph nodes, it is referred to as Stage IV-A.

Stage IV-B: This is the most advanced stage and notes that cancer has spread to distant lymph nodes and/or organs in other part of the body.

Obviously, the sooner your esophageal cancer is diagnosed, the sooner treatment can begin. Regular checkups with your doctor can help identify changes in your health that may warrant more in-depth tests for esophageal cancer at the Florida Hospital Cancer Institute.

Contact us now to schedule an appointment with Florida Hospital Cancer Institute.