Esophageal Cancer

Diagnosis

The best cancer care begins with a comprehensive evaluation. At Mayo Clinic, the first step in evaluating esophageal cancer is usually an endoscopic examination of the esophagus (esophagoscopy). During this procedure, your doctor guides a thin, lighted tube called an endoscope down the esophagus and into your stomach. The endoscope provides a clear view of the esophagus and allows your doctor to remove a small sample of tissue (biopsy), which is sent to a pathologist for further study.

In some cases, you may have a barium X-ray, a test in which a chalky liquid (barium) is used to coat the lining of your esophagus so that the lining shows up clearly on a series of X-rays.

Staging tests

If you are diagnosed with esophageal cancer, you will need further tests to determine how deeply the cancer has penetrated into the layers of the esophagus and whether it has spread to your lymph nodes or other organs — a process called staging.

Mayo Clinic doctors use state-of-the-art, minimally invasive diagnostic techniques to stage esophageal cancer. Precisely identifying the extent and spread of the disease is a crucial step in selecting the appropriate treatment for each patient. Staging tests used at Mayo Clinic include:

• CT scans: The first step in staging esophageal cancer is usually a CT scan, a type of X-ray that produces images of your body in cross sections rather than in the overlapping images produced by conventional X-rays. Mayo Clinic offers the most advanced CT technology, which is faster, more sensitive and uses less radiation than do older CT scans.
• Positron Emission Tomography (PET) scan: Over the past decade, Mayo Clinic radiologists have performed thousands of PET scans. This test uses a small amount of radioactive glucose to identify rapidly growing cancer cells and detect changes that aren't visible by other methods. Mayo Clinic often combines PET scanning with CT scanning to further improve the accuracy of the images.
• Endoscopic ultrasound (EUS): During endoscopic ultrasound, a tiny ultrasound probe is placed into the esophagus through an endoscope. The probe produces sound waves that penetrate deep into tissue, detecting how far a tumor may have spread into the esophagus wall. EUS can be technically demanding, and produces the best results when performed by an experienced endoscopist. Mayo Clinic physicians have used this procedure for nearly two decades and perform more than 3,000 endoscopic ultrasounds every year.