Diagnosis & staging
Diagnosis
These are tests that may be used to diagnose this type of cancer.
- Barium swallow test: a liquid is swallowed to help the esophagus show on x-rays. The barium drink is not radioactive.
- Endoscopy: using a small medical camera on an endoscope (tube) to see inside the esophagus without surgery
- Biopsy: surgery to take a sample of the area or growth, which is examined for cancer
- Once a diagnosis of esophagus cancer is confirmed, then the doctors need to check and see if the cancer has spread. These are some of the tests that may be done:
- CT scan
- Endoscopic ultrasound of the surrounding tissue
- Bronchoscopy may be required to see if tumour is invading patient's airway
- Mediastinoscopy may be necessary to assess lymph nodes
- Laparoscopy may be helpful to assess presence of intra-abdominal spread or liver involvement
- PET scan is sometimes useful
For more information on tests used to diagnose cancer, see our Recommended Websites, Diagnostic Tests section.
Types and Stages
Types
- Squamous cell cancer develops in the squamous cells that line the esophagus.
- Squamous cell cancer usually develops in the middle or upper part of the esophagus.
- Adenocarcinoma develops in the glandular cells in the lower part of the esophagus.
Stages
Staging describes the extent of a cancer. The TNM classification system is used as the standard around the world. In general a lower number in each category means a better prognosis. The stage of the cancer is used to plan the treatment.
-
T describes the site and size of the main tumour (primary)
-
N describes involvement of lymph nodes
-
M relates to whether the cancer has spread (presence or absence of distant metastases)
-
Stage 0
Very early cancer; has not spread below the lining of the first layer of esophageal tissue -
Stage I
Tumour involves inner lining only -
Stage II
Tumour may involve entire wall or may involve nodes and inner lining only -
Stage III
Tumour involves entire wall and lymph nodes -
Stage IV
Metastases (tumour has spread outside the esophagus)