Diagnosis

Wilmot Cancer Institute provides the full spectrum of esophageal cancer care, from the initial diagnosis and treatment to recovery and rehabilitation.

We work in multidisciplinary teams. Multidisciplinary means that our care providers include experts with a variety of specialties: surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, nurse practitioners, social workers, and clinical researchers. They work together on your case to provide the most personalized care possible.

Symptoms

Getting an accurate diagnosis is essential to getting the best treatment. Cancer of the esophagus is usually found because of symptoms, the most common being trouble swallowing or a feeling that food is stuck in the throat.  As swallowing becomes more difficult some people will unconsciously change their diet to include more liquids and softer foods.

It's important to check with a doctor if you have trouble swallowing, especially if any other symptoms are present such as weight loss without trying, pain in the chest behind the breastbone, hoarseness or a chronic cough, vomiting, hiccups and indigestion.

How is esophageal cancer diagnosed? 

Medical history and physical examination: This step includes a complete medical history and assessment of risk factors and symptoms. A doctor will also conduct a clinical exam to check for lumps or other signs of disease, paying special attention to the neck and chest.

Chest x-ray: Imaging tests such as x-rays use energy beams to make pictures of bones inside the body. Other imaging tests, such as CT scans, MRIs, and PET scans also provide detailed views of the esophagus and digestive system.

Upper gastrointestinal (GI) series: This involves drinking a chalky substance called barium that coats the lining of the esophagus, and then undergoing x-rays to look for cancer. This is often the first test used if a patient is having trouble swallowing. It can also be used to diagnose a serious complication of esophageal cancer, called a tracheo-esophageal fistula.

Upper endoscopy/esophagoscopy: Doctors pass a thin, lighted tube with a tiny camera into the esophagus to look for tumors. This is an important test because it gives information about the size and location of the tumor, to help determine if surgery is possible.

Biopsy: This involves removing cells or other tissue for further examination by a pathologist. Doctors can perform a biopsy using special instruments during an esophagoscopy.

Bronchoscopy: This also involves passing a lighted, flexible tube through the mouth or nose into the windpipe to look for cancer.

Thoracoscopy and laparoscopy: This is a more involved procedure, done in the operating room, to examine lymph nodes and other organs near the esophagus. Small incisions are made in either the chest or abdomen and then doctors use a thin, lighted tube with a camera to check the spaces around the esophagus for cancer and remove lymph nodes.

Blood and lab tests: This involves collecting blood and running lab tests to check for anemia and the function of the kidneys, liver, and lungs.