Penn Medicine's cancer team includes nationally recognized gastroenterologists, pathologists and radiologists who are experts at finding and diagnosing esophageal cancer.
If cancer is suspected, one or more of these diagnostic tests may be ordered:
- Imaging tests. Pictures of the inside of the body can help find out whether a suspicious area might be cancerous, to learn how far cancer may have spread, and to help determine if treatment is working.
- Barium swallow. Patients swallow a liquid containing barium and then a series of X-rays are taken. The barium coats the lining of the esophagus, stomach and intestines, so abnormalities are easier to see on the X-ray. If there is an abnormality detected, an endoscopic biopsy can help make the diagnosis of cancer.
- Endoscopy. An endoscope, a thin instrument with a camera and biopsy channel, is used to examine the esophagus. Tissue samples may be taken to check for cancerous cells.
- Endoscopic ultrasound. An ultrasound uses sound waves to create a picture of the internal organs. This procedure is often done at the same time as the upper endoscopy. The endoscopic ultrasound can show enlarged lymph nodes, which may indicate a tumor or advanced disease. Needle biopsies may be obtained to help in staging and diagnosis.
- Computed tomography (CT) scan. A CT scan creates a 3-D X-ray of the inside of the body. A computer combines the images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan is used to see if the cancer has spread to the liver and to detect a carcinoid tumor in lymph nodes behind the abdomen. Sometimes, a contrast medium (dye) is used to provide better detail.
- Positron emission tomography (PET) scan. A PET scan creates pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into the patient and cancer cells absorb the radioactive substance. A scanner then detects this substance to produce images.
- Bronchoscopy. A bronchoscopy uses an endoscope to look into the windpipe (trachea) and lung structures to examine if cancer is present in some patients.
- Thoracoscopy and laparoscopy. These procedures allow a physician to see lymph nodes and other organs to see if cancer has spread. Biopsies may be taken of the organ tissue if there is a question concerning suitability for surgery.
- Biopsy. A sample of the suspicious area is removed and viewed under a microscope. A biopsy, such as fine-needle aspiration, is the only way to tell if cancer is truly present.