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    Esophageal Cancer

    How Is Esophageal Cancer Diagnosed? continued...

    Tests for esophageal cancer may include:

    • Barium swallow X-ray, in which you drink a liquid that coats your esophagus. This makes the esophagus stand out on the X-ray so that your doctor can identify certain problems.
    • Endoscopy: the doctor passes an endoscope, a thin, lighted tube, down your throat into your esophagus to examine it. Endoscopic ultrasound uses sound waves to provide more information about the extent of tumor involvement in nearby tissues.
    • Biopsy: during an endoscopy, the doctor can take cells or tissue from your esophagus. The cells are examined under a microscope for the presence of cancer.

    Other tests, including computed tomography (CT) scans, positron emission tomography (PET) scan, thoracoscopy, and laparoscopy, may be performed to determine if the cancer has spread, or metastasized, outside of the esophagus. This process is called "staging." The doctor needs this information in order to plan your treatment.

    What Are the Stages of Esophageal Cancer?

    The stages of esophageal cancer are given a number (I through IV); the higher the number, the more advanced the cancer. The stages are:

    • Stage 0 . Abnormal cells (not yet cancer) are found only in the layer of cells that line the esophagus.
    • Stage I . Cancer cells are found only in the layer of cells that line the esophagus.
    • Stage II . The cancer has reached the muscle layer or the outer wall of the esophagus. In addition, the cancer may have spread to 1 to 2 nearby lymph nodes (small glands that are part of the immune system).
    • Stage III . The cancer has reached deeper into the inner muscle layer or the connective tissue wall. It may have spread beyond the esophagus into surrounding organ and/or has spread to more lymph nodes near the esophagus.
    • Stage IV . This is the most advanced stage. The cancer has spread to other organs in the body and/or to lymph nodes far from the esophagus.

    There are several tests to determine the stage of esophageal cancer, including:

    • Chest X-ray .
    • Bronchoscopy. The trachea (windpipe) and airways are examined with a bronchoscope, a thin, lighted tube that is inserted through the nose or mouth. This test is used to check for cancer involvement in the trachea or branching airways.
    • CT scan. A procedure that creates sharp pictures of the inside of the body.
    • Endoscopic ultrasound , or endosonography . Used during endoscopy, sound waves bounce off organs in the body to create pictures called sonograms. This test can provide more information on the size and extent of the tumor.
    • Thoracoscopy . An endoscope is placed into the chest through an incision to examine the inside of the chest to look for lymph nodes and other chest organs that may have cancer spread. Biopsies can be done during this procedure.
    • Laryngoscopy . A procedure where a doctor uses a mirror or a laryngoscope to examine the larynx (voice box).
    • Laparoscopy . The lighted tube is inserted through an incision in the abdomen to examine the abdominal organs and take tissue samples to check for cancer spread.

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