Esophageal Cancer (cont.)
Recognizing symptoms
Early esophageal cancer usually does not cause symptoms. However, as the
cancer grows, symptoms may include:
These symptoms may be caused by esophageal cancer or by other conditions. It
is important to check with a doctor.
Diagnosing esophageal cancer
To help find the cause of symptoms, the doctor evaluates a person's
medical history and performs a physical exam. The doctor usually orders a
chest x-ray and other diagnostic tests. These tests may include the
following:
- A barium swallow (also called an esophagram) is a series of x-rays of
the esophagus. The patient drinks a liquid containing barium, which coats the
inside of the esophagus. The barium makes any changes in the shape of the
esophagus show up on the x-rays.
- Esophagoscopy (also called endoscopy) is an examination of the inside
of the esophagus using a thin lighted tube called an endoscope. An anesthetic
(substance that causes loss of feeling or awareness) is usually used during this
procedure. If an abnormal area is found, the doctor can collect cells and tissue
through the endoscope for examination under a microscope. This is called a
biopsy. A biopsy can show cancer, tissue changes that may lead to cancer, or
other conditions.
Staging the disease
If the diagnosis is esophageal cancer, the doctor needs to learn the stage
(or extent) of disease. Staging is a careful attempt to find out whether the
cancer has spread and, if so, to what parts of the body. Knowing the stage of
the disease helps the doctor plan treatment. Listed below are descriptions of
the four stages of esophageal cancer.
- Stage I. The cancer is found only in the top layers of cells lining
the esophagus.
- Stage II. The cancer involves deeper layers of the lining of the
esophagus, or it has spread to nearby lymph nodes. The cancer has not spread to
other parts of the body.
- Stage III. The cancer has invaded more deeply into the wall of the
esophagus or has spread to tissues or lymph nodes near the esophagus. It has not
spread to other parts of the body.
- Stage IV. The cancer has spread to other parts of the body. Esophageal
cancer can spread almost anywhere in the body, including the liver, lungs,
brain, and bones.
Some tests used to determine whether the cancer has spread include:
- CAT (or CT) scan (computed tomography). A computer linked to an x-ray
machine creates a series of detailed pictures of areas inside the body.
- Bone scan. This technique, which creates images of bones on a computer
screen or on film, can show whether cancer has spread to the bones. A small
amount of radioactive substance is injected into a vein; it travels through the
bloodstream, and collects in the bones, especially in areas of abnormal bone
growth. An instrument called a scanner measures the radioactivity levels in
these areas.
- Bronchoscopy. The doctor puts a bronchoscope (a thin, lighted tube)
into the mouth or nose and down through the windpipe to look into the breathing
passages.
Next: How is cancer of the esophagus treated? »
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