Esophageal Cancer (cont.)
If the biopsy shows that you have cancer, your doctor needs to learn the
extent (stage) of the disease to help you choose the best treatment.
Staging is a careful attempt to find out the following
- how deeply the cancer invades the walls of the esophagus
- whether the cancer invades nearby tissues
- whether the cancer has spread, and if so, to what parts of the body
esophageal cancer spreads, it's often found in nearby lymph nodes. If cancer has
reached these nodes, it may also have spread to other lymph nodes, the bones, or
other organs. Also, esophageal cancer may spread to the liver and lungs.
Your doctor may order one or more of the following staging tests:
- Endoscopic ultrasound: The doctor passes a thin, lighted tube (endoscope)
down your throat, which has been numbed with anesthetic. A probe at the end of
the tube sends out sound waves that you can't hear. The waves bounce off tissues
in your esophagus and nearby organs. A computer creates a picture from the
echoes. The picture can show how deeply the cancer has invaded the wall of the
esophagus. The doctor may use a needle to take tissue samples of lymph nodes.
- CT scan: An x-ray machine linked to a computer takes a series of detailed
pictures of your chest and abdomen. Doctors use CT scans to look for esophageal
cancer that has spread to lymph nodes and other areas. You may receive contrast
material by mouth or by injection into a blood vessel. The contrast material
makes abnormal areas easier to see.
- MRI: A strong magnet linked to a computer is used to make detailed pictures
of areas inside your body. An MRI can show whether cancer has spread to lymph
nodes or other areas. Sometimes contrast material is given by injection into
your blood vessel. The contrast material makes abnormal areas show up more
clearly on the picture.
- PET scan: You receive an injection of a small amount of radioactive sugar.
The radioactive sugar gives off signals that the PET scanner picks up. The PET
scanner makes a picture of the places in your body where the sugar is being
taken up. Cancer cells show up brighter in the picture because they take up
sugar faster than normal cells do. A PET scan shows whether esophageal cancer
may have spread.
- Bone scan: You get an injection of a small amount of a radioactive substance.
It travels through the bloodstream and collects in the bones. A machine called a
scanner detects and measures the radiation. The scanner makes pictures of the
bones. The pictures may show cancer that has spread to the bones.
- Laparoscopy: After you are given general anesthesia, the surgeon makes small
incisions (cuts) in your abdomen. The surgeon inserts a thin, lighted tube
(laparoscope) into the abdomen. Lymph nodes or other tissue samples may be
removed to check for cancer cells.
Sometimes staging is not complete until after
surgery to remove the cancer and nearby lymph nodes.
When cancer spreads from its original place to another part of the body, the
new tumor has the same kind of abnormal cells and the same name as the primary
tumor. For example, if esophageal cancer spreads to the liver, the cancer cells
in the liver are actually esophageal cancer cells. The disease is metastatic
esophageal cancer, not liver cancer. For that reason, it's treated as esophageal
cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic
These are the stages of esophageal cancer:
- Stage 0: Abnormal cells are found only in the inner layer of the esophagus.
It's called carcinoma in situ.
- Stage I: The cancer has grown through the inner layer to the submucosa. (The
picture shows the submucosa and other layers.)
- Stage II is one of the following:
- The cancer has grown through the inner
layer to the submucosa, and cancer cells have spread to lymph nodes.
- Or, the
cancer has invaded the muscle layer. Cancer cells may be found in lymph nodes.
- Or, the cancer has grown through the outer layer of the esophagus.
- Stage III is one of the following:
- The cancer has grown through the outer
layer, and cancer cells have spread to lymph nodes.
- Or, the cancer has invaded
nearby structures, such as the airways. Cancer cells may have spread to lymph
- Stage IV: Cancer cells have spread to distant organs, such as the liver.
Viewers share their comments
Esophageal Cancer - Types
Question: Do you or someone you know have adenocarcinoma or squamous cell carcinoma of the esophagus? Please share your story.
Esophageal Cancer - Risk Factors
Question: Do you have any of the risk factors for esophageal cancer? What are they, and what are your concerns?
Esophageal Cancer - Diagnosis
Question: What kinds of tests and exams led to a diagnosis of esophageal cancer?
Esophageal Cancer - Treatment
Question: What kinds of treatment, including radiation or chemotherapy, did you receive for esophageal cancer?
Esophageal Cancer - Surgery
Question: Please describe the surgical experience you or someone you know had for esophageal cancer.
Esophageal Cancer - Second Opinion
Question: How did you go about getting a second opinion for your esophageal cancer?
Esophageal Cancer - Follow-Up Care
Question: What type of follow-up care did you receive for your esophageal cancer?
Esophageal Cancer - Symptoms and Signs
Question: What were the symptoms and signs you experienced with esophageal cancer?
Esophageal Cancer - Prognosis
Question: What is your esophageal cancer prognosis?