Before considering sophisticated diagnostic techniques, your doctor will ask you questions about your current health and your medical history. In addition, he will do a physical examination of your mouth and throat looking for esophageal cancer signs: difficulty swallowing, pain behind the chest bone (sternum), painful swallowing, etc. However, these signs are not enough to establish the diagnosis; more special tests must be done to confirm an esophageal cancer diagnosis.
Upper GI endoscopy – this exam allows your doctor to detect precancerous or cancerous formations in your upper GI tract: esophagus, stomach, and duodenum. During the examination, your physician uses a hollow tube equipped with a lens called endoscope. He passes the endoscope down through your throat into your esophagus to examine your esophagus cavity with precision. Endoscopy may be uncomfortable for some patients, but it is completely painless.
Barium swallow – also called upper gastrointestinal (GI) series, a barium swallow is performed to detect abnormalities in the upper digestive system such as ulcers, tumors or inflammation.While standing in front of the x-ray machine, you will be asked to swallow a contrast agentcalled barium sulfate. The x-ray will control the progress of the liquid through your system, and image the hollow structure of your esophagus.
Your doctor will recommend barium swallow if you experience trouble swallowing, gastroesophageal reflux, pain in the chest or abdomen, unreasonable vomiting, indigestion or blood in the stool (which indicates internal bleeding).
Biopsy – to confirm the diagnosis accurately, your doctor will recommend a biopsy. It involves removing cells or tissues of your esophagus to examine under a microscope. Your physician may also take samples of lymph nodes near the tumor to examine for laboratory analysis. If cancer cells are found, additional procedures will be performed to determine how fast those cancer cells grow.
Ultrasound – if your oncologist suspects that the cancer has spread to other organs, he may recommend an ultrasound of the chest and liver to confirm the presence of cancer in these sites.