Health A-Z

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Diagnosis

Your doctor will examine you and review your medical history. He or she probably will order chest x-rays and other diagnostic tests, too. These may include the following:

  • Routine laboratory studies Basic blood tests can help determine if you have been losing blood and whether your organs are functioning normally. These tests can help your doctor determine what other tests are needed.

  • Barium swallow This test is an x-ray of the esophagus. You drink a liquid containing barium, which coats the interior of your esophagus. It makes it easier for your doctor to see blockages or changes in the esophagus on x-rays.

  • Endoscopy The doctor inserts a thin, lighted tube called an endoscope into your esophagus. A small video camera sits at the end of the tube. With this tool, the doctor can look for problems in your esophagus. He or she can also collect tissue samples from suspicious areas for examination. You will be given a sedative or pain medicine to minimize discomfort.

  • Computed tomography (CT) scan X-ray pictures taken from different angles provide a three-dimensional view of your internal organs. Doctors can then see if you have any masses or blockages. CT scans are especially helpful in determining the extent of cancer. This information can guide treatment decisions.

  • Endoscopic ultrasound A tiny ultrasound machine sits at the end of a tube inserted into the esophagus. It creates pictures with sound waves. This test may be better than CT at determining how far cancer has grown into the esophagus, surrounding tissue, and lymph nodes. This information is especially important in choosing a treatment and planning surgery. As with endoscopy, doctors can remove bits of suspicious-looking tissue. The tissue will then be examined in a lab.

  • PET scanning A positron emission tomography, or PET, scan is an imaging technique that uses positively charged particles (radioactive positrons) to detect subtle changes in the body's metabolism and chemical activities. A PET scan provides a color-coded image of the body's function, rather than its structure. Because the metabolic activity of cancer cells differs from normal cells, PET can detect cancer that has spread to other areas of the body. This information can affect your choice of treatment.

People with esophageal squamous cell carcinoma have a higher risk of mouth, throat, lung, and stomach cancer. That's why you may also have tests with endoscopes inside the throat and lungs, as well as chest x-rays and CT scans.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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