There are several ways that physicians may detect esophageal cancer, after doing a medical history and physical examination:
A barium swallow (also called a contrast esophagram), is a series of x-rays of your esophagus. For the test, you will drink a barium-containing liquid, which coats the inside of the esophagus and makes its shape and contours appear on x-rays. As the liquid moves from the mouth down to the esophagus, the physician can assess any narrowing, enlargement or abnormalities. You will most likely be asked not to eat or drink for 8 to 10 hours before the test.
During a bronchoscopy, your physician will give you a sedative and then pass a small, hollow tube (bronchoscope) through your nose and throat into the main airway of the lungs. He or she can then see any abnormal areas and extract a tissue sample for analysis.
Computed Tomography (CT) Scan
CT scans use x-ray equipment and computer processing to produce 2-dimensional images of the body. The patient lies on a table and passes through a machine that looks like a large, squared-off donut. Doctors order CT scans when they want to see a two-dimensional image of the body to look for tumors and examine lymph nodes and bone abnormalities. If contrast dye is used to improve the computer image, the patient may need to avoid eating or drinking for 4 to 6 hours before the test. Patients should tell their provider before the test if they have any allergies or kidney problems.
You will receive an intravenous sedative and pain medication. Once comfortable, the physician will then examine the area using an endoscope—a lighted tube with a small camera at the end. The physician will be able to view any abnormalities and take a tissue samples (biopsies) if necessary.
Sound waves are used to generate images of the affected area of the esophagus. This helps to determine how much of the tissue has been invaded by the cancer.
Positron Emission Tomography (PET) scan
A PET scan is used to detect cellular reactions to sugar. Abnormal cells tend to react and "light up" on the scan, thus helping physicians diagnose a variety of conditions. For the PET scan, a harmless chemical, called a radiotracer, is injected into your blood stream. Once it has had time to move through your body, you will lie on a table while a scanner follows the radiotracer and sends three-dimensional images to a computer screen. Patients are generally asked to wear comfortable clothing and refrain from eating for 4 hours before the scan. Tell your doctor if you are pregnant or breastfeeding. Patients with diabetes should discuss diet guidelines with their physician for the hours leading up to the scan.
Pulmonary Function Test (PFT)
To understand how well your lungs are working, your physician may order a series of pulmonary function tests. With each breath you take in and breathe out, information is recorded about how much air your lungs take in, how the air moves through your lungs and how well your lungs deliver oxygen to your bloodstream.
A stress test is used to gain more information about how your heart functions during exercise. Your physician will monitor your heartbeat and blood flow as you walk on a treadmill, and will then be able to diagnose any problems as well as plan treatment.