Cancer Of The Oesophagus

See your GP if you experience symptoms of oesophageal cancer . They will carry out an initial assessment and decide whether you need to have any further tests.

Seeing your GP

Your GP may:

• ask about the symptoms you're experiencing
• carry out a physical examination
• take a look at your medical history

Ifyour GPthinks you need to have some tests, they can refer you to a hospital specialist. This will usually be a gastroenterologist (specialist in conditions affecting the digestive system).

The tests your gastroenterologistmay recommend are described below.

Tests to diagnose oesophageal cancer

The two main tests used todiagnose oesophageal cancer are:

• an Endoscopy this is the most common test
• a barium swallow or barium meal

Endoscopy

An endoscopy is a procedure that allows your doctor to see inside your oesophagus so they can check forcancer.

Athin, flexibletube with alight and camera at the end(an endoscope) is passed into your mouth and down towards your stomach.

Small samples of tissue are also removed fromyour oesophagus so they can be checked for cancer under a microscope. This is called a biopsy .

You'll be awake whilean endoscopy is carried out. It shouldn't be painful, but may be a bit uncomfortable.

You'll normally be given local anaesthetic to numb your throatand possibly asedative to help you relax.

Barium swallowor barium meal

A barium swallow or barium meal involves drinking a harmless white liquid called barium before several X-rays are taken.

The barium coats the lining of your oesophagus so it shows up on the X-ray. This can show whether there's anything blockingyour oesophagus, which may be a sign of cancer.

This test isn't used to diagnose oesophageal cancer very often nowadays because the best way to confirm a diagnosis is to use tissue samples taken during an endoscopy.

Further tests

Ifyou have oesophageal cancer, further tests willberecommended to determine how far the cancer has spread known as called the "stage". See below for more information about this.

These tests may include:

• a computerised tomography (CT) scan where a series of X-rays are taken and put together by a computer to create a detailed picture of the inside of your body
• an endoscopic ultrasound scan where a small probethat produces sound waves is passed down your throat to create an image of your oesophagus and the surrounding area
• a positron emission tomography (PET) scan a scan that can help show how far the cancer has spread
• a laparoscopy a type of keyhole surgery performed under general anaesthetic (where you're asleep), in which a thin tube with a camera at the end is inserted through a cut in your skin to examine the area around your oesophagus

Stages of oesophageal cancer

The most widely used system for staging oesophageal cancer is the TNM system. This involves scoring the cancer in three categories:

• T (tumour) the location and size of the tumour
• N (node) whether the cancer has spread to the lymph nodes (a network of glands throughout the body)
• M (metastasis) whether the cancer has spread to other parts of the body, such as the lungs, liver or bones

Scores for eachcategory are then often used in a simpler number system, ranging from stage 1 (early cancer) to stage 4 (advanced cancer).

Knowing the stage of your cancer will help yourcare teamwork out the best treatment for you. .

Want to know more?

• Cancer Research UK: diagnosing oesophageal cancer
• Cancer Research UK: stages and grades of oesophageal cancer
• Macmillan: how oesophageal cancer is diagnosed
• Macmillan: staging oesophageal cancer