Doctors may also use special instruments such as flexible tubes with lights and special cameras to get a clear picture of a patient’s internal organs. These instruments help doctors determine the size and shape of the tumor, as well as the extent to which the cancer has spread to organs outside the esophagus.
An upper endoscopy involves placing a flexible 10-millimeter wide tube called an endoscope through the patient’s mouth into the esophagus and the stomach. This procedure is performed while the patient is sedated. The endoscope has a light and a video camera at its end, with the camera connected to a monitor. This allows the doctor to see whether there are any abnormalities in the esophagus.
An endoscopic examination can give doctors information on how large the tumor is and the extent to which it has spread. Surgeons can also use the information to determine whether the tumor can be removed completely.
A biopsy or tissue sample may also be taken through the endoscope. This tissue sample, examined under a microscope, can help doctors determine not just whether cancer is present but, if it is, the kind of esophageal cancer that it is.
An upper endoscopy is also helpful in cases where the opening of the esophagus is blocked by cancer. Special instruments operated through the endoscope can be used to widen the opening so that food and liquid can pass through more easily.
An endoscopic ultrasound involves using an endoscope that has a small ultrasound probe at its end to send extremely sensitive sound waves into the body in order to penetrate tissues. These sound waves bounce off the normal tissues and the cancer. The probe in the endoscope then detects the sound waves. The images created by this procedure show how deeply the esophagus has been affected by cancer.
Recent studies suggest that an endoscopic ultrasound may be more accurate than an upper endoscopy or a CT scan in terms of learning about the cancer’s size, shape, and the extent of its spread to nearby tissues. Knowing just how much the cancer has spread to nearby tissues can help surgeons determine which of the tumors can be taken out surgically and which cannot.
A bronchoscopy is similar to an upper endoscopy. The difference in a bronchoscopy is that the doctor looks into the windpipe and the bronchi, which are tubes that lead from the windpipe to the lungs. Its main purpose is to see whether these areas have been affected by the cancer. As with an upper endoscopy, this procedure requires the patient to be sedated.
Other procedures use a hollow, lighted tube inserted into the patient’s body through a small incision. In a thoracoscopy (using a thoracoscope), a doctor can view the lymph nodes in the chest. In a laparoscopy (using a laparoscope), a physician can view the lymph nodes in the abdomen.
Biopsies may also be extracted using special instruments operated through these tubes. The tissue samples are then examined under a microscope. Information derived from these procedures may suggest the best treatment option for a patient with esophageal cancer.
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Reviewed by:
Jiade J. Lu, M.D.
Diplomate, American Board of Radiology (Radiation Oncology)
Medical Director
The Cancer Information Network
Date Modified: 06/10/04
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