Oesophageal cancer

X-rays are taken of your oesophagus as you drink a white chalky liquid called barium. The liquid shows up any abnormal areas in your oesophagus. This test normally takes about 15 minutes and is not painful. Even though the liquid tastes chalky, it should not make you feel sick.

Read more about having a barium swallow.

A thin flexible tube with a camera and a light is put into your oesophagus so the doctor can check for unusual changes. This test is also called a gastroscopy.

Read more about having an endoscopy.

A device like a microphone passed over the area to give a picture of the tissues inside your body. It can show any abnormal changes. 

Read more about liver ultrasound scans.

An ultrasound probe is passed through a tube into your body through your mouth. It can take ultrasound pictures from inside your oesophagus.

Read more about having an EUS.

This means taking a sample of the cells in the oesophagus and looking at them under a microscope. This is usually done during an endoscopy or EUS.

A type of X-ray that gives a detailed picture of the tissues inside your body.

Read more about CT scans.

An ultrasound probe is passed through a tube into your body through your mouth. This probe makes sound waves that allow your doctor to see the tissues inside your oesophagus and nearby areas. This can help your doctor assess the size and
depth of the tumour. 

They can also check if nearby lymph nodes are enlarged due to cancer or infection. 

A sample of the lymph nodes can be taken and examined under a microscope to check for signs of cancer.

Read more about having an EUS.

Blood tests can check your general health, including how well your kidneys and liver are working. They can also check the level of different blood cells and monitor your response to certain treatments.

• Full blood count (FBC): Checks the number of different types of blood cells in your blood.
• Kidney function tests (urea and electrolytes) check how well your kidneys are working.
• Liver function tests (LFT) check your liver’s health.
• Routine blood tests will be done throughout chemotherapy treatment.
• A blood test called a micronutrient screen can check levels of vitamins, minerals and other essential nutrients to see if you have a deficiency.
• Tumour marker blood tests may be done to monitor your response to chemotherapy.

A PET CT scan is a combination of a CT scan and a PET scan. It can show if the cancer has spread to other tissues and organs. 

You may have to travel to a specialist centre to have a PET scan, as not every hospital has these scanners. 

Read more about PET scans.

Sometimes you will have an MRI scan if your doctors want to have a closer look at areas outside the oesophagus, such as the liver. During the scan you will lie inside a tunnel-like machine.

Read more about MRI scans.

You may have this test if your doctor needs more information after other tests have been done. 

A laparoscopy is a small operation that is performed under general anaesthetic. A mini telescope is passed through a small cut in your abdomen (tummy) so that your doctor can see the organs close to your oesophagus and check the lining of your abdomen for cancer. 

Your doctor may make another cut in the tummy if a small sample of tissue (biopsy) needs to be taken and checked for cancer.

Your doctor will discuss this test with you if you need it.

Read more about having a laparoscopy.

Lung (pulmonary) function tests can see how well your lungs are working – normally before neo-adjuvant chemotherapy (chemotherapy given before surgery) and again before surgery. For a pulmonary function test (PFT), you blow into a mouthpiece on
a machine. PFTs are not painful and take about 20 minutes.

These tests can see how well your heart is working. They may be used to check your general health or to see if treatment has affected your heart. For example, some chemotherapy drugs can affect the muscles of the heart (this is usually temporary).

The 2 main types of test are:

• ECG: Sensors are attached to your skin that can pick up the signals produced by your heart when it beats.
• Echocardiogram (‘Echo’ scan): This is a type of ultrasound that can produce a moving image of your heart at work and nearby blood vessels to give information about your heart function.

The size of the tumour and how far it has grown into the lining of the oesophagus. Doctors put a number next to the T to describe the size and spread of the cancer.

This describes whether the cancer has spread to the nearby lymph nodes and how many nodes are affected. 

• N0 means there is no cancer in the nodes.
• If cancer has spread to the lymph nodes (positive nodes) the N will have a number to describe how many lymph nodes are affected.
• NX means the doctors cannot tell if the nodes are affected.

This describes if the cancer has spread to another part of the body, such as the liver or lungs. The M may have a number next to it. This gives extra information about where the cancer has spread to.

The cancer is at a very early stage. Cancer cells are found in the lining of your oesophagus but are completely within the lining. This stage is also known as carcinoma in situ. 

The cancer is at an early stage. The cancer cells are found only in the surface layers of the lining of your oesophagus. Or it may be found in only a small part of your oesophagus. There is no sign of it spreading anywhere. 

The cancer has spread to the muscle layer of your oesophagus or to nearby lymph nodes. But it has not spread to any other organs. If the cancer has not spread to nearby lymph nodes, it is stage 2A. If the cancer has spread to nearby lymph nodes, it is stage 2B. 

The cancer has spread beyond the wall of your oesophagus. It may also have spread to nearby lymph nodes and other tissues next to your oesophagus. But there are no signs of it spreading to other parts of your body.  

The cancer is advanced and has spread to your lymph nodes and other parts of your body. For example, your liver, lungs or stomach. Cancer in another part of your body is called secondary or metastatic oesophageal cancer.