Esophageal Cancer Diagnosis

Winship Cancer Institute of Emory University has a team of oncologists, abdominal radiologists and pathologists dedicated solely to gastrointestinal cancers. This means they are experts at esophageal cancer diagnosis and staging. That’s important because the stage of your disease indicates how much it has spread throughout the esophageal tissue and whether it has spread to your lymph nodes and other parts of the body.

But we don’t stop there. Winship goes beyond staging to analyze your cancer on a molecular level to determine exactly what’s driving it — so we can figure out how best to stop it. Because your esophageal cancer is as unique as you are. And your treatment plan should reflect that.  

If you have symptoms of esophageal cancer, your physician will order tests to detect, and, if present, to analyze and stage your cancer. At Winship, we take a multi-stage approach to ensure every patient gets a thorough and accurate esophageal cancer diagnosis. Because no two esophageal cancers are the same — even those in the same stage and location — your cancer will differ from another patient’s. It’s imperative that we understand your cancer to treat it properly. We know patients can be anxious to move forward with treatment. But it’s critical to get a full and precise esophageal cancer diagnosis, and it won’t take long – we promise.

Diagnostic imaging. At Winship, we have access to a variety of imaging technologies that help us diagnose esophageal cancer. The barium swallow test, during which a patient drinks a special liquid form of barium and then has X-rays taken, can detect even small lesions on the esophagus. We also use positron emission tomography (PET), magnetic resonance imaging (MRI) and computed tomography (CT) to distinguish between types of esophageal cancer and determine how far the disease has spread within the body.

Esophagoscopy. During this exam, a long, flexible tube called an endoscope is inserted through the mouth and into the esophagus. The endoscope has a light and a camera at the end so your physician can get a close-up look at the length of the esophagus. During this exam, which is performed under sedation, your physician can also collect samples of tissue for lab testing.

Endoscopic ultrasound. Performed in the same manner as endoscopy, endoscopic ultrasound allows for even closer examination of esophageal tumors. Using ultrasound technology, your physician can see how large a tumor is and determine whether it would be suitable for treatment with surgery.

Bronchoscopy. During this procedure, your physician can take a closer look at your tumor by inserting a scope into the large airways of the lungs. This is used to determine whether cancer has spread to the trachea (windpipe) or air passageways to the lungs.

Minimally invasive surgery. In some cases, surgery is needed to obtain tissue for testing. Our team of dedicated gastrointestinal, abdominal and thoracic surgeons is skilled at laparoscopy and thoracoscopy, surgeries that are used to access tumors in difficult-to-reach places.

Molecular pathology. If your tumor is determined to be cancerous, our molecular pathologists will conduct genomic profiling to look at the DNA inside your tumor to identify any genetic mutations and biomarkers, or cell characteristics. Winship scientists, genomic- and tumor-sequencing experts will analyze what’s driving your particular esophageal cancer, and then work with your oncologists to determine which types of treatment are most likely to work best against your specific cancer.