Further tests for oesophageal cancer

If your tests show you have oesophageal cancer you may need further tests to see if the cancer has spread. Your doctor may call this staging your cancer. Knowing the stage of your cancer helps your doctor to decide on the best treatment.

The most common sites for oesophageal cancer to spread are the liver, lungs, stomach and lymph nodes. The liver, lungs and stomach are all quite nearby. The lymph nodes are often a first site of spread in many cancers. Tissue fluid circulates around the body organs, drains into lymph vessels and is carried to the lymph nodes. If any cancer cells have broken away, they can be carried to the lymph nodes in tissue fluid.

Remember - Having these tests does not necessarily mean your cancer has spread, or that your doctor thinks it has. Your doctor needs to rule out cancer spread to treat you properly. You are bound to be nervous about all this. But try not to worry too much before you know all the facts.

CT scans are computerised scans that use X-rays. You may be asked to have a CT scan of your tummy (abdomen) and lungs. This is to check for any signs of enlarged lymph nodes or other cancer spread. There is more about having a CT scan in the section about cancer tests.

This is a test that uses an endoscope and an ultrasound scanner. For the patient, it is much the same as having an endoscopy. But an ultrasound probe is attached to the endoscope tube. The doctor uses it to scan more deeply into the wall of the food pipe (oesophagus). It may be possible to see how far the cancer cells have travelled into the oesophageal wall with this test. It can also show whether there are cancer cells in the lymph nodes close to the oesophagus. There is information about having an endoscopy in our section about cancer tests.

PET scans can show up areas of active disease, and can help your doctor know the stage of your cancer before surgery. Some people may have a PET-CT scan, which combines this with a CT scan. But PET or PET-CT scanners may not be available at all hospitals. There is information about having a PET scan in the section about cancer tests.

This is a small operation that you have under general anaesthetic. A tube with a camera and a light is put into your abdomen through a small cut. Your surgeon can look inside to see whether there is any sign of cancer spread. Afterwards, you will have one or more small wounds with a couple of stitches in each. This test isn't necessary very often for cancer of the oesophagus. Your doctor is most likely to suggest it if your cancer is very low down in your food pipe (near where it joins the stomach) and if the results of some of your other tests are uncertain.

This is a scan using sound waves to look at your liver. You may have this test if your doctor thinks that the cancer could have spread to your liver. There is more about having an ultrasound in the section about cancer tests.

Your doctor may occasionally suggest you have an MRI scan. MRI scans use magnetism to build up a picture. Soft tissue can show up more clearly on this scan than on a CT scan. There is more about having an MRI scan in the section about cancer tests.

You will be asked to come back to the hospital when your test results have come through. This is bound to take a little time, even if only a week or so. You are likely to feel anxious during this time. While you are waiting for results it may help to talk to your clinical nurse specialist or a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience. Look in our cancer organisations section for an organisation that can give you information about support groups or counselling services near you.