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Endoscopic ultrasound

This test combines ultrasound and endoscopy to look at the areas around your food pipe. The main airway (wind pipe) is close to the food pipe.

An endoscopic ultrasound can check whether lung cancer has spread into the lymph nodes in the centre of the chest close to the wind pipe.

To do the test your doctor uses a long flexible tube called an endoscope. It has a tiny camera and light on the end and an ultrasound probe attached. The ultrasound scan uses high frequency sound waves to create a picture of the inside of your body.

Preparing for your test

You might have a blood test 2 days beforehand to check how well your blood clots.

Tell your doctor if you're taking medicine that changes how your blood clots. This includes:

  • aspirin
  • clopidogrel
  • arthritis medicines
  • warfarin

Your doctor tells you if you need to stop taking any other medicines.

You can't eat for 6 to 8 hours before the test but you might be able to drink sips of water up to 2 hours before your appointment. Your doctor or nurse gives you written instructions about this beforehand.

Talk to your doctor if not eating could be a problem for you. For example, if you have diabetes.

How you have it

Usually you have an endoscopy in hospital as an outpatient. A doctor or a specialist nurse (endoscopist) does the test. A nurse stays with you when you have it. The test usually takes less than 30 minutes.

When you arrive at the clinic, the staff might ask you to take your upper clothing off and put on a hospital gown. 

You might have the test while you're awake but you can choose to have a medicine to make you drowsy (a sedative).

Having the test

You lie down on the couch and have an injection of the sedative. It takes a few minutes for you to become sleepy.

Then the endoscopist passes the endoscope down your throat into your food pipe.

Diagram showing an endoscopic ultrasound to stage lung cancer

The tube has an ultrasound probe. This uses sound waves to build up a picture so your doctor can measure the cancer and see whether it has spread into nearby tissues. They might also be able to see if nearby lymph nodes are swollen (enlarged).

The endoscopist might use a special needle passed out of the end of the endoscope to take small samples of tissue (biopsies).

After your endoscopy

You need to rest for a while after the test.

You can't eat or drink for about an hour, until the local anaesthetic throat spray wears off. You might not remember much about the test if you have had a sedative drug.

You should be able to go home the same day. You can't drive or drink alcohol for 24 hours after having a sedative. You need someone to take you home from hospital and stay with you during this time.

For support and information, you can call the Cancer Research UK information nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday. They can give advice about who can help you and what kind of support is available.

Possible risks

An endoscopy is a very safe procedure. But your nurse tells you who to contact if you have any problems afterwards. Your doctors make sure the benefits of having an endoscopy outweigh the possible risks.

The possible risks include:

A sore throat

You might have a sore throat for up to 24 hours. Contact the hospital if you have severe pain in your throat, chest or tummy (abdomen).

Bleeding

There is a risk of bleeding from the biopsy site. This is usually a small amount and stops on its own. Rarely you may need a blood transfusion.

Small tear in the food pipe

There is a risk of a small tear (perforation) in the food pipe. This is rare. If it happened, you would need to stay in hospital and have antibiotics and possibly an operation to repair the tear.

Fluid going into your lungs

There is a very small risk of fluid going into your lungs from your mouth during the test. Your nurse uses a tube to remove most of the fluid from your mouth to reduce this risk.

Shortness of breath

A reaction to the sedative can cause breathing difficulties but this is rare. Your nurse checks your oxygen levels during the test. You have oxygen through a tube that fits into your nose (nasal cannulae).

Getting your results

You should get your results within 1 to 2 weeks. The doctor who arranged your endoscopy gives them to you. 

Waiting for results can make you anxious. You can ask your doctor or nurse how long it takes to get them. Contact the doctor who arranged the test if you haven't heard anything after a couple of weeks.

Last reviewed: 
08 Oct 2019
  • Lung cancer: diagnosis and management
    National Institute for Health and Care Excellence (NICE), 2019

  • Management of lung cancer
    Scottish Intercollegiate Guideline Network, 2014

  • The Royal Marsden Manual of Clinical Nursing Procedures, 9th, Professional Edition
    L Dougherty and S Lister (Editors)
    Royal Marsden Manual Series, Wiley-Blackwell, 2015

  • British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults
    I A Du Rand and others
    Thorax 2011;66:iii1-ii21
    PDF available to download 

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