Further tests for oesophageal cancer
If the biopsy shows you have oesophageal cancer, you will have some of the following tests to find out whether the cancer has spread to other areas of your body. This is called staging. Some of the tests may be repeated during or after treatment to check your health and see how well the treatment is working.
Learn more about these further tests:
You might have blood tests to assess your general health, look for signs of anaemia, and see how well your liver and kidneys are working. Blood tests can also help identify nutritional problems.
A computerised tomography (CT) scan uses x-ray beams to create detailed, cross-sectional pictures of the inside of your body. It helps determine how far the cancer has spread from the primary tumour site. You may have a CT scan of your neck, chest, abdomen and pelvis for oesophageal cancer.
Before a CT scan, you may have an injection of dye and/or be asked to drink a liquid dye. This dye, known as the contrast, helps ensure that anything unusual can be seen more clearly. The dye might make you feel hot all over and leave a strange taste in your mouth for a few minutes. Rarely, more serious reactions can occur.
The CT scan machine is large and round like a doughnut. You will need to lie still on a table while the scanner moves around you.
The scan itself is painless and takes only a few minutes, but the preparation can take 10–30 minutes.
|Before having scans, tell the doctor if you have any allergies or have had a reaction during previous scans. You should also let them know if you have diabetes or kidney disease or are pregnant.|
A positron emission tomography (PET) scan combined with a CT scan is a specialised imaging test. The two scans provide more detailed and accurate information about the cancer than a CT scan on its own. A PET–CT scan is most commonly used to help determine whether oesophageal cancer has spread to other parts of the body. Only some people need this test. As PET scans do not detect some stomach cancers, Medicare does not currently cover the cost.
To prepare for a PET–CT scan, you will be asked not to eat or drink for a period of time (fast). Before the scan, you will be injected with a glucose solution containing a small amount of radioactive material. Some cancer cells may show up brighter on the scan because they take up more glucose solution than normal cells do.
You will be asked to sit quietly for 30–90 minutes as the glucose spreads through your body, then you will be scanned. The scan itself will take around 30 minutes. Let your doctor know if you are claustrophobic, as you need to be in a confined space for the scan.
A laparoscopy is usually done as day surgery under general anaesthetic. This procedure allows your doctor to look inside your abdomen and examine the outer layer of the stomach for signs that the cancer has spread. A laparoscopy is used to stage oesophageal cancer that is located in the gastro-oesophageal junction and also involves the upper part of the stomach.
The doctor will make small cuts in your abdomen and pump in gas to inflate your abdomen. A tube with a light and camera attached (a laparoscope) will then be inserted into your body. The camera projects images onto a TV screen so the doctor can see cancer cells that are too small to be seen on CT or PET–CT scans. The doctor may take more tissue samples for biopsy. Your doctor will explain the risks before asking you to agree to the procedure.
If you are diagnosed with very early cancer in the oesophagus, you may have an endoscopic resection. This procedure may help your doctor assess the risk that cancer has spread to the lymph nodes and needs further treatment.
If you are diagnosed with advanced cancer in the stomach or gastro-oesophageal junction, your doctor may order extra tests on the biopsy sample to look for particular features that can cause the cancer cells to behave differently. These tests may look for mutations in the HER2 gene or specific proteins linked with the growth of cancer cells.
Knowing whether the tumour has one of these features may help your treatment team decide on suitable treatment options. For more on this, see Targeted therapy for stomach cancer.
|For an overview of what to expect during all stages of your care for oesophageal cancer, visit Optimal Care Pathways. This is a short guide to what is recommended, from diagnosis to treatment and beyond.|
Download a PDF booklet on this topic.
Prof David Watson, Senior Consultant Surgeon, Oesophago-gastric Surgery Unit, Flinders Medical Centre, and Matthew Flinders Distinguished Professor of Surgery, Flinders University, SA; Kate Barber, 13 11 20 Consultant, Cancer Council Victoria; Katie Benton, Advanced Dietitian, Cancer Care, Sunshine Coast Hospital and Health Service, QLD; Alana Fitzgibbon, Clinical Nurse Consultant, Gastrointestinal Cancers, Royal Hobart Hospital, TAS; Christine Froude, Consumer; Dr Andrew Oar, Radiation Oncologist, Icon Cancer Centre, Gold Coast University Hospital, QLD; Dr Spiro Raftopoulos, Interventional Endoscopist and Consultant Gastroenterologist, Sir Charles Gairdner Hospital, WA; Grant Wilson, Consumer; Prof Desmond Yip, Clinical Director, Department of Medical Oncology, The Canberra Hospital, ACT. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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