Esophageal Cancer Diagnosis

Before you start any treatment, we’ll help you understand your disease clearly. Our doctors will discuss your medical history and give you an overall health exam. We will probably take a sample of the tumor so we can look at the tissue under a microscope.

We may also look at the tumor with endoscopic ultrasound, MRI, or CT and PET scans. Getting an accurate diagnosis is the first step toward getting the best cancer care.


A biopsy is when your doctor looks at your actual tissue. Biopsies for esophageal cancer are usually done with an endoscope (a thin, lighted tube) that lets your doctor see the inside of the esophagus. After you take an anesthetic to relax you, your doctor puts the endoscope through your mouth and into your esophagus, giving a clear picture of the esophagus and what’s inside it.

Your doctor will take a small sample of tissue from the tumor so it can be looked at. After the biopsy, a doctor who specializes in esophageal cancer looks at the cells under a microscope and does other tests to learn more about the tumor.

Molecular Diagnostics

In addition to doing standard tests, we do research to make the diagnosis of esophageal cancer even better. Our researchers are working to find mutations and markers in tumors that could be used to figure out how aggressive certain cancers are and help decide when chemotherapy is needed.

Stages of Esophageal Cancer

If a tissue sample from the tumor shows that you have esophageal cancer, the next step is to find out if the cancer has spread, and if so, how far. This process, called staging, is important in deciding which treatment will be best for you.

Staging the tumor requires one or more tests, including:

  • CT scans of the chest and upper gastrointestinal tract
  • a combined PET and CT scan, which allows our doctors to measure and analyze the location of tumors
  • an endoscopic ultrasound, which uses an endoscope with a small ultrasound probe at its tip to measure how thick the tumor is and see whether the cancer has spread to the wall of the esophagus or the lymph nodes
  • bronchoscopy, an endoscopy procedure that can see whether the cancer has entered the windpipe or airways
  • interventional radiology or surgical biopsies if suspicious areas are identified outside the esophagus

From these test results, your doctors will know what stage the cancer is at. The stage indicates how large the tumor has grown and how widely it has spread in the body.

These are the stages of esophageal cancer:

Stage 0

Cancer cells are found only in the cells lining the esophagus. This may also be called high-grade dysplasia.

Stage 1

Cancer is in the inside layers of the esophagus.

Stage 2

Cancer has spread to the outer layers of the esophagus. It may also have spread to lymph nodes.

Stage 3

Cancer has spread beyond the esophagus to nearby tissue and has also spread to lymph nodes.

Stage 4

Cancer has spread (metastasized) to another part of the body.