Materiały źródłowe

• #1 Oesophageal Cancer

  https://www.parkwaycancercentre.com/sg/learn-about-cancer/types-of-cancer/cancer-details/esophageal-cancer

  This endoscopic test may be done in cases where the cancer is in the upper part of the oesophagus to see if it has spread to the trachea (windpipe) or the bronchi (tubes leading from the windpipe into the lungs). […] This procedure may be done for some patients with locally advanced adenocarcinoma of the oesophagus who may have small metastasis (spread) that may have been missed on CT or PET-CT (also known as occult metastasis). […] The overall five-year survival rate is 22%. […] The best outcome is seen in those who are diagnosed in the very early stages, when the tumour is still confined to the oesophagus and can be removed completely with surgery. […] If diagnosed and treated early (Stage 1), the 5-year survival rate can be up to 65%. […] It is often difficult to detect oesophageal cancer early because signs and symptoms usually do not appear until it has progressed to an advanced stage. […] If you are at high risk for oesophageal cancer, for example if you have Barretts oesophagus, regular endoscopic surveillance is recommended to detect early cancerous changes.

• #1 Esophageal Cancer: Symptoms, Diagnosis and Treatment | Onco.com

  https://onco.com/blog/esophageal-cancer-symptoms-diagnosis-and-treatment/

  Esophageal cancer usually does not present any symptoms in its early stages. Hence, it is often diagnosed during its advanced stages. […] If there are signs of esophageal cancer, further tests may be done, which may include: […] In this test, you are asked to swallow a barium-containing liquid which is radiopaque. The barium coats the inner lining of your esophagus and shows changes in the tissues on an X-ray. This helps the doctor assess if there are any growths or obstructions in the esophagus. […] A flexible tube with a camera at one end, called endoscope is passed down your throat. This test facilitates to look for esophageal cancer or areas of irritation. […] For this test, a special endoscope will be passed down the throat to collect a small sample of suspicious tissue, which is analysed in the laboratory.

• #1 Esophageal Cancer: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/277930-overview

  Esophageal cancer is a disease in epidemiologic transition. Until the 1970s, the most common type of esophageal cancer in the United States was squamous cell carcinoma, which has smoking and alcohol consumption as risk factors. Since then, there has been a steep increase in the incidence of esophageal adenocarcinoma, for which the most common predisposing factor is gastroesophageal reflux disease (GERD). […] Presenting signs and symptoms of esophageal cancer include the following: Dysphagia (most common); initially for solids, eventually progressing to include liquids (usually occurs when esophageal lumen 13 mm). […] Imaging studies used for diagnosis and staging include the following: Esophagogastroduodenoscopy (EGD; allows direct visualization and biopsies of the tumor). […] For staging information, see Esophageal Cancer Staging.

• #1 Esophageal Cancer Treatment – NCI

  https://www.cancer.gov/types/esophageal/patient/esophageal-treatment-pdq

  Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus. […] Tests that examine the esophagus are used to diagnose esophageal cancer. […] Signs and symptoms of esophageal cancer are weight loss and painful or difficult swallowing. […] Certain factors affect prognosis (chance of recovery) and treatment options. […] After esophageal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the esophagus or to other parts of the body. […] The grade of the tumor is also used to describe the cancer and plan treatment. […] The following stages are used for squamous cell carcinoma of the esophagus: Stage 0 (High-grade Dysplasia), Stage I squamous cell carcinoma of the esophagus, Stage II squamous cell carcinoma of the esophagus, Stage III squamous cell carcinoma of the esophagus, Stage IV squamous cell carcinoma of the esophagus.

• #1 Oesophageal Cancer | Guts UK Charity

  https://gutscharity.org.uk/advice-and-information/conditions/oesophageal-cancer/

  Oesophageal cancer may cause no symptoms until it begins to obstruct passage of food and fluids down the oesophagus, or to make swallowing painful. […] Most patients seek medical attention because of problems swallowing. Going to the doctor early when symptoms begin is important, to increase the chances of early diagnosis and effective treatment. The GP is likely to make a referral to a specialist for investigations. These are likely to include a barium swallow. This involves swallowing a white liquid containing barium, which shows up on X-ray, outlining the oesophagus and revealing any obstruction. Another test likely to be used is an endoscopy, in which a narrow, flexible telescope is passed gently into the oesophagus through the mouth, using a local anaesthetic throat spray or sedation. Changes in the lining of the oesophagus can be seen and samples taken (biopsy) for laboratory examination.

• #1 Oesophageal cancer | healthdirect

  https://www.healthdirect.gov.au/oesophageal-cancer

  Oesophageal cancer occurs in the tube that takes food from your mouth to your stomach. […] The most common type of oesophageal cancer is adenocarcinoma it usually occurs in the lower oesophagus. […] Common symptoms include food getting stuck in your oesophagus and coming back up (regurgitation), bloody vomit, a change in your voice and fatigue. […] Oesophageal cancer is treated with surgery, an oesophageal stent, chemotherapy, radiotherapy or immunotherapy. […] How is oesophageal cancer diagnosed? […] Your doctor will ask about your symptoms and examine you. […] You may be referred for tests including: blood tests to assess your general health, imaging tests such as ultrasound, CT or PET scans, endoscopy where a flexible tube with a camera at the end is used to look down your oesophagus and into your stomach, biopsy during endoscopy, the doctor can remove a small sample of tissue to be checked in the lab for signs of cancer. […] Sometimes laparoscopy (keyhole surgery) may be used to look inside your abdomen (tummy area) and check if the cancer has spread.

• #1 Esophageal Cancer Screening, Symptoms, Diagnosis & Treatment | Mary Bird Perkins Cancer Center

  https://marybird.org/cancer-types/esophageal/

  The American Cancer Society estimates that each year, more than 17,000 people (13,750 men and 3,900 women) in the U.S. are diagnosed with esophageal cancer. The lifetime risk of esophageal cancer in the U.S. is about one in every 132 men and one in every 455 women. […] Cancer of the esophagus starts in the inner layer of the esophagus and grows outward. Since 2 types of cells can line the esophagus, there are 2 main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. […] At Mary Bird Perkins Our Lady of the Lake Cancer Center, our patients can receive an esophagectomy, a surgical procedure to remove the esophagus affected by esophageal cancer. […] Talk to your doctor about how often you should be screened for esophageal cancer. […] The symptoms associated with esophageal cancer may be: trouble swallowing, chest pain, weight loss, hoarseness, chronic cough, vomiting, hiccups, bone pain, bleeding into the esophagus, black stool, anemia, or fatigue. If you experience any of these symptoms, please talk to your doctor. […] Clinical trials are research studies that involve human beings in order to test new ways to prevent, detect, diagnose or treat diseases.

• #1 Oesophageal Carcinoma. Cancer of the oesophagus; information

  https://patient.info/doctor/oesophageal-cancer-pro

  The initial investigation of a patient with symptoms suggestive of oesophageal carcinoma should include: […] Urgent endoscopy – with brushings and biopsy of any lesion seen. […] Offer urgent, direct access upper gastrointestinal endoscopy (to be performed within two weeks) to assess for oesophageal cancer in people: […] Consider non-urgent direct access upper gastrointestinal endoscopy to assess for oesophageal cancer in people with haematemesis. […] The National Institute for Health and Care Excellence (NICE) have issued guidance on the assessment and management of patients, once the diagnosis of cancer involving the gastro-oesophageal junction has been made. Such assessment helps differentiate those patients who should receive radical treatment from those who should receive palliative care.

• #1 Esophageal cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-cancer/diagnosis-treatment/drc-20356090

  During an upper endoscopy, a healthcare professional inserts a thin, flexible tube equipped with a light and camera down the throat and into the esophagus. The tiny camera provides a view of the esophagus, stomach and the beginning of the small intestine, called the duodenum. […] Esophageal cancer diagnosis often begins with imaging tests to look at the esophagus. A thin, flexible tube with a camera may be passed down the throat to see the esophagus. A sample of tissue may be taken for lab testing. […] Upper endoscopy is a test to look at the upper digestive system. It uses a long, flexible tube with a camera at the end, called an endoscope, to see inside the body. To see inside the esophagus, a healthcare professional passes the endoscope down the throat and into the esophagus. The health professional looks for signs of cancer.

• #1 Diagnosis of esophageal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/esophageal/diagnosis

  An upper GI endoscopy is done to examine the upper gastrointestinal tract, including the esophagus, stomach and the first part of the small intestine (called the duodenum). It uses an endoscope, which is a flexible tube with a light and lens on the end. […] EUS is often done at the same time as an upper GI endoscopy. […] During a biopsy, the doctor removes tissues or cells from the body so they can be tested in a lab. The report from the lab will confirm whether or not cancer cells are present in the sample. […] A CT scan is used to look at the chest and abdomen to find out the size and location to help stage an esophageal tumour. It is also used to look for cancer that has spread to the nearby lymph nodes, liver, lungs or adrenal glands. […] A PET scan is used to look for very small tumours in the chest or abdomen that may have spread from an esophageal cancer.

• #1 How Is Esophageal Cancer Diagnosed? | Esophagus Cancer Diagnosis | American Cancer Society

  https://www.cancer.org/cancer/types/esophagus-cancer/detection-diagnosis-staging/how-diagnosed.html

  Esophagus cancers are usually found because of signs or symptoms a person is having. If esophagus cancer is suspected, exams, tests, and a biopsy (a sample of esophagus cells) will be needed to confirm the diagnosis. If cancer is found, further tests will be done to help determine the extent (stage) of the cancer. […] If the results of your history and physical exam suggest you might have esophageal cancer, more tests will be done. These could include imaging tests and/or biopsies of the esophagus. […] Imaging tests might be done for a number of reasons both before and after a diagnosis of esophageal cancer, including: To look at a suspicious area that might be cancer. […] This test can show even small, early cancers. Early cancers can look like small round bumps or flat, raised areas (called plaques), while advanced cancers look like large irregular areas and can cause narrowing of the inside of the esophagus.

• #1 Diagnosis of esophageal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/esophageal/diagnosis

  Diagnosis is the process of finding out the cause of a health problem. Diagnosing esophageal cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and may do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for esophageal cancer or other health problems. […] The following tests are usually used to rule out or diagnose esophageal cancer. Many of the same tests used to diagnose cancer are used to find out the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment. […] An upper GI series is often the first diagnostic test used to check for esophageal cancer. It can show: a break in the surface of the esophagus (called ulceration), narrowing of the esophagus (called a stricture), the location and general size of a tumour in the esophagus, an abnormal opening from the esophagus into the trachea (called tracheoesophageal fistula), how well you can swallow, if the cancer has spread to the stomach.

• #1 How Is Esophageal Cancer Diagnosed? | Esophagus Cancer Diagnosis | American Cancer Society

  https://www.cancer.org/cancer/types/esophagus-cancer/detection-diagnosis-staging/how-diagnosed.html

  This test can also be used to diagnose one of the more serious complications of esophageal cancer called a tracheo-esophageal fistula. […] This test can help tell if esophageal cancer has spread to nearby organs and lymph nodes (bean-sized collections of immune cells to which cancers often spread first) or to distant parts of the body. […] An endoscope is a flexible, narrow tube with a tiny video camera and light on the end that is used to look inside the body. Tests that use endoscopes can help diagnose esophageal cancer or determine the extent of its spread. […] Upper endoscopy can give the doctor important information about the size and spread of the tumor, which can be used to help determine if the tumor can be removed with surgery. […] If esophageal cancer is too advanced for surgery, your biopsy samples may be tested for the HER2 gene or protein.

• #1 Esophageal Cancer Workup: Approach Considerations, Imaging Studies, Staging

  https://emedicine.medscape.com/article/277930-workup

  Laboratory studies in patients with esophageal cancer focus principally on patient factors that may affect treatment. […] Upper GI endoscopy allows direct visualization and biopsies of the tumor. […] Endoscopy is a very important tool in the diagnosis, staging, and surveillance of patients with esophageal cancer. […] Diagnostic endoscopies are performed to determine the following: Detection of esophageal tumor, Biopsy of any suspicious lesions, Location of the tumor relative to the teeth and esophagogastric junction, Tumor length, Degree of obstruction. […] Esophageal tumor length, as assessed by preoperative endoscopy, has been identified as an independent predictor of long-term survival in patients with adenocarcinoma of the esophagus. […] Endoscopic resection (ER) of focal nodules should be performed in the setting of early-stage disease (T1a or T1b) to provide accurate assessment of depth of invasion, degree of differentiation, and the presence of lymphovascular invasion. […] Thus, ER is an essential procedure for the accurate staging of early-stage cancer especially in patients with small nodular lesions (2 cm).

• #1 Esophageal cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophageal-cancer/diagnosis-treatment/drc-20356090

  A biopsy is a procedure to remove a sample of tissue for testing in a lab. To get the tissue sample, a healthcare professional passes special cutting tools through an endoscope. The health professional uses the tools to remove a very small amount of tissue from the inside of the esophagus. The tissue sample is sent to a lab to look for cancer cells. […] After an esophageal cancer diagnosis, you may have other tests to see if the cancer has spread. These tests help your healthcare team find out the extent of your cancer, called the stage. Cancer staging tests often involve imaging tests. The tests might look for signs of cancer in your lymph nodes or in other parts of your body. Your healthcare team uses the cancer staging test results to help create your treatment plan. […] Imaging tests may include bronchoscopy, endoscopic ultrasound, CT, MRI and positron emission tomography scans, also called PET scans. Not every test is right for every person. Talk with your healthcare professional about which tests you will need.

• #1 Diagnostics and Early Diagnosis of Esophageal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4789940/

  The management of esophageal cancer is challenging not only in terms of identifying patients at high risk but also because of the overall poor prognosis of the disease. […] Typical symptoms of esophageal carcinoma are dysphagia (reduction of esophagus lumen to 50%), vomiting, loss of body weight, and gastrointestinal bleeding. […] Gastroscopy unveils mucosal irregularities with high-resolution white-light endoscopy. […] A targeted biopsy can be performed in suspect areas to ensure the diagnosis of the endoscopist. […] Due to the fact that the sensitivity for mucosal biopsies to detect esophageal carcinoma reaches 96% when multiple samples are obtained, a minimum of eight biopsies should be taken from the margins and the center of the lesion. […] Accurate staging information is crucial in order to establish appropriate treatment choices for esophageal cancer. The depth of the tumor determines the feasibility of endoscopic management or whether to establish tumor margins and/or lymph node involvement before possible surgical resection or chemoradiation. […] An abdominal ultrasound and a multi-slice CT scan of the thorax and abdomen are required for staging the tumor before therapy is initiated.

• #1 Esophageal Cancer Diagnosis | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/esophageal-cancer/esophageal-cancer-diagnosis.html

  The stage of esophageal cancer indicates how advanced the tumor is and if it has spread. It also informs your care team about potential treatment options. […] The most common system used to stage esophageal cancer is the TNM system. […] Staging also takes into account the cell type of the cancer, grade of the cancer and, in some cases, location of the tumor. […] The overall stage of a cancer is a combination of the key elements described above. Cancer stages range from stage 0 (pre-cancer) to stage IV (advanced cancer.) […] The grade of a cancer is based on how normal (or differentiated) the cells appear when they are looked at under the microscope. The higher the number, the more abnormal the cells look. Higher-grade tumors tend to be more aggressive, spreading faster than lower-grade tumors.

• #1 How Is Esophageal Cancer Diagnosed? | Esophagus Cancer Diagnosis | American Cancer Society

  https://www.cancer.org/cancer/types/esophagus-cancer/detection-diagnosis-staging/how-diagnosed.html

  Esophageal cancers that test positive for MMR changes or high MSI and cannot be treated with surgery, have come back after initial treatment, or have spread to other parts of the body might benefit from treatment with an immunotherapy drug. […] Your doctor might order certain blood tests if they think you have esophageal cancer.

• #1 Esophageal Cancer Workup: Approach Considerations, Imaging Studies, Staging

  https://emedicine.medscape.com/article/277930-workup

  Imaging studies used in the diagnosis and staging of esophageal cancer include the following: CT scanning, PET scanning, Endoscopic ultrasound (EUS), Bronchoscopy, Barium swallow. […] EUS is the most sensitive test for determining the depth of tumor penetration (T staging) and the presence of enlarged periesophageal lymph nodes (N staging). […] The accuracy of diagnosing nodal disease is significantly increased with the combination of above-mentioned features, but also is confirmed with the use of fine needle aspiration (FNA) biopsy for cytology assessment. […] The combined use of EUS and FNA (EUS-FNA) has a greater accuracy than EUS alone in the evaluation of lymph node metastasis. […] Esophageal cancer staging follows the tumor-node-metastasis (TNM) classification of the American Joint Cancer Committee/Union for International Cancer Control/ (AJCC/UICC). […] No completely satisfactory method is available to clinically stage esophageal cancer. […] The revised 2010 AJCC staging classification was based on the risk-adjusted random forest analysis of the data generated by the Worldwide Esophageal Cancer Collaboration (WECC) for 4627 patients who were treated with primary esophagectomy without preoperative or postoperative therapy. […] The 2017 TNM classification for esophageal cancer is shown below (staging is detailed in Tables 2-4, below. T staging is illustrated in the image below).

• #1 Esophageal Cancer Diagnosis and Treatment – Pi Health Cancer Hospital

  https://www.pihealthcancerhospital.com/blog/esophageal-cancer-diagnosis-and-treatment/

  There are several types of tests to diagnose esophageal cancer. The most common tests are: […] The most common test for esophageal cancer is an esophagogastroduodenoscopy, sometimes known as an EGD. A doctor uses an endoscope (a flexible tube with a camera attached that allows your doctor to look inside your body) to collect tissue samples from problematic locations. […] If the biopsy findings show cancer, your doctor may arrange an endoscopic ultrasonography. This is one of the most accurate imaging methods for detecting esophageal cancer. EUS combines two techniques to examine your esophagus: […] A PET scan, or positron emission tomography, is used to see if cancer has gone beyond the esophagus. A PET scan utilizes radioactive dye to illuminate sections of your body during scanning, allowing a doctor to identify possibly malignant spots for treatment.

• #1 Esophageal Cancer Workup: Approach Considerations, Imaging Studies, Staging

  https://emedicine.medscape.com/article/277930-workup

  In 2013, the Society of Thoracic Surgeons released clinical practice guidelines to assist in the diagnosis and treatment of localized esophageal cancer. Their recommendations for diagnosis include the following: […] Flexible endoscopy with biopsy is the primary method for diagnosis of esophageal cancer. […] Computed tomography (CT) of the chest and abdomen is an optional test for staging of early-stage esophageal cancer, and a recommended test for staging of locoregionalized esophageal cancer. […] Positron emission tomography (PET) is an optional test for staging of early-stage esophageal cancer, and a recommended test for staging of locoregionalized esophageal cancer. […] In patients without metastatic disease, endoscopic ultrasonography is recommended to improve the accuracy of staging. […] In patients with small, discrete nodules or areas of dysplasia in whom disease appears limited to the mucosa or submucosa as assessed by endoscopic ultrasonography, endoscopic mucosal resection should be considered as a diagnostic/staging tool. […] In patients with locally advanced (T3/T4) adenocarcinoma of the esophagogastric junction infiltrating the anatomic cardia or Siewart type III esophagogastric tumors, laparoscopy is recommended to improve the accuracy of staging.

• #1 Esophageal Cancer Diagnosis | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/esophageal-cancer/esophageal-cancer-diagnosis.html

  A biopsy is the removal of suspected cancer cells for examination under a microscope. […] Esophageal cancer biopsy procedures include: […] An endoscope, a tube with a high-definition camera and light, is inserted through the mouth into the esophagus. The doctor looks at the esophagus and removes small pieces of tissue for review by our Pathology department. […] An endoscope with an ultrasound device attached to the tip is inserted through an opening in the body, usually the mouth. […] This method helps the physician determine how deeply a tumor invades into the esophageal wall. It can also be used to examine nearby lymph nodes for cancer spread. […] Using a tool called a bronchoscope, the doctor looks at the trachea (windpipe) and the tubes that go into the lungs. This may be performed if there is suspicion of esophageal cancer invading the respiratory tract.

• #1 Diagnosis of esophageal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/esophageal/diagnosis

  A laparoscopy is used to accurately stage esophageal cancer so doctors can plan treatment. It may find cancer that has spread to other parts of the abdomen that wasn’t seen on a PET or CT scan. […] HER2 status testing is done on esophageal tumours found where the esophagus and stomach join (called the gastroesophageal, or GE, junction). This information will help your healthcare team decide which treatments will work best for you.

• #1 How We Diagnose Esophageal Cancer | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/esophageal-cancer/diagnosis

  A procedure to look inside the esophagus to check for abnormal areas. An esophagoscope is inserted through the mouth or nose and into the esophagus. […] Your doctor uses an endoscope (a thin tube) to look inside your stomach. […] The process used to find out if cancer has spread within the esophagus or to other parts of the body is called staging. […] The staging process is the most important factor in determining your treatment plan. […] Pathologists’ findings are critical to determining the best treatment, and, at our center, pathologists are key members of your medical team. […] When this condition is found, it presents a rare opportunity for your doctors to try to prevent it from progressing into esophageal cancer. […] The stage of cancer is carefully divided into categories based on the size and spread of cancer beyond the esophagus and into other places in the body (metastasis).

• #1 Esophageal Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459267/

  Esophageal cancer staging is crucial for determining prognosis and guiding treatment decisions. […] The most widely used staging system is the TNM (Tumor, Node, Metastasis) classification developed by the American Joint Committee on Cancer (AJCC). […] The overall stage grouping for esophageal cancer, based on the TNM classification, is as follows: Stage 0: Tis N0 M0, Stage I: T1 N0-1 M0, Stage II: T2 N0-1 M0 or T3 N0 M0, Stage III: T1-2 N2 M0, T3 N1-2 M0, or T4a N0-2 M0, Stage IVA: T4b Any N M0 or Any T N3 M0, Stage IVB: Any T Any N M1. […] The prognosis of esophageal cancer depends on various factors, including the stage at diagnosis, histologic subtype, grade, and patient characteristics such as age and overall health.

• #1 How is oesophageal cancer diagnosed?

  https://pancare.org.au/cancer/oesophageal-cancer/diagnosing-oesophageal-cancer/

  Positron Emission Tomography (PET) is a test where a small amount of radioactive substance is injected into a vein. […] The TNM gives a number according to tumour size (T), how many lymph nodes are affected (N), and how far the cancer has spread, or metastasised, to distant parts of the body (M). […] Your test results will enable your doctors to make a detailed diagnosis and indicate to them at what stage your cancer is. […] Receiving the diagnosis of oesophageal cancer can be unnerving, confusing, and disorienting.

• #1 Oesophageal cancer – symptoms, treatment, staging, diagnosis | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/oesophageal-cancer

  These tests may include: Blood tests, Chest x-ray, CT scan, PET-CT scan, Endoscopic ultrasound (EUS), Laparoscopy, Barium swallow. […] The results of your tests help your doctors find out more about the position of the cancer and whether it has spread. This is called staging. […] A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread. […] Knowing the stage and grade helps your doctors plan the best treatment for you.

• #1 Esophageal Cancer | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0101/p22.html

  Esophageal cancer has a poor prognosis and high mortality rate, with an estimated 16,910 new cases and 15,910 deaths projected in 2016 in the United States. […] Physicians should have a low threshold for evaluation with endoscopy if any symptoms are present. […] If cancer is confirmed, integrated positron emission tomography and computed tomography should be used for initial staging. […] If no distant metastases are found, endoscopic ultrasonography should be performed to determine tumor depth and evaluate for nodal involvement. […] The Society of Thoracic Surgeons and the National Comprehensive Cancer Network (NCCN) recommend that patients with the clinical presentation described previously undergo upper endoscopy as the initial diagnostic evaluation to exclude esophageal cancer. […] Chromoendoscopy (topical application of stains to improve visualization of different mucosal tissues) and narrow band imaging (use of blue and green light to improve visualization of blood vessels and other mucosal features) are often used during endoscopy to improve identification of suspicious lesions.

• #1 Early diagnosis of oesophageal cancer | British Journal of Cancer

  https://www.nature.com/articles/6605126

  Traditional white-light endoscopy can identify macroscopic features of early cancer, such as nodules, ulcers or strictures. […] Chromoendoscopy is the application of a chemical capable of selective light absorption, which results in colouration of certain organic compounds to enhance endoscopic visualisation. […] A trimodal endoscope, which combines the ability to provide high-resolution white-light endoscopy, autofluorescence and narrow-band imaging, is now commercially available. […] Confocal fluorescence microscopy attempts to highlight morphological changes in tissue, which occur in dysplasia, through imaging of the autofluorescence properties of the mucosa. […] The epithelial elastic scattering index depends on the composition of sub-cellular components, such as the nucleus and mitochondria, which alter during malignant transformation.

• #1 Esophageal Cancer Diagnosis – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/esophageal-cancer/screening-diagnosis

  When esophageal cancer is suspected, physicians look for evidence of cancerous cells and tumors within your esophagus, nearby lymph nodes and other organs. […] At the University of Chicago Medicine Center for Gastrointestinal Oncology, some of the tests used to diagnose esophageal cancer include: […] Upper endoscopy: In an upper endoscopy, a thin, flexible tube is guided down the mouth and throat, into the esophagus. […] Endoscopic ultrasound (EUS): EUS can help physicians determine the extent to which tumors have penetrated the esophagus or involved nearby lymph nodes. […] Probe-based confocal laser endomicroscopy (pCLE): Using one of the world’s smallest microscopes, our doctors are able to view esophageal cells without removing tissue. […] Computed tomography (CT): A CT scan is a noninvasive imaging test that combines X-rays and computer technology to produce images of the body.

• #1 Smart probe for oesophageal cancer diagnosis begins human trials – News

  https://news.exeter.ac.uk/faculty-of-health-and-life-sciences/smart-probe-for-oesophageal-cancer-diagnosis-begins-human-trials/

  Surgeons and scientists are now undertaking clinical trials for a pioneering new technique that could detect and diagnose one of the deadliest forms of cancer within seconds. […] A team of experts from the University of Exeter, University of Bristol, and Gloucestershire Hospitals NHS Foundation Trust has developed a ground-breaking technique to help detect and diagnose oesophageal (food pipe) cancers. […] The new medical device uses light to pinpoint cancerous tissues or cells almost instantaneously, using a laser-based technique called Raman spectroscopy. This new approach could significantly reduce the time for diagnosis and treatment by providing results in under 30 seconds, compared to up to two weeks for current diagnosis techniques. […] The joint research team have started undertaking clinical trials involving patients regularly screened for oesophageal cancers to help demonstrate the technique and reveal the true extent to which this new diagnostic tool could be used across the healthcare system.

• #1 ‘Pill on a string’ test to transform oesophageal cancer diagnosis | University of Cambridge

  https://www.cam.ac.uk/research/news/pill-on-a-string-test-to-transform-oesophageal-cancer-diagnosis

  A pill on a string test can identify ten times more people with Barretts oesophagus than the usual GP route, after results from a 3-year trial were published in the medical journal The Lancet. […] The test, which can be carried out by a nurse in a GP surgery, is also better at picking up abnormal cells and potentially early-stage cancer. […] The Cytosponge test, developed by researchers at the University of Cambridge, is a small pill with a thread attached that the patient swallows, which expands into a small sponge when it reaches the stomach. […] In a study funded by Cancer Research UK, the researchers studied 13,222 participants who were randomly allocated to the sponge test or were looked after by a GP in the usual way. Over the course of a year, the odds of detecting Barretts were ten times higher in those offered the Cytosponge with 140 cases diagnosed compared to 13 in usual care.

• #1 Smart probe for oesophageal cancer diagnosis begins human trials – News

  https://news.exeter.ac.uk/faculty-of-health-and-life-sciences/smart-probe-for-oesophageal-cancer-diagnosis-begins-human-trials/

  Mr Oliver Old, Consultant Upper GI Surgeon, from Gloucestershire Hospitals, said: We are excited by the prospect of introducing this new technology to benefit patients. It has the potential to achieve more accurate and earlier diagnosis of oesophageal cancer. Early detection is crucial to improving outcomes. […] The new technique uses a miniature optical probe that slides through a channel in the endoscope (telescope) to the surface of the oesophagus. Medical professionals are then able to see whether the light patterns can reveal cancerous changes in the lining of the oesophagus quickly, safely and avoiding the need for an invasive biopsy. […] The technique has been used previously on oesophageal tissue biopsy samples from over 500 patients. This new phase of the research is the first study demonstrating the technology in patients.

• #1 Esophageal Cancer Screening – NCI

  https://www.cancer.gov/types/esophageal/patient/esophageal-screening-pdq

  Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread. […] If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests. […] Tests are used to screen for different types of cancer when a person does not have symptoms. […] There is no standard or routine screening test for esophageal cancer. […] Although there are no standard or routine screening tests for esophageal cancer, the following tests are being used or studied to screen for it: Esophagoscopy, Biopsy, Brush cytology, Balloon cytology, Chromoendoscopy, Fluorescence spectroscopy.

• #1 Finding Esophageal Cancer Early | Can Esophageal Cancer Be Found Early? | American Cancer Society

  https://www.cancer.org/cancer/types/esophagus-cancer/detection-diagnosis-staging/detection.html

  Screening is the process of looking for cancer or pre-cancer in people who have no symptoms of the disease. In the United States, screening the general public for esophageal cancer is not recommended by any professional organization at this time. This is because no screening test has been shown to lower the risk of dying from esophageal cancer in people who are at average risk. […] However, people who have a high risk of esophageal cancer, such as those with Barretts esophagus, are often followed closely to look for early cancers and pre-cancers. […] Many experts recommend that people with a high risk of esophageal cancer, such as those with Barretts esophagus, have upper endoscopy regularly. For this test, the doctor looks at the inside of the esophagus through a flexible lighted tube called an endoscope.

• #1 Finding Esophageal Cancer Early | Can Esophageal Cancer Be Found Early? | American Cancer Society

  https://www.cancer.org/cancer/types/esophagus-cancer/detection-diagnosis-staging/detection.html

  Doctors arent certain how often the test should be repeated, but most recommend testing more often if areas of dysplasia are found. […] If the area of Barretts is large and/or there is high-grade dysplasia, treatment of the abnormal area might be advised because of the high risk that an adenocarcinoma is either already present (but was not found) or will develop within a few years. […] People with inherited syndromes (sometimes called hereditary syndromes) that put them at increased risk of developing esophageal cancer, might also need frequent endoscopies to look for cancer or pre-cancer. […] Careful monitoring and treatment (if needed) may help prevent some esophageal cancers from developing. It may also detect some cancers early, when they are more likely to be treated successfully.

• #2 Oesophageal cancer | healthdirect

  https://www.healthdirect.gov.au/oesophageal-cancer

  Oesophageal cancer occurs in the tube that takes food from your mouth to your stomach. […] The most common type of oesophageal cancer is adenocarcinoma it usually occurs in the lower oesophagus. […] Common symptoms include food getting stuck in your oesophagus and coming back up (regurgitation), bloody vomit, a change in your voice and fatigue. […] Oesophageal cancer is treated with surgery, an oesophageal stent, chemotherapy, radiotherapy or immunotherapy. […] How is oesophageal cancer diagnosed? […] Your doctor will ask about your symptoms and examine you. […] You may be referred for tests including: blood tests to assess your general health, imaging tests such as ultrasound, CT or PET scans, endoscopy where a flexible tube with a camera at the end is used to look down your oesophagus and into your stomach, biopsy during endoscopy, the doctor can remove a small sample of tissue to be checked in the lab for signs of cancer. […] Sometimes laparoscopy (keyhole surgery) may be used to look inside your abdomen (tummy area) and check if the cancer has spread.

• #2 Esophageal Cancer Screening, Symptoms, Diagnosis & Treatment | Mary Bird Perkins Cancer Center

  https://marybird.org/cancer-types/esophageal/

  The American Cancer Society estimates that each year, more than 17,000 people (13,750 men and 3,900 women) in the U.S. are diagnosed with esophageal cancer. The lifetime risk of esophageal cancer in the U.S. is about one in every 132 men and one in every 455 women. […] Cancer of the esophagus starts in the inner layer of the esophagus and grows outward. Since 2 types of cells can line the esophagus, there are 2 main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. […] At Mary Bird Perkins Our Lady of the Lake Cancer Center, our patients can receive an esophagectomy, a surgical procedure to remove the esophagus affected by esophageal cancer. […] Talk to your doctor about how often you should be screened for esophageal cancer. […] The symptoms associated with esophageal cancer may be: trouble swallowing, chest pain, weight loss, hoarseness, chronic cough, vomiting, hiccups, bone pain, bleeding into the esophagus, black stool, anemia, or fatigue. If you experience any of these symptoms, please talk to your doctor. […] Clinical trials are research studies that involve human beings in order to test new ways to prevent, detect, diagnose or treat diseases.

• #2 Diagnostics and Early Diagnosis of Esophageal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4789940/

  In the esophagus two different kinds of primary neoplasias may arise: squamocellular carcinomas (SCC) and esophageal adenocarcinomas (EAC). […] The management of esophageal cancer is challenging. There are no specific symptoms of early esophageal cancers. Due to this fact, most of the esophageal cancers are found incidentally, and only 12.5% of esophageal tumors are endoscopically resectable. Gastroscopy is the gold standard for the diagnosis of esophageal cancer. […] The sensitivity of detecting early-stage carcinoma may be improved by adjunct techniques such as chromoendoscopy, virtual chromoendoscopy, magnification endoscopy, and other advanced endoscopic imaging techniques. The diagnosis of esophageal cancer can be verified with targeted biopsies. […] Accurate staging information is crucial for establishing appropriate treatment choices for esophageal cancer, while the depth of the tumor determines the feasibility of therapy. In terms of staging, endosonography, abdominal ultrasound, and computed tomography scan of the thorax and abdomen should thus be performed before initiation of therapy.

• #2 Diagnosis of esophageal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/esophageal/diagnosis

  Diagnosis is the process of finding out the cause of a health problem. Diagnosing esophageal cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and may do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for esophageal cancer or other health problems. […] The following tests are usually used to rule out or diagnose esophageal cancer. Many of the same tests used to diagnose cancer are used to find out the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment. […] An upper GI series is often the first diagnostic test used to check for esophageal cancer. It can show: a break in the surface of the esophagus (called ulceration), narrowing of the esophagus (called a stricture), the location and general size of a tumour in the esophagus, an abnormal opening from the esophagus into the trachea (called tracheoesophageal fistula), how well you can swallow, if the cancer has spread to the stomach.

• #2 Esophageal Cancer Workup: Approach Considerations, Imaging Studies, Staging

  https://emedicine.medscape.com/article/277930-workup

  Laboratory studies in patients with esophageal cancer focus principally on patient factors that may affect treatment. […] Upper GI endoscopy allows direct visualization and biopsies of the tumor. […] Endoscopy is a very important tool in the diagnosis, staging, and surveillance of patients with esophageal cancer. […] Diagnostic endoscopies are performed to determine the following: Detection of esophageal tumor, Biopsy of any suspicious lesions, Location of the tumor relative to the teeth and esophagogastric junction, Tumor length, Degree of obstruction. […] Esophageal tumor length, as assessed by preoperative endoscopy, has been identified as an independent predictor of long-term survival in patients with adenocarcinoma of the esophagus. […] Endoscopic resection (ER) of focal nodules should be performed in the setting of early-stage disease (T1a or T1b) to provide accurate assessment of depth of invasion, degree of differentiation, and the presence of lymphovascular invasion. […] Thus, ER is an essential procedure for the accurate staging of early-stage cancer especially in patients with small nodular lesions (2 cm).

• #2 Diagnosis of esophageal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/esophageal/diagnosis

  A laparoscopy is used to accurately stage esophageal cancer so doctors can plan treatment. It may find cancer that has spread to other parts of the abdomen that wasn’t seen on a PET or CT scan. […] HER2 status testing is done on esophageal tumours found where the esophagus and stomach join (called the gastroesophageal, or GE, junction). This information will help your healthcare team decide which treatments will work best for you.

• #2 Esophageal Cancer Workup: Approach Considerations, Imaging Studies, Staging

  https://emedicine.medscape.com/article/277930-workup

  In 2013, the Society of Thoracic Surgeons released clinical practice guidelines to assist in the diagnosis and treatment of localized esophageal cancer. Their recommendations for diagnosis include the following: […] Flexible endoscopy with biopsy is the primary method for diagnosis of esophageal cancer. […] Computed tomography (CT) of the chest and abdomen is an optional test for staging of early-stage esophageal cancer, and a recommended test for staging of locoregionalized esophageal cancer. […] Positron emission tomography (PET) is an optional test for staging of early-stage esophageal cancer, and a recommended test for staging of locoregionalized esophageal cancer. […] In patients without metastatic disease, endoscopic ultrasonography is recommended to improve the accuracy of staging. […] In patients with small, discrete nodules or areas of dysplasia in whom disease appears limited to the mucosa or submucosa as assessed by endoscopic ultrasonography, endoscopic mucosal resection should be considered as a diagnostic/staging tool. […] In patients with locally advanced (T3/T4) adenocarcinoma of the esophagogastric junction infiltrating the anatomic cardia or Siewart type III esophagogastric tumors, laparoscopy is recommended to improve the accuracy of staging.

• #2 Esophageal Cancer Workup: Approach Considerations, Imaging Studies, Staging

  https://emedicine.medscape.com/article/277930-workup

  Imaging studies used in the diagnosis and staging of esophageal cancer include the following: CT scanning, PET scanning, Endoscopic ultrasound (EUS), Bronchoscopy, Barium swallow. […] EUS is the most sensitive test for determining the depth of tumor penetration (T staging) and the presence of enlarged periesophageal lymph nodes (N staging). […] The accuracy of diagnosing nodal disease is significantly increased with the combination of above-mentioned features, but also is confirmed with the use of fine needle aspiration (FNA) biopsy for cytology assessment. […] The combined use of EUS and FNA (EUS-FNA) has a greater accuracy than EUS alone in the evaluation of lymph node metastasis. […] Esophageal cancer staging follows the tumor-node-metastasis (TNM) classification of the American Joint Cancer Committee/Union for International Cancer Control/ (AJCC/UICC). […] No completely satisfactory method is available to clinically stage esophageal cancer. […] The revised 2010 AJCC staging classification was based on the risk-adjusted random forest analysis of the data generated by the Worldwide Esophageal Cancer Collaboration (WECC) for 4627 patients who were treated with primary esophagectomy without preoperative or postoperative therapy. […] The 2017 TNM classification for esophageal cancer is shown below (staging is detailed in Tables 2-4, below. T staging is illustrated in the image below).

• #3 Esophageal Cancer Screening, Symptoms, Diagnosis & Treatment | Mary Bird Perkins Cancer Center

  https://marybird.org/cancer-types/esophageal/

  The American Cancer Society estimates that each year, more than 17,000 people (13,750 men and 3,900 women) in the U.S. are diagnosed with esophageal cancer. The lifetime risk of esophageal cancer in the U.S. is about one in every 132 men and one in every 455 women. […] Cancer of the esophagus starts in the inner layer of the esophagus and grows outward. Since 2 types of cells can line the esophagus, there are 2 main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. […] At Mary Bird Perkins Our Lady of the Lake Cancer Center, our patients can receive an esophagectomy, a surgical procedure to remove the esophagus affected by esophageal cancer. […] Talk to your doctor about how often you should be screened for esophageal cancer. […] The symptoms associated with esophageal cancer may be: trouble swallowing, chest pain, weight loss, hoarseness, chronic cough, vomiting, hiccups, bone pain, bleeding into the esophagus, black stool, anemia, or fatigue. If you experience any of these symptoms, please talk to your doctor. […] Clinical trials are research studies that involve human beings in order to test new ways to prevent, detect, diagnose or treat diseases.

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