Tests (oesophago-gastric cancer)

A number of tests are needed to aid in the diagnosis of oesophageal cancer, and to help us and you make further decisions around your treatment plan. As we care for patients over a regional network, you may have your tests in different hospitals. As far as possible, we will minimise the number of trips and the distance you need to travel.

Upper GI endoscopy

The first test for people with difficulty swallowing or problems with heartburn is usually an upper GI endoscopy (often referred to as an OGD). This is a common procedure involving the insertion of a thin tube with a camera on the end through the mouth into the oesophagus, stomach and first part of the small bowel called the duodenum. This test is important to look for cancer as well as a range of other problems such as acid damage or early cell changes.

Computed tomography (CT)

A CT scan is usually the first of a series of specific tests that are done to assess the cancer itself and look for any spread to glands or lymph nodes, and other organs around the body. Having a CT scan involves lying down on a narrow bed which moves through an open ring, like a big doughnut. The scan itself usually takes a few minutes. It involves exposure to x-rays, a form of ionising radiation. Doctors always minimise the amount of radiation to which patients are exposed. For people with oesophageal cancer, the benefits of this test and the information it provides to plan treatment outweigh its risks.

Positron emission tomography (PET)-CT

This is a special type of CT. It is another way of looking for spread of oesophageal cancer to glands or lymph nodes and to other organs. It involves a special injection of a radioactive, sugar-based dye which is combined with a CT scan. The dose of this radioactive dye is very low. The test is very similar to having a normal CT, as described above.

Endoscopic ultrasound (EUS)

This test is similar to having a standard upper GI endoscopy, as described above, but involves using a slightly different endoscope that has a small ultrasound device at the end of the tube. This procedure is done with a combination of injections (a painkiller and a sedative medication) to help the person relax and allow a careful examination to be performed. The procedure is designed to gain more information about the cancer itself, and it also allows a close look at the glands or lymph nodes near the cancer. If needed, small samples of these nodes can be taken to try and determine if they are affected by spread of cancer.

Staging laparoscopy

This procedure may be performed in selected cases of oesophageal cancer and gastric cancer, although it is not necessary for everybody. It is a small operation that is done under a general anaesthetic, using key-hole surgery to have a look inside the tummy or abdomen. It usually requires 3 small incisions. It is performed to look for any evidence of spread of the cancer within the space around the different organs in the abdomen. Most people go home the same day. As with any operation, there are some risks which your doctor will explain to you.