If the tests show that you have cancer of the oesophagus, your doctor may want to carry out further tests. These help the doctor to see the extent (or stage ) of the cancer and decide on the best type of treatment. You will probably have a chest x-ray (if one has not already been done) and other tests, which may include any of the following:
A CT (computerised tomography) scan takes a series of x-rays which build up a three-dimensional picture of the inside of the body. The scan is painless but takes from 10 to 30 minutes. CT scans use a small amount of radiation, which will be very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.
Having a CT scan
You may be given a drink or injection of a dye which allows particular areas to be seen more clearly. For a few minutes, this may make you feel hot all over. If you are allergic to iodine or have asthma you could have a more serious reaction to the injection, so it is important to let your doctor know beforehand. You will probably be able to go home as soon as the scan is over.
Endoscopic ultrasound (EUS)
The involves the same procedure as the upper gastrointestinal endoscopy, but a tiny ultrasound probe is connected to the end of the endoscope tube and passed along the oesophagus.
Ultrasound uses sound waves to build up a picture of the area. It allows the doctors to get a deeper view of the wall of the oesophagus and surrounding areas. This may give them a clearer idea of the size and depth of the tumour. It also allows them to see whether lymph nodes nearby are enlarged, and possibly, whether this enlargement is due to cancer or simply an inflammation caused by infection.
This test involves a small operation done under a general anaesthetic and will mean a short stay in hospital. It allows the doctor to look at the upper part of the abdomen (tummy) from the inside. This is to see whether the cancer has spread into the abdomen.
The doctor makes a small cut (about 2cm) in the skin and muscle near the tummy button (navel) and carefully inserts a thin, flexible fibre-optic tube (laparoscope) into your abdomen. The doctor can then examine the area and may take samples of tissue (biopsies) to be examined under the microscope. Whether or not a laparoscopy is needed depends on the position of the tumour within the oesophagus.
Positron emission tomography scans (PET scans) can be used to find whether the cancer has spread beyond the oesophagus, or to examine any lumps that remain after treatment to see whether they are scar tissue or whether cancer cells are still present.
A PET scan uses low-dose radioactive glucose (a type of sugar) to measure the activity of cells in different parts of the body. A very small amount of a mildly radioactive substance is injected into a vein, usually in your arm. A scan is then taken a couple of hours later. Areas of cancer are usually more active than surrounding tissue and show up on the scan.
PET scans are a new type of scan and you may have to travel to a specialist centre to have one. They are not always necessary but you can discuss with your doctor whether one would be useful in your case.
Waiting for your test results
It will probably take from one to two weeks for the results of your tests to be ready, and a follow-up appointment should be arranged for you before you go home. This waiting period will be an anxious time for you and it may help to talk things over with the hospital's specialist nurse, a close friend, a relative or a knowledgeable support organisation such as Cancerbackup or the Oesophageal Patients Association.