University Hospitals Seidman Cancer Center Performs Precise Esophageal Cancer Staging and Testing
Staging is an important step in determining an effective treatment plan for a patient with esophageal cancer. At UH Seidman Cancer Center, our goals during the staging process include finding out how deeply the cancer has invaded the lining of the esophagus and whether the cancer has spread to nearby tissues or other parts of the body like the lymph nodes, lungs or liver.
The five stages of esophageal cancer are:
- Stage 0: Cancer cells are only found in the inner lining of the esophagus.
- Stage I: Cancer is present in both the inner layer of the esophagus and the submucosa.
- Stage II: In addition to the inner layer and submucosa, cancer cells have spread to the patient’s lymph nodes, invaded the muscle layer of the esophagus or grown through the outer layer of the esophagus.
- Stage III: Cancer has developed in the outer layer of the esophagus and spread to the lymph nodes, or cancer has attacked nearby structures, such as the airways.
- Stage IV: The cancer has spread to outlying organs such as the liver.
To ascertain the stage of esophageal cancer, University Hospitals doctors may perform one or more of the following tests:
- Endoscopy: After light sedation, an endoscope, which is a thin, flexible tube with a small light and lens at the end, is placed down the patient’s throat to examine how deeply the cancer has invaded the wall of the esophagus. Our doctors also may perform a biopsy, to remove tiny pieces of tissue from the esophagus, trachea (windpipe) or lymph nodes and examine them under a microscope for cancerous cells.
- Computed tomography (CT) Scan: A computed tomography scan is a specialized X-ray that provides a detailed picture of the patient’s chest and abdomen. This test helps physicians to determine whether cancer has spread to the patient’s lymph nodes or other areas.
- Magnetic resonance imaging (MRI): This procedure uses a magnet, radio waves and a computer to create a visual image of the body. Like computed tomography scans, magnetic resonance imaging can show whether cancer has spread to lymph nodes or other parts of the body.
- Positron emission tomography (PET) scan: These scans use a radio-labeled substance to measure the metabolic activity of abnormal cells. Since cancerous cells have a higher metabolic rate than benign cells, malignant cells absorb more of the radio-labeled substance than benign tumors and normal tissues during the positron emission tomography scan. This technique is used to determine if esophageal cancer has spread to other areas of the body.
- Bone scan: During this procedure, a small amount of radioactive material is injected into the patient’s vein. As the substance travels through the bloodstream and collects in the bones, a scanning device takes pictures that show whether the cancer has spread to the bones.
- Laparoscopy: This minimally invasive surgery may be performed to check lymph nodes and other tissues for cancer. While the patient is under general anesthesia, a UH surgeon makes small incisions and inserts a thin, lighted tube into the abdomen. Samples, or biopsies, of the lymph nodes and surrounding tissues are removed and sent to a laboratory for microscopic examination.