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Diagnosis of esophageal cancer will generally be made by an x-ray imaging study such as a CT scan, or by an internal examination of the esophagus using an endoscope, or by both.
An endoscope is a flexible tube which can be extended into the esophagus and threaded down to the stomach. It is often equipped with fiber optics that can transmit images of the inside of the esophagus to a television monitor. It may also have a small attachment to take a sample or biopsy of the esophageal tissue. If the endoscope is also outfitted with another imaging system, an ultrasound probe, it may be possible to determine if lymph nodes outside of the esophagus and perhaps lungs have signs of tumor cells.
Endoscopy is done with the patient lightly sedated and generally causes no major discomfort afterwards. Microscopic analysis of the biopsy determines whether or not cancerous cells are present and how far they have invaded into the wall of the esophagus. The microscopic evaluation and the endoscopic procedures together will confirm how advanced the cancer is, if tumor cells are present.
In advanced cases of esophageal cancer, other methods to visualize tumors with thin fiber optic systems may be necessary. These include larynogoscopy to check the voice box or larynx; bronchoscopy to look at the lungs and large airways; colonoscopy to scan the colon or large intestine, and thorascopy to examine the organs inside the thorax or chest cavity.
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