If cancer is found the following tests are performed:

Once a diagnosis of oesophageal cancer has been made it is important for the patient and doctors to understand how far the cancer has spread. This allows accurate treatment planning and gives an idea of the potential outcomes from different available treatments. A series of tests will be performed that are referred to as “staging investigations”.

The first staging investigation will usually be a CT scan of the chest, abdomen, and pelvis. The patient lies flat on a bench while they are slowly moved through a large donut shaped x-ray machine. At the same time a dye is injected into a vein to help improve the detail of the x-ray pictures. This is often performed straight after the endoscopy when the cancer is first seen.

The purpose of a CT is to assess the size and spread of the primary cancer and identify any secondary (metastatic) disease to more distant organs. In those patients where the cancer has not spread on CT and possible curative treatment is proposed then further imaging in the form of Positron Emission Tomography (PET)-CT and Endoscopic Ultrasound (EUS) may be performed. 

A PET CT is like a CT scan but involves a special dye that will show up brightly on the scan pictures wherever cells in the body are working hard and using a lot of energy. Cancer cells tend to use a lot of energy and therefore appear as bright areas on these images.

An EUS is very similar to an endoscopy except the scope that the doctor uses will have a small ultrasound probe on the end which will help to assess the depth of any tumours in the wall of the oesophagus. This gives clinicians a very accurate picture of the extent of local growth of the cancer through the layers of the oesophagus and occasionally into surrounding structures.

In some patients a small operation called a staging laparoscopy will be performed. This allows doctors to examine the inside of the abdomen to check for cancer spread not seen on the scans and to plan future surgery.