Screening for Esophageal Cancer

Esophageal cancer often causes symptoms only in advanced stages, making early detection challenging. For individuals at higher risk, however—such as those with chronic gastroesophageal reflux disease (GERD), Barrett's esophagus, or significant lifestyle risk factors such as smoking and heavy alcohol use—screening can help detect the disease early, when it has a greater chance of being cured. We use the following techniques to screen these individuals for esophageal cancer: 

• Endoscopy: The primary screening tool for esophageal cancer is upper endoscopy, where a thin, flexible tube with a camera is inserted through the mouth to examine the esophagus. This allows us to directly see the esophageal lining.
• Biopsy: During an endoscopy, tissue samples may be taken from the esophagus if the doctor sees any abnormalities. These samples are then analyzed by a pathologist to determine if cancer cells are present.

Diagnosing and Staging Esophageal Cancer

• Staging: Once cancer is confirmed, staging tests are conducted to determine the extent of the disease. This includes imaging studies like CT, MRI, and PET scans to assess whether the cancer has spread to nearby lymph nodes or other tissues or to other parts of the body. 
• Endoscopic Ultrasound (EUS): A procedure that combines endoscopy and ultrasound to assess how far esophageal cancer has spread and determine the stage, helping guide treatment decisions.
• Molecular and genetic testing: Some patients may benefit from molecular testing to identify specific mutations or biomarkers that could guide the use of targeted therapy or predict outcomes.