Physicians in the clinic Assuta apply advanced technology and methods for diagnosis of esophageal cancer. Accurate and reliable diagnosis increases the chances of successful treatment . Although cancer of the esophagus has no symptoms in the early stages, it can be detected through special procedures and tests.
The preliminary cost of esophageal cancer diagnostics program is $ 4810.
Medical history and physical examination
In the process of diagnosis, the doctor first collects information on medical history and symptoms. When taking the history the doctor will ask questions about personal history - the absence / presence:
- gastroesophageal reflux disease (GERD);
- Barrett's esophagus;
- alcohol consumption;
- keratoderma - rare inherited disease that causes scaly patches (hyperkeratosis) in the palms and soles or papillomas in the esophagus;
- stimulation, injury or damage to the esophagus;
- Plummer-Vinson syndrome / Paterson-Kelly;
- cancer of the upper respiratory tract (throat or laryngeal cancer);
- achalasia (diseases caused by abnormal function of the nerves and muscles of the esophagus, which creates difficulty in swallowing).
It is also in the process of diagnosing esophageal cancer physician queries on family history - about cancer of the esophagus, increasing the likelihood of other cancer risk factors.
The doctor performs a physical examination looking for any signs of the disease:
- probes stomach and lymph nodes above the clavicle and the neck;
- checks for hoarseness in his voice;
- probes the region of the back, revealing the pain in the spine.
The patient is losing blood tests - a complete and biochemical. Full analysis is aimed at:
- determination of the quantity and quality of blood cells,
- metering a baseline for future comparison before and after treatment;
- monitor the results of treatment.
Biochemical analysis faces during diagnosis of esophageal cancer in certain organs by operation and the detection of anomalies, as well as to determine the stage. Increased levels of enzymes (lactate dehydrogenase, alanine aminotransferase, aspartate transaminase, alkaline phosphatase) may indicate the spread of cancer to the liver, or bone. Excess bilirubin level indicating that the penetration of the disease to the liver.
Patient undergoing chest X-ray to check the level of overall health. Next appoints specialized tests.
Endoscopic diagnosis of esophageal cancer
This is the basic test for this disease. The endoscope is a long, thin, flexible tube equipped with a light and camera. At the time of diagnosis the patient is given a sedative. There is a version without its use, in this case, the area of the throat is sprayed anesthetic.
The doctor puts a tube into the mouth and asks her to swallow. The endoscope allows to inspect the entire inside of the esophagus. Images are transferred to the monitor. It may be taken tissue sample (biopsy).
This kind of diagnosis of cancer of the esophagus is studying organ for the subject:
Barium is clearly seen on x-ray. This study is not often used in the diagnosis of cancer of the esophagus.
Barium is white as chalk liquid. Once the patient drinks it, the radiologist takes a series of snapshots of the throat and stomach. If there is a tumor in the esophagus, it is displayed. There are certain side effects in this study. Some patients experience nausea afterwards, as constipation and white chair for several days until the barium goes from the body.
In this process, the sample cell type doctors diagnosing esophageal cancer or tissues removed for study by the microscope in the laboratory. Report pathologists confirm whether cancer cells are present in the sample. Doughs:
- Endoscopic biopsy suggests a study during esophagectomy or endoscopic ultrasound, when the tissue is removed through an endoscope.
- Fine-needle aspiration is performed through the wall of the esophagus to detect cancer in surrounding lymph nodes. The needle is inserted and removed through the endoscope.
- The brush biopsy uses a special brush to extract cells from the suspicious area. The brush is inserted and removed through the endoscope.
If these tests reveal the presence of cancer, further research may be needed to find out whether it has spread. Determined step for selecting optimal treatment option.
The spread of malignancy
Most often, cancer of the esophagus enters the liver, lungs, stomach and lymph nodes. All these bodies are close, the first to suffer the lymph nodes. Tissue fluid is circulated around the organs of the body, it flows into the lymph vessels and carried thereon. If cancer cells are detached, they can be moved in the interstitial fluid of the lymph nodes.
CT - computerized scan that uses X-rays. It may be assigned CT of the abdomen and the lung. The purpose of this type of diagnosis of cancer of the esophagus:
- check the symptoms of enlarged lymph nodes;
- determine the degree of esophageal cancer;
- to determine whether the cancer has not spread to nearby areas organs and tissues (liver, lung or adrenal glands).
Endoscopic ultrasound - a test that applies an endoscope and ultrasound. The probe is attached to the endoscope. A doctor uses it to scan deeper esophageal wall. It allows you to see how far the cancer cells have penetrated into the wall of the esophagus. It also makes it possible to find out whether there is a pathological lesions in the lymph nodes near the esophagus.
PET-CT displays the field of active lesions, helps determine the stage of cancer before surgery. It can be assigned to PET-CT instead of CT, because the survey combines PET and CT.
Laparoscopy - small operation with general anesthesia. Through a small incision in the abdomen placed a laparoscope - a tube with a camera and illumination. With it possible to identify signs of cancer proliferation. This test is rarely done. Your doctor may suggest it if malignancy is very low in the esophagus, or when the results of other tests are questionable.
MRI is performed in some cases. This kind of diagnosis of esophageal cancer using the magnetic properties for creating an image of the affected organ. Soft tissues appear on the MRI clearer than with CT. The main objectives of the study:
- determine the extent of the tumor;
- find out whether secondary centers - in the brain and spinal cord, adrenal glands, and so on.