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Saturday, May 10, 2008

How oesophageal cancer is diagnosed

Your GP will examine you, and will arrange for you to go to hospital for tests and to see a specialist. At the hospital the specialist will ask you about your general health and any previous medical problems before examining you. You may have blood tests and a chest x-ray taken to check your general health. The following tests are commonly used to diagnose cancer of the oesophagus:

Upper gastrointestinal endoscopy (oesophagoscopy)

This procedure enables the doctor to look directly at the oesophagus through a thin flexible tube called an endoscope. The endoscope has a tiny camera and a light on the end. If necessary, the doctor can take a small sample of the cells (a biopsy) to be examined under a microscope. This can usually confirm whether or not there is a cancer.

You can usually have an endoscopy as an outpatient, but occasionally an overnight stay in hospital is needed. Once you are lying on your side on the couch you may be given a sedative, usually injected into a vein in your arm, to make you feel sleepy and reduce any discomfort during the test.

Alternatively, a local anaesthetic may be sprayed on to the back of your throat before the doctor passes an endoscope down into your oesophagus. Sometimes both an injection and the spray are used. The doctor then looks through the endoscope and examines the inside of the oesophagus.

Endoscopy can be uncomfortable but should not be painful. After a few hours, the effect of the sedative will wear off and you will be able to go home. You should not drive for several hours after the test and if possible you should arrange for someone to travel home with you.

If you have had the local anaesthetic spray to the back of your throat you may need to stay in the hospital until the anaesthetic has worn off. This usually takes about four hours and you should not try to swallow anything during this time. Some people have a sore throat afterwards; this is normal and should disappear after a couple of days. If it doesn’t, let your doctor at the hospital know. You should also tell your doctor if you have any chest pain.

Occasionally, the doctor may want to carry out treatment such as stretching (dilatation) of the oesophagus at the same time as an endoscopy. This can help you to swallow food more easily.

Barium swallow

A liquid barium solution is swallowed, which shows up on x-ray. Using an x-ray machine, the doctor can watch the barium as it flows down the oesophagus towards your stomach. At the same time x-ray pictures are taken of your oesophagus. A barium swallow takes about 15 minutes and should not be painful.

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