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Diagnostic Tests

Many of the tests used for the diagnosis of gastric and esophageal cancer are the same. They include:

Endoscopy
An endoscopy (also called EGD) is a procedure performed by a gastroenterologist in which a flexible plastic tube with a camera is placed into the mouth and then the esophagus and stomach are examined. Suspicious areas have small pieces of tissue removed ("biopsied") for further evaluation. The patient is sedated during the process.

Upper gastrointestinal x-ray
Also called UGI or barium swallow. For this x-ray, the patient swallows barium, which outlines the entire esophagus and stomach so that any tumor growing in the lining of either the esophagus or stomach can be seen.

Biopsy
A biopsy involves removing cells or tissue so they can be examined under a microscope by a pathologist. A biopsy is necessary to know the specific type of cancer and to guide in treatment planning. Biopsies can also show cells that are dysplastic, meaning they are abnormal and haven’t developed into cancer but may lead to cancer in the future. The pathologist is a disease specialist who works in the laboratory to assist the other physicians.

CT scan
The CT (computerized tomography) scan takes detailed computer generated pictures of areas inside the body. Internal features of the esophagus and stomach can be seen. This x-ray can help detect metastases to the liver, lungs or lymph nodes.

PET scan
"PET" is an abbreviation of positron emission tomography. In this procedure a small amount of radioactive glucose (sugar) is injected into a vein. A scanner makes computerized pictures of areas inside the body where the glucose is picked up or used. Cancer cells grow at a faster rate than normal cells and they need more energy (sugar). A PET scan can find evidence of metastases that may not be discovered by the other diagnostic tests.

Endoscopic ultrasound
Also called an EUS, this procedure is similar to an endoscopy but uses an ultrasound attachment on the end of the scope. High energy sound waves bounce off the internal structures forming a picture. The ultrasound can help determine the presence of abnormal lymph nodes and how deep the cancer invades the tissue. It is also possible to get biopsies of nearby lymph nodes. This procedure is performed with sedation.

Bronchoscopy
A thin lighted flexible tube is inserted through the nose or mouth which allows examination of the trachea and bronchi (air passages that lead to the lung). This test can help determine whether the breathing tube is invaded by tumor from the esophagus.

Pulmonary function tests, echocardiogram, cardiac stress testing etc. are used selectively depending on the patient’s past history of illnesses and the need for possible chest surgery if the tumor is close to the esophagus.

 

Virginia Piper Cancer Institute
Abbott Northwestern Hospital
800 East 28th Street
Minneapolis, MN 55407
612-863-0200

First published: 10/17/2005
Last updated: 10/17/2005

Reviewed by: Dr. Daniel Dunn, Marge Watry