If you have difficulty in swallowing, or feeling painful or burning in the gullet when eating, or feeling something near the throat and chest, you should see your family doctor even though these symptoms are not necessarily resulted from Oesophageal Cancer. Your family doctor will refer you to specialist for treatment if needed.
(1) Barium swallow and meal examination
Since the gullet is invisible under X-ray, patient has to drink a contrast containing barium before examination. If there is tumour, the gullet will be narrowed. Endoscopy and biopsy have to be performed to fully determine the existence of tumour.
It takes 15 minutes to drink the barium contrast. Patient would not feel unwell but the barium may cause constipation. Thus, patient needs to drink more water for a few days after the examination and may need to take some mild laxative (a type of medicine that can help empty the bowels).
(2) Oesophagogastroduodenoscopy (OGD)
Doctor can observe any lesions in the gullet directly by this test. Doctor uses a tube-shape endoscope, which looks like a thick cable, to pass through the patient's gullet to check any change in tissues by naked eye, and remove specimen from suspicious area for pathological examination to confirm whether it is cancer or other diseases.
During the OGD, patient shall lie down and may need sedative injection to ease the discomfort caused by the test and the throat may need local anesthesia. Patient should not eat or drink four hours after test until the effect of anesthesia disappears. Some people may have sore throat afterward, which is normal and usually will recover in two days.
Generally, this test does not require staying overnight in the hospital. But patient may need local anesthesia and sedative injection, therefore, patient should better be escorted home by friends or family after the test.
Examination for Spread of Oesophageal Cancer
If patient is confirmed to have Oesophageal Cancer by tests, doctor may still need to perform further tests to ensure whether the cancer cells have spread and in which stage it is so as to determine the most appropriate treatment for patient. Tests include:
(1) Computerised Tomography (CT) Scan
CT scan is a high-precision X-ray test which can show the 3D image inside the body. It takes about 15 minutes.
Patient should fast in the four hours before the scan. Doctor will inject a contrast into the patient before the scan to ensure a clear image to be shown. In a few minutes, you may feel hot all over the body. If patient is allergic to iodine, has asthma or other history of allergy, he/she may have very strong reaction to this contrast, and the doctor should be informed before test.
CT scan does not cause any pain. Most people can go home immediately after the scan.
(2) Endoscopic Ultrasonography
The examination of Endoscopic Ultrasonography is same as OGD. The main difference is this endoscope has a small ultrasound probe at the end, which can reach deep inside the gullet to detect the gullet intine and the area around. Doctor can have a better understanding of tumour and to determine if there is enlargement of the lymph glands nearby.
(3) Bronchoscopy
By passing a soft, thin endoscope through the mouth, throat, trachea and bronchi and their branches, doctor can observe the condition of tissues through the lens to know whether the tumour affects respiratory organs of trachea, bronchi, etc.
(4) Positive emission tomography scan (PET scan)
It is an advanced isotope imaging technology for detecting spread of cancer cells in other parts of the body.