Esophageal Cancer: Stages

If the biopsy shows you have cancer, your oncologist needs to learn the extent or stage of the disease. Staging is done to help identify how deeply the cancer has invaded the walls of the esophagus, if the cancer has invaded nearby tissues, or if the cancer has spread to other parts of the body. You may receive one or more of these staging tests:

• Endoscopic ultrasound (EUS) – The doctor passes a thin, lighted tube (endoscope) down your throat. A probe at the end of the tube sends out sound waves that bounce off tissues in your esophagus and nearby organs.  A computer creates a picture from the echoes. This picture can show how deeply the cancer has invaded the wall of the esophagus.
• CT Scan – An x-ray machine linked to a computer takes a series of pictures of your chest and abdomen. This test is done to look for cancer that may have spread to lymph nodes or other areas. This test can be done with or without contrast that makes the structures in your body easier to see in the x-ray.
• MRI – A strong magnet linked to a computer makes detailed pictures of the inside of your body. This test is done to look for cancer that may have spread to other parts of your body.
• PET Scan – You will receive a small amount of radioactive sugar, which gives off signals the PET scanner uses to make a picture of the places in your body that are using the sugar. Cancer cells show more brightly in the picture because they take up sugar faster than normal cells.
• Bone Scan – You will receive a small amount of radioactive substance that travels through your bloodstream and collects in the bones. A scanner detects and measures the radiation and makes pictures of the bones. The pictures may show cancer that has spread to your bones.
• Laparoscopy – This is an operation. After you receive general anesthesia, the surgeon makes small incisions (cuts) in your abdomen. The surgeon inserts a thin, lighted tube (laparoscope) into the abdomen. Lymph nodes or other tissue samples may be removed to check for cancer cells.
• Surgery – Sometimes cancer staging is not complete until after surgery to remove the cancer and nearby lymph nodes.

Stages of Esophageal Cancer

Treatment recommendations for esophageal cancer are based on the stage of cancer. Esophageal cancer stages include:

Stage I - Cancer is found only in the top layer of cells that line your esophagus.

Stage II - Cancer has invaded deeper layers of the lining of your esophagus and may have spread to nearby lymph nodes.

Stage III – Cancer has spread to the deepest layers of the wall of the esophagus and to nearby tissues or lymph nodes.

Stage IV – Cancer has spread to other parts of your body.