The doctor will arrange an endoscopy/oesophagoscopy with a fibreoptic scope that is malleable enough to be safely manipulated through the mouth and then down the oesophagus with direct vision all the way. A biopsy is taken of any suspicious areas of the lining wall – the structure from which oesophageal cancers arise. It is the discovery of cancer cells on the biopsy that gives a certain diagnosis. An alternative first investigation is the barium swallow examination; here, the patient swallows a drink containing a barium solution (which is radio-opaque) and the outline of the oesophagus can be viewed on a screen. X-ray pictures are taken which will show any irregularity of the walls – a characteristic stricture is seen in cancers. A biopsy is still advised for certain diagnosis.
