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Esophageal Cancer

Esophageal Cancer Stage III

10/28/2009

Question:

My father-in-law was diagnosed with EC Stage III December 2008. Had surgery in January 2009 removing almost all of the esophagus, reconnecting stomach and removing 5 lymph nodes. Went thru chemo and radiation. Now in October 2009, he is experiencing upper abdominal pain and continues to lose weight. It has been months since chemo/radiation treatment. PET scan showed nothing. What is going on?

Answer:

Weight loss by itself could be due to malnutrition or due to swallowing problems: not sure. But having new abdominal pain is worrisome for recurrent disease specifically in the upper abdomen/peritoneum. PET scan could be still negative if the disease is small or has small nodules or peritoneal carcinomatosis.

Recommend: Repeating EGD (upper endoscopy) is helpful to make sure he has no ulcers or gastritis. Also, he should have dedicated CT chest, abdomen and pelvis with IV contrast since PET scan is negative and it is done without IV contrast in most centers. 

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Response by:

Malek  Safa, MD Malek Safa, MD
Assistant Professor of Medicine
College of Medicine
University of Cincinnati