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Esophegeal cancer

ttsqky
Posts: 9
Joined: Aug 2018

Can someone please explain this too me I know my dad has esophegeal cancer in the lower part of his esophagus and the junction to his stomache but dont know what all this means. He has stage 3 adenocarcinoma

FINDINGS: 

There is a hypermetabolic mass at the gastroesophageal junction, with

a maximum SUV of 11.6. This is indicative of patient's known primary

neoplasm of the esophagus. The small adjacent lymph nodes do not

demonstrate any appreciable FDG uptake.

There is physiologic FDG uptake within the head and neck. 

Mild emphysema is present in the lungs. No hypermetabolic pulmonary

nodules or masses. There are no hypermetabolic mediastinal or hilar

lymph nodes.

There is physiologic FDG uptake within the liver, spleen, and adrenal

glands. No focal bowel uptake.

No FDG avid bone lesions. 

IMPRESSION: 

Hypermetabolic mass at the GE junction is consistent with patient's

known primary malignancy. No local or distant metastatic disease is

appreciated

paul61's picture
paul61
Posts: 1355
Joined: Apr 2010

Hello ttsqky,

I am so sorry to hear of your Dad’s diagnosis of esophageal cancer. Having been there myself, I know how frightening that can be for him and for you.

First of all, I should start out by saying that I am not a medical professional and in no way qualified to interpret the results of a PET scan. That should be done by your Dad’s oncologist in consultation with a radiologist.

However, let me try to do some basic vocabulary education. A PET (Positron emission tomography) is a non-invasive imaging modality used in the diagnosis and staging of cancer. Fluoro-deoxyglucose (FDG) is a glucose (sugar) based substance that also contains a tracer dye that can be seen inside your Dad’s body with the PET scanning equipment. Prior to the PET scan your Dad was given an injection of fluoro-deoxyglucose. Areas that are “suspicious” for cancer show an increased absorption of the glucose and therefore of the tracer dye. That increased absorption of the FDG is referred to as “hypermetabolic activity”. FDG uptake by itself is not necessarily indicative of cancer. However, hypermetabolic activity with a standardized uptake value (SUV) of 11.6 is certainly “suspicious” for a cancerous mass.

The results of your Dad’s PET scan seem to indicate that he has a cancerous mass at his gastroesophageal junction (where his esophagus joins to his stomach). This is a very common place for adenocarcinoma esophageal cancer to occur, and is in fact where my cancer was located. The findings also seem to indicate that there is no evidence of spread of the cancer outside the esophagus to other major organs, and no indication of spread of cancer to your Dad’s bones.

So, it appears that your Dad would be a candidate for “tri-modal” cancer treatment that would include, chemotherapy, radiation therapy, and surgical removal of the cancer that is located where his esophagus meets his stomach. His surgeon would have to evaluate the level of emphysema that is present in your Dad’s lungs to decide if that is a concern for surgery.

Again, I should stress that interpretation of PET scan results should be done with your Dad’s oncologist and supported by other medical tests that provide additional information typically gathered from CT scans that would show physical structure abnormalities, Endoscopic Ultrasound examination of your Dad’s esophagus with biopsies to determine specifically what kind of cancer this might be, and blood tests to evaluate the presence of certain cancer “markers” that would help provide additional information to determine the best treatment plan for your Dad.

Your Dad is fortunate to have you there to support him.

Wishing you both the best as his treatment moves forward.

Best Regards,

Paul Adams

McCormick, South Carolina

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009

Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU

Eight Year Survivor

Life may not be the party we hoped for, but while we are here we might as well dance!

ttsqky
Posts: 9
Joined: Aug 2018

Thank you so much Paul he did have the ultrasound done and a ed done he has had 19 radiations and 7 chemos done tomarrow is his last chemo. He is so sick and hurting worse than he did before it all started he cant swollow even water and he has lost a lot of weight since this all began.

Deathorglory's picture
Deathorglory
Posts: 315
Joined: Jul 2013

Hello,

Sorry you find yourself here.  Paul did a good job explaining your dad's PET scan.  I just want to point out to you that the test shows no metasteses (which you know, b/c he's stage 3, not stage 4).  It also seems that there's no lymph node involvement.  That's good.  This is exactly where I found myself in 2008.  Stage III adenocarcinoma at the gastric junction.  I had chemo/radiation (28 rounds of radiation and carbo/taxol chemo), an esophajectomy (was supposed to be laparoscopic, but complications forced an open surgery) and then had a bonus course of full strength chemo a few months after surgery.  I had a "complete response" to my treatment, and thought I was done with it and could go back to living my life.  A couple of years later, I had a recurrence. I'm still dealing with the recurrence, but I'm still here to complain about it, so I'm winning.   

My story shows the ups and downs.  Stage 3 EC can be beaten with good medical care.  It is of critical importance that your dad is going to good doctors at a good hospital.  It is the single most important thing you guys can do that is in your control.  50% of all doctors and hospitals are below average.  That's just simple math.  Make sure your dad is going to the other half.  

Best Wishes,

Ed

ttsqky
Posts: 9
Joined: Aug 2018

Thank you so much for responding and Im so sorry to hear that it came back. He has had 19 radiations so far and 7 chemos last chemo tomarrow but the radiation is making it so much worse to the point of not being able to eat or drink. His doctors are at a cancer center here in kansas but I think they are just there for the money never tells us anything or answers our questions. Always just pushing treatments. Except at the last radiation the dr suggested taking time off from radiation. We feel that it is getting bigger instead of smaller but he will not tell us anything

Deathorglory's picture
Deathorglory
Posts: 315
Joined: Jul 2013

Hello,

When I did the chemo/radiation, the radiation nearly fried my esophagus shut.  It was impossible to eat anything but very soft food.  And I needed help to do even that.  My doctor prescribed liquid morphine to help with the pain of eating/swallowing.  You can talk with your dad's docs about allieviating such side effects.  Hopefully, they're experienced dealing with EC and can help.  

A further point, ask the doctors whatever you're wondering about and don't stop until you understand the answer.  Your father and you have every right to have your questions answered in terms you can understand.  Frequently, the patient is fully consumed just trying to deal with the treatments and needs an advocate there to ask things on his behalf and then explain the answers later when he is able to have a full conversation.  Don't be afraid to press the doctors on your father's behalf.  

 

Best Wishes,

Ed

LorettaMarshall's picture
LorettaMarshall
Posts: 682
Joined: Sep 2012

 “ttsqky” – Have chosen to answer you here since there is so much you need to know that your doctors apparently are not telling you.  This is a “tutorial” of sorts and cannot be absorbed in one reading.  However, I believe you will understand what you need to know.  I am so sorry that your Dad’s doctors are not answering your questions.

  https://csn.cancer.org/node/317799

Loretta

 

ttsqky
Posts: 9
Joined: Aug 2018

Ty I think the doctors are getting tired of me now lol he was put in the hospital for 3 days because all his levels took a huge nose dive he had nutrophilia fever and his wbc is only .87 so idk what they are doing and a few other lads that I dont know what they mean but good news is his tumor shrank a little after 21 radiations

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