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Endoscopy as a followup after surgery

flmo's picture
Posts: 72
Joined: Jan 2011

My husband's new doctor is recommending an endoscopy rather than a CT or PET scan for his 2 year checkup following an MIE in 2011. Has this been suggested to anyone?  The doctor is concerned about too much radiation from the CT and PET scans. We aren't sure if this is the best approach. Any advice would be appreciated. 





paul61's picture
Posts: 1262
Joined: Apr 2010


I am now three years out from my Ivor Lewis surgery. On my last six month checkup my oncologist  did not schedule my typical annual CT scan. Instead, he said he felt an endoscopy with biopsies was best. I should add that, for the first year I had a CT scan every six months and an endoscopy. The second year, I had both a CT scan and an endoscopy. Now after my third year, I just had an endoscopy. I do still have blood work done with each six month physical exam.

There seems to be a lot of variability in follow up procedures after year two. I have seen some folks posting that they were having issues with insurance company approval for scans after year two, particularly for PET scans.

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 - Three Year Survivor

flmo's picture
Posts: 72
Joined: Jan 2011

Thanks for answering my question. My husband's surgeon, Dr. Luketich, told him to aviod CT scans for one year after surgery since the radiation can cause cancer.  He had PET/CT scan at one year which showed NED.  Now new Dr. also said too many CT scans can cause cancer.  Hence the recommendation of endoscopy with biopsies. Interesting to hear that you had the same recommendation from your doctor. 


I know William had a  full body PET/CT scans each year. He thinks it's the best way to see if the cancer has spread to other parts of the body.  We will discuss again with new doctor. i don't think insurance is a problem.  Medicare and BCBS has paid for everything to date.



jim2011's picture
Posts: 116
Joined: Sep 2011

In my mind, I would like an endoscopy with samples taken at the 2 year past surgery point(April 7, 2013 for me). Nothing like getting in there and taking a good look around. I am however scheduled for a CT.

I wish you the best...as always. Thanks for your sharing your information Paul.

BobHaze's picture
Posts: 162
Joined: Sep 2011

I certainly wouldn’t presume to disagree with any doctor, but it seems to me an endoscopy only looks at the inside of the gastric system, and won’t tell you if there might be a recurrence or metastasis elsewhere.





Dx   8/3/11

MIE 9/23/11

Posts: 2
Joined: Mar 2013

My post-treatment is similar to Paul's. I also had the same three drugs he had and was diagnosed and treated in 2009-2010. I'm a three year survivor. Now, I see my oncologist every six months. Have not had a CT scan in a year. I still have a yearly endoscopy, and I look forward to it in May.

God bless you!


Bobs1wife's picture
Posts: 153
Joined: Sep 2010

My husband was diagnosed 3-31-10 and had a succesful MIE with clean margins and one lymph node with scattered cancer cells. Pre chemo & radiation, and post surgery chemo.  At the end of December 2011 he was diagnosed with a local recurrence at the anastomosis. The cancer had jumped to the trachea and aorta. No other cancer detected. He had been having repeated stretches for a period of time every 4-6 weeks. In essence they were doing an endoscopy and stretching the tumor, not a stricture of scar tissue.  I believe had an ultrasound been done with the scope the thickening would have been noticed and he could have at least had a chance instead of having a large tumor not discovered by endoscopy.  After the fact I have found that most local recurrences occur on the outside of the esophagus and the endoscopy only looks at the inside as said in the earlier post. If this can happen at  Mayo Clinic where they are more well versed in esophageal cancer than many facilities, I think it is a concern for anyone. It went undetected until too late. I don't want this to happen to anyone else if it can be prevented. Don't just assume almost everyone needs stetches because of the surgery, it may be a recurrence and early detection would have made a big difference.  He had also just gone from a 3 month CT scan, to a 6 month interval. Had the 3 month scan schedule still been in place it would have detected this recurrence  1 1/2- 2 months sooner. Would it have made a difference?Only God knows the plan, so I have to accept things are as they were meant to be, but it is a really, really rough road. There's so much we just don't know until it happens to us. I hope this will help others to demand answers when they feel something just isn't right.


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