Adenocarcinoma

It has been a long and frustrating day of trying to find out answers and collect information. I won't bore you with the many confusing details and will just share the end results.

A consultation with the surgeon, Dr. H., has been scheduled for February 18th.

After many crossed wires and much miscommunication, Dr. N. himself finally called at 4:55 p.m. and cleared up much of the day's confusion.

The CT scan showed no evidence of the disease spreading. It did show a severe thickening in the walls of the esophagus.

The bioposy indicated "Adenocarcinoma." There are two types of esophageal cancer; Adenocarcinoma is one of them.

Dr. N. recommended an Endoscopic Ultrasound (EUS). EUS is a state-of-the-art technology that combines endoscopy with ultrasound. The ultrasound will be able to determine how deep the tumor is in the walls of the esophagus, which would help determine what type of surgery needs to be performed, how deep the surgeon has to cut, etc. In general, it will provide a much more detailed look at the tumor. The EUS also has the ability to scrutinize and biopsy the lymph nodes in the area to see if the disease has spread. (Wait a minute, didn't the CT show "no evidence of the disease spreading?" Yup, you read that right, BUT the CT isn't always conclusive.) One of the most helpful outcomes of the EUS is "staging." For cancer patients, staging describes the extent of the cancer and how early or advanced it is. Staging is important because it helps the doctors plan the most appropriate course of treatment.

Because the EUS is so advanced, there are only two physicians with specialized training and expertise to peform the EUS in the entire state. Fortunately, they are both located in Reno. Unfortunately, that means they are in high demand. E. currently has an appointment scheduled with Dr. C. for an EUS on March 9th, although Dr. N. is trying to squeeze him in before that. (And prior to the EUS, E. has to get an EKG, a chest x-ray and more lab work.)

In the meantime, Dr. N. wants E. to continue to meet with the surgeon for the consultation on February 18th. He indicated that Dr. H. may want to proceed with surgery even without the EUS information. Whether pre or post surgery, the EUS will hopefully provide valuable information.

S.