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Oncology (General Cancer)/Endoscopy Results: further testing suggested


Dr. Higby,

I'm a 49yr Caucasian male; 6', 170 LB non-smoker. I've been complaining for several months of pain "to the touch" of the area just below my sternum/above stomach. Negative chest and sternum X-rays and chest and pelvic CT's w/contrast. Upper GI performed yesterday discovered "the lesser curvature had an external compression into the stomach that was firm" see attached photo.  EUS next to evaluate compression

2 Questions: are we looking for gastric or other cancer and What does an EUS so differently than upper endo?

While they had me on the table we did a colonoscopy screen. 7 polyps ranging from 1-3mm were removed from the ascending, descending and sigmoid. Path report pending.

2 Question: regardless of the path report, finding 7 polyps at my age seemingly indicates I may be more prone to bowel cancer than the average Joe - would you agree? Any significance to their size and being found in 3 locations (ascending, sigmoid, etc).

Thank you for your generous time and gifts. B

The polyps do predict that your risk of colon cancer is higher than normal, assuming they are "adenomatous".  However, it's not likely that your risk of other bowel cancer is raised, unless you have a rare genetic abnormality.  And finally, presuming you get colonoscopies and removal of new polyps every five years, you probably won't get colon cancer, or if you do, it will be at an early stage and relatively easy to cure.  As for the upper GI finding, it seems that the endoscopy raises the suspicion of a mass.  I am assuming that the CT scan you previously had did not show anything, so it is reasonable to do an endoscopic ultrasound, which can determine if there is a solid or cystic mass in the area.  If there is a mass, further studies need to be done to determine its nature, including fine needle biopsies, perhaps.  
The upper endoscopy can only reveal the surface, and in your case, the suspicion of an abnormality.  The EUS sends an ultrasonic wave through the mass, and changes in the absorption of the sound wave can be measured and visualized.  In this way the operator can "see" below the surface.  
Please keep me posted, I'm interested in what they will find.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

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America's Best Physicians, last 14 years

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