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Medical Forum / Diseases and Disorders / Cancer / January 2006

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Possible recurrence of small bowel cancer.

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doyleb3@yahoo.co.uk - 11 Jan 2006 13:01 GMT
Hi,
I posted about this before and Steph replied. I asked about the chance
of recurrence 5.5 years after an adenocarcinoma (Stage III, spead to
regional lymph nodes) was resected from a patient's small bowel. I
thought that the chance of recurrence was small and Steph confirmed
this.

However at the patient's most recent checkup a slight blockage and
thickening of the intestine in the same location as before was observed
on CT. Oncologist seems worried and has scheduled more investigations.
The patient has no symptoms and feels well. In the 5.5 years since the
resection, she has had two further ops to fix adhesions in the small
intestine. The last op was about 2.5 years ago and the surgeon did not
find any cancer but did warn that adhesions might re-occur in the
future. We are hoping that this is what has happened. Anyone care to
give an opinion on the likelihood of this. What are the chances of it
being
1) a local recurrence
2) a metastatic recurrence
3) benign adhesions
4) a new primary cancer

By the way, CEA levels are normal but from what I've read the CEA test
is next to useless.

Thanks for any information.
Steph - 11 Jan 2006 18:49 GMT
> Hi,
> I posted about this before and Steph replied. I asked about the chance
[quoted text clipped - 22 lines]
>
> Thanks for any information.

I would think that in order of probability, adhesions would be top,
recurrence unlikely, and new cancer very unlikely.
However, it's all casting around in the dark unless a surgeon has a look.

Was the CEA elevated at the time of the original surgery?
doyleb3@yahoo.co.uk - 11 Jan 2006 19:47 GMT
Hi Steph,
Thanks for your responses. I do not know if the CEA was elevated at the
time of the original resection. I have a feeling that it wasn't as it
was never mentioned at that time.

A new cancer does seem unlikely given how rare small intestine cancer
is. How unlucky would an individual be to develop small intestine
cancer twice in their lifetime. Unless perhaps certain individuals are
prone to developing cancers of the small intestine.

The patient did not expect to still be around and feeling good  5+
years after Stage III cancer so she is thankful for that. Still, this
latest episode is a worry.
 
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