Could my father, 56, still have cancer despite clear biopsies?

Question

Hello doctor,

My 56-year-old father has been complaining about difficulty in swallowing for four months. So we did an endoscopy and CT scan, and it looked like a 0.59-inch neoplasm. We thought it was esophagus cancer.

But the biopsy showed no sign of dysplasia or metaplasia (in the first biopsy). Then again, another biopsy was taken, and the third and fourth biopsies showed mild dysplasia. I have attached the biopsy reports below. The inner tube of the esophagus seems to be inflamed (around 0.5 inches), which could be the reason for the difficulty in eating. We were given antibiotics for the inflammation, and another endoscopy was done after three months.

Could it still be esophagus cancer even if the pathology reports do not show it?

Thanks.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

The pathology reports are considered more accurate as the tissue sample is examined. So even if the CT (computed tomography) scan showed neoplasia-like features, a pathology report is followed when it comes to treatment.

I have gone through the reports (attachment removed to protect the patient’s identity), and it says there is ulceration with dysplasia present. So, for the inflammation, considering it as a primary cause, your father was prescribed antibiotics. I suggest waiting until you complete the antibiotic course. Again, consult your treating doctor. He might suggest another biopsy depending on the overall response to the medications. At present, the pathology reports do not indicate cancer. So it is not cancer. Make sure you regularly follow up.

Hope this helps.

Feel free to contact me for any further queries in the future.

Thanks.