@lovelexia92 :

Thank you for all this. Here are the details.

Size of the Mass
The report does not provide a specific measurement for the overall size of the mass, but it describes its location and impact:
• The mass is described as a mass-like lesion located in the distal esophagus and extending into the cardia of the stomach.
• The area where the lesion is located is definitely mildly narrowed compared to what would usually be.
• However, the area is not blocked. During the endoscopy, the area was open and large enough for the endoscope to pass through, meaning the opening was more than one centimeter.
• The lesion was described as "friable" and was bleeding upon contact with the scope even before the biopsy was taken.
• The biopsy fragment collected from the esophageal lesion (Specimen 7) measured 0.4 x 0.3 x 0.2 cm.

Tests Done So Far Other Than the Endoscopy
In addition to the EGD performed on October 9, 2025, several other diagnostic tests have been completed, and others are pending or planned:

Completed Tests:
• Laboratory Tests (Blood work): Labs taken during a late September 2025 ER visit showed mild normocytic anemia. This drop in Hemoglobin (from 13.6 g/dL in January to 11.1 g/dL in September) was one of the reasons the endoscopy was ordered, to look for blood leaks.
• H. pylori Testing: A stool antigen test performed in early October 2025 was negative. The stomach biopsy (cardia lesion) also tested negative for Helicobacter pylori.
• PET-CT Scan: This scan was performed on October 23, 2025. The results were available by October 29, 2025, and indicated no evidence of distant metastasis. The PET scan did show a couple of lymph nodes near the esophagus and stomach that were "a little bit bright," which is consistent with possible lymph node involvement.
• Cardiology Workup: EKG and echocardiogram performed in early October 2025 were normal.

Pending or Planned Tests/Steps:
• Endoscopic Ultrasound: While the oncology & GI teams had contemplated an EUS, they have determined that it is not necessary.
• Microsatellite Stability Test: This special test from pathology is pending. The result could potentially change the treatment from chemotherapy plus immunotherapy to immunotherapy alone, although the abnormal result required for this change is quite rare.
• Tumor Board Review: My case was scheduled for today (Monday, October 30th) to be discussed by the surgeons, radiation doctors, and oncologists at a Tumor Board meeting to determine the best plan.
• Genetic Testing: A referral for genetic testing was discussed and deemed reasonable due to the family history of various cancers.

What the Biopsy Said
The pathology report provided a definitive diagnosis:
• The pathology report for the esophageal lesion diagnosis is Adenocarcinoma, poorly differentiated.
• The doctors confirmed that the type of cancer is adenocarcinoma.
• Special testing showed that the tumor cells exhibited high proliferative activity (Ki67 proliferation index is >90%) and were positive for CDX2 and CK7.

Biopsy Location (Distal End vs. Upper Part)
The biopsies were taken from the area of the lesion, which is located at the lower end of the esophagus:
• The lesion was found in the distal esophagus and extending into the top of the stomach (cardia).
• The endoscope was able to slide past the lesion. The doctor confirmed that the area was open and large enough for the endoscope to pass through.
• Because the EGD could pass the lesion and the lesion itself is in the distal esophagus/cardia, the biopsies were successfully obtained from this lower area. The pathology report confirms samples were taken from the "esophageal lesion" and the "cardia lesion (stomach)".

The goal of the upcoming Endoscopic Ultrasound (EUS) is to use specialized advanced endoscopy to see how deep the tumor has invaded the tissue layers, which is a level of detail beyond the initial diagnostic endoscopy.

They have prescribed Omeprazole, which I just started taking (2X/day) yesterday. I have been able to swallow, and still am, but in the past couple of days it has gotten a little uncomfortable. I also have globus sensation a lot of the time now. Dr. ChatGPT says that this is most likely a result of irritation from both acid and the endoscopy/biopsy. (I've never had symptoms of GERD, by the way.)