Swallow test and mediastinum lymph nodes - 1265878

6 posts / 0 new
Last post
agent99
Swallow test and mediastinum lymph nodes - 1265878

Good day Cancergrace,

Today is my sweetie's birthday but it seems that there is no vacation from unsettling health issues. A swallow test is scheduled hopefully to diagnose the frequent choking and coughing episodes while eating and drinking. I haven't done a crash course in anatomy and physiology yet so I would like to ask if it is possible for enlarged mediastinum lymph node(s) to show up as a cause for swallowing difficulties during a barium swallow test, or is CT or other test more definitive to blame the lymph nodes? I can't imagine that something obvious won't pop out of the x-ray but just in case I want to be able to advocate for further evaluation if necessary.

Thanking you in advance

Respectfully yours,
Lisa

catdander
Your assumptions are correct

Your assumptions are correct in that x ray or CT is used to find physical changes in the mediastinum. From Cleveland Clinic's website,

"What are the symptoms of a mediastinal tumor?
Almost 40% of people who have mediastinal tumors experience no symptoms. Most of the growths are often discovered on a chest x-ray that is performed for another reason. When symptoms are present they are often a result of the compression of surrounding structures, such as the spinal cord, heart or the pericardium (the heart’s lining), and may include:

Cough
Shortness of breath
Chest pain
Fever
Chills
Night sweats
Coughing up blood
Hoarseness
Unexplained weight loss
Lymphadenopathy (swollen or tender lymph nodes)
Wheezing
Stridor (a high-pitched, noisy respiration, which can be a sign of respiratory obstruction, especially in the trachea or larynx)
How is a mediastinal tumor diagnosed?
The tests most commonly used to diagnose and evaluate a mediastinal tumor include:

Chest x-ray
Computed tomography (CT) scan of the chest or CT-guided needle biopsy
Magnetic resonance imaging (MRI) of the chest
Mediastinoscopy with biopsy (Performed under general anesthesia, this examination of the chest cavity uses a lighted tube inserted through a small incision under the chest bone; a sample of tissue is taken to determine if cancer is present. Mediastinoscopy with biopsy allows doctors to accurately diagnose 80 to 90% of mediastinal tumors, and 95 to 100% of anterior mediastinal tumors.)" http://my.clevelandclinic.org/disorders/mediastinal_tumor/hic_mediastina...

Janine

Dr West
Either test can be helpful,

Either test can be helpful, but a barium swallow study is probably the most direct test of swallowing problems. A chest CT "casts a wider net", is less focused on the esophagus, but it's more likely to show lymph nodes in the mediastinum.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

agent99
Update

Update

Swallow test showed reflux!!! After 5 days on Nexium (the purple pill) almost complete elimination of coughing and choking. We are both getting many more uninterrupted hours of sleep. My sweetie, who was extremely defiant about getting the test, is now very thankful. As if I didn't have enough proof that getting medical help will improve his quality of life (NPH, TBIs), here's another. I'm relieved that the coughing and choking is not directly related to the lung cancer.

I am curious though, is it possible for 4 rounds of carbo/alimta adjuvant chemo to initiate reflux? If so, are there any recommendations to take anti-GERD meds as a precaution during chemo?

Next CT is November 10th. Hopefully it's clear sailing until then.

Thank you all so much.

JimC
Hi agent99,

Hi agent99,

So happy to hear that the coughing and choking has cleared up! When battling cancer, we have a tendency to think every symptom is cancer-related, but often it is not.

Others here have reported reflux problems after similar chemo. Here is a thread in which the use of omeprazole was recommended: http://cancergrace.org/forums/index.php?topic=5724.0 It's worked well for me with non-chemo-related reflux.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

Dr West
It's not a common association

It's not a common association, and we don't generally recommend it prophylactically, but we do have a low threshold for recommending it for any issues that might be related to reflux.

Glad you're feeling better.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education