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Forum Name: Miscellaneous Cancer Topics

Question: Can chest pain be related to lymphoma?


 PaulPT - Tue Jul 19, 2005 12:11 pm

Hi All, (sorry for the long post but I am trying to give as much information as possible).

I am a 38 year old mail having intermittent chest pain for almost 3 months now. Let me give you my recent history. This started 3 months ago with episodes of near syncope and heart palpitations (no pain) for no apparent reason. It would happen at any time of the day and follow no pattern. I had several trips to the ER because i thought I was having a heart attack. They couldn't find anything in the ER and said it was probably stress. The episodes lasted on average for about 30 seconds to 10-20 minutes. After about two weeks of these I started having very mild chest pain just to the left of my sternum. Since then the syncope episodes have all but vanished, but I am having singificantly more chest pain and it seems to be broadening in area to the left side of my chest, and have developed this chronic non productive cough. It is hard for me to inhale or exhale completely withough coughing and feeling like something is tickling the back of my throat. I also get fatigued very easily now. I used to be much more active with sports and such but just don't have the energy. I have had numerous EKG's, and and Echocardiogram, the only thing they found was slight left atrial dilation. The valves all worked normally. My blood pressure is normal, cholesterol and blood sugar tests also came back normal. I was tested for H-Pylori and blood in my stool but both were negative. I had a CT of the head which was normal. X-rays of the chest were normal. I have been in and out of the doctors office at least a dozen times since this started. They have tried putting me on Prilosec which hasn't helped. The last visit in the doctors office about a week ago I asked him about the possibility of lung cancer or lymphoma. He seems to be stuck on thinking it's GI stuff. I asked isn't there some kind of blood tests they can do to screen for it? He said a lot of cancers don't have markers they can look for... I am wondering if he is giving me a brush off or is this true? I get the feeling they are not taking me seriously. I am a physical therapist and am somewhat trained to look for red flags in my patients. Right now I feel I have a few, but because I am fairly athletic and don't smoke or drink, I don't think the doctors I have seen think anything serious can be wrong with me. What do you guys feel about this? What other tests should be done? I know x-ray is not a gold standard for cance screening..does this sound like GI stuff.
Oh another thing my cough and chest pain used to be better in the AM after sleeping but now it doesn't seem to make much of a difference. I swear if one more doctor tells me it's anxiety...I'm just kidding, but this has been going on way too long and I am a very relaxed person. I don't stress too easily.
Please educate me
Thanks in Advance
PPT
 Dr. Wafaa Abdel-Hadi - Wed Jul 27, 2005 4:58 am

Dear PaulPT,

Ironically,you'd think why a chest pain,fatigue,palpitaion and all your other syptoms should be related to the GIT!? but sometimes it does it you have inflammation ifn the oesophagus for an example(esophagitis) and several other causes.

They can exclude that if they put you on antacids which they did but it hasn't helped. If they are certain about GIT causes they can do an upper endoscopy.

So your Chest X-ray is Absolutely normal? I advice you to have a CT-scan for your chest. Have you visited a Chest Physician? It can be minor asthmatic attacks as well. So he can order some respiratory tests for you,since they've nearly excluded cardia problems.

Keep me updated,
Best regards,
 PaulPT - Thu Sep 15, 2005 12:06 am

I just wanted to give an update.

At this point I have had a lot of tests done, including Cardiac Stress test, a chest CT with contrast, and echocardiogram and I just had an upper endoscopy yesterday. The stress test was normal, the chest CT was normal, the echo showed a slightly dialated left atrium but otherwise normal heart and valves, and I am not sure about the endoscopy. I vaguely remember after the procedure the doctor telling me there were some kind of rings in my esophagus, something like Schwart's rings??? Anyway I was fairly sedated and I can't remember too well, but I know he said they weren't cancer related and I think he said something about they dialated them and stretched them out..maybe??? What I do remember is him saying something about biopsy and he will make an appointment for me in three weeks. The pulmoonologist suggested a bronchoscopy if endoscopy doesn't show anything.

Interestingly enough my syncope symptoms had pretty much disappeared, chest pain has reduced, and the cough has remained about the same. However I have had a little bit more chest pain today and for the first time in several months I had a near syncope episode with a racing heart and breaking out in a sweat. Not sure if it was related to the endoscopy but I would think it's a little more than near coincidence that it's been a long long time since I had an episode and the day after the scope I get one..I dunno

Anyway, I just wanted to keep all informed as a lot of people don't follow up with their posts and we end up without a conclusion. So I will keep posting until we figure out exactly what is causing these symptoms.
 PaulPT - Tue Oct 11, 2005 8:54 pm

Update #2

Well I have gotten the results of the endoscopy. The doctor found I have esphogeal webs and rings, one of them was quite constricted which he enlarged during the endoscopy. He explained these are something I have had all my life and nobody really understands why people get them. He is not entirely convinced that my symptoms are from my esophagus however. He stated there may be some kind of a vasovagal response from the esophagus, but can't reason why these would just start for no apparent reason, and the fact that the reflux meds have not had any effect on my symptoms makes him think there is something other than GI stuff. He suggested I should get a referral to a cardiologist to further examine my heart. I am going to contact the pulmonologist and see if he thinks we should go ahead with the bronchoscopy just to be safe. I figure if nothing else it will be one more test to rule out whatever it can. So at least it's not looking like any detecable cancer, but still no explination. I will still keep all informed as I learn more...
-PaulPT

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