Adenocarcinomas and Their Often Misleading Symptoms When Dyspepsia Is an Indication of Cancer - Case Study

Medical History
Jane is a 40-year-old, married mother of two teenage boys.  She teaches at the local elementary school and has been in good health for most of her life. She has no surgical history.  Her most severe ailment up to this point has been the flu at age 27.  Her students are first-graders; they are often difficult to control. She also experiences the normal stresses of raising teenagers.  Jane takes mile-long walks daily, but historically has indulged in junk food and high-calorie snacks.  She set out to change her eating habits and has thus far been successful.

For the past year she has had dyspepsia and vague abdominal discomfort.  The onset was after a vacation to Mexico last year. She sometimes thinks that the symptoms are related to anxiety brought on by classroom overcrowding at her school.  Initially, she would use Zantac and other over-the-counter H2-blockers and they would provide relief from uncomfortable symptoms such as heartburn.  But lately, these non-prescription drugs have not provided reprieve from the pain.

About six months ago, she noted that her clothes felt looser. One morning, Jane stepped onto a scale to learn that she had lost about 20 pounds over the past year and thought this was because of her dieting and better eating.  She silently praised herself for her healthy choices.

However, after a few more months co-workers began to notice the continued weight loss.  They were concerned with Jane’s appearance and at the encouragement of a peer she went to see her family physician. Laboratory testing showed mild anemia.  Her family history was a bit sketchy since her mother had died in a car accident when Jane was just a child.  Jane knew little about her mother, and it was difficult to trace her roots as her mother had emigrated from Russia.  Jane’s father died of a heart attack two years ago.