Everyone told me I had stomach cancer because the original pathology report from my stomach tissue samples said that there were "foci of signet ring adenocarcinoma." The University of Chicago reviewed those samples and and confirmed "apparent signet ring cells," though it did also note that all the samples were "artifactually distorted."
Those results were really the second time they thought they'd found cancer, since I'd had a previous endoscopy--the one with the "suspicious" cells. But, with much-appreciated caution, no one was willing to do any surgery until they had confirmed the results themselves. I had a very thorough endoscopy done at the University of Chicago, which added ultrasound and dye to the regular "white light" endoscopy. I waited a long week for the results, but they found nothing. No signet ring cells, no lesions, no thickening of the stomach walls.
But I knew that in diffuse gastric cancer, it wasn't unusual for one endoscopy to simply miss the small clumps of signet ring cells. What I didn't know were two things: 1) "artifactually distorted" would turn out to be pretty important and 2) there are such things as benign signet ring cells in the stomach.
The University of Chicago decided that, given the distortion in the original slides, and the fact that their own endoscopy showed no signs of cancer at all, "on balance," the evidence suggested that I don't have stomach cancer. Put that way, it doesn't sound so very convincing, but I had a spy in their multidisciplinary meeting--well, there was someone there with whom I'd spoken in an unofficial capacity, and who could report things to me more informally, without the surpassing caution that has to accompany their official recommendations. I found out that the debate hadn't been between those recommending a gastrectomy and those favoring a follow-up endoscopy, but between those favoring a follow-up endoscopy and those who wanted to send me home and tell me to forget the whole thing. The latter group was convinced that the original findings were just a strange anomaly--not a mistake, exactly, but not worth worrying about. Older, more cautious doctors eventually brought everyone around to the consensus that they couldn't take even the small chance that I do have cancer lightly, so a follow-up is warranted. But even the doctor I talked to "officially" said "we don't expect to find anything."
A few days after that, I heard from the other cancer center in Chicago, where I've been pursuing the case in parallel. Their pathologist was a co-author on one of the very few papers which recognizes that not all stomach signet ring cells are malignant, so he's one of the very best people in the world to have looking at apparent signet ring cells in your stomach. His opinion is that the original slides don't show signet ring cells, but only seem to show them, because of the artifactual distortion (which I take to mean that something happens to the samples when they're collected, or put on slides). Their multidsciplinary committee made the same recommendation as the U of C: we don't think you have stomach cancer, but you should have a follow-up in a few months, just to be sure.
Though no one can say (either scientifically or legally) that they're 100% sure that I don't have stomach cancer, they've come as close to unfinding the original cancer as they can. I'm not so unconcerned that I won't be relieved if the follow-up also shows nothing, but this time, nothing is what we all expect.