My brother was diagnosed about a month ago with signet ring cell adenocarcinoma of an unknown primary that is confined in his abdomen. He went for numerous tests prior to the diagnosis and the only tumor marker that was elevated was his CA125. It was 468. His symptoms were severe abdominal pain, constipation, and weight loss, because he couldn't eat anything due to the pain. He spent about 3 weeks going for numerous tests before they said he needed exploratory surgery. After laparoscopic surgery the surgeon removed ascites from his abdomen and stated that the cancer was very widespread and advanced. The oncologist says it is confined in his abdomen and mimics ovarian cancer, so they are somewhat at a loss on where it started.. They started him on chemo treatments of Cisplatin and Taxol within a week of his diagnosis. One week later, he started throwing up bile and had a NG tube inserted due to a small bowel obstruction. He has since had the NG tube removed and is on a liquid diet. His doctor contacted MD Anderson for a consult, upon our request, and he had his first treatment of FOLFOX last week. After the scar from the surgery has healed they will start him on Avastin, as well. Although he can eat liquids, they have added a TPN bag which is inserted through his port a cath, so he can get the nutrients he needs. They plan to send him home tomorrow with the TPN bag and we have not been told how long he will need it. The oncologists hates it when we ask questions, but my brother really likes him so our hands are tied. They have not done a PET scan on my brother, so I don't know if they are doing everything they can to find out answers. My brother is only 45 years old and has a 13 year old son. I have spent all of my time researching as much information as possible, but a lot of things just don't add up. When I suggested taking him to MD Anderson for a second opinion the doctor said it was a good idea, but because he was in the hospital at the time, the Dr. had to make the call. Once he called and consulted with someone there, he started the treatment of FOLFOX as they suggested. I know I am in denial about his condition, but it just seems to me that it is too late to get a second opinion. They claim this cancer is very aggressive and will cause his organs to fuse together if the chemo isn't kept up. It is to be done every two weeks. Should I have him insist on a PET scan or just trust the doctors are doing everything they can do right now. I am so scared for him, and I just need some advice.