CT and PET scans negative after chemo and radiation: Still do surgery?

I'm not your oncologist, GI doctor, nor thoracic surgeon... or Tumor Board. But these folk should be individually (and collectively as a Tumor Board) be advising you as to next steps. And my guess is the consensus would overwhelmingly be to now have the esophagectomy. This because it offers a big statistical advantage towards never seeing your esophageal cancer again (buy not a 100% guarantee).

I've counseled hundreds of our fellow EC patients all over the world... so I've seen the paths they took.

Yes... two ways to go... stay closely monitored... and wait to see if it "returns"... or... have the surgery.

I put "returns" in quotes because it's somewhat meaningless that your solid original EC tumor is now showing no signs of existence. But are these cancer cells still around... whether in your esophagus, or in some lymph nodes, or in your bloodstream? Most likely.... but it's just tough to see right now. The whole reason we do chemotherapy... do radiation... maybe do immunotherapy... is to beat the crap out of our cancer... to prepare the breeding ground (esophagus) for removal. And NOW is the time to cut it out. And after they cut it out, they should still follow up with more chemo and/or immunotherapy... but this will be highly dependent on what is seen on your post-op pathology. I've seen stage 1's go straight to surgery (zero neoadjuvant treatments) and wake up as stage 4s due to many positive lymph nodes. How is this possible? Because again, scans cannot see tumors smaller than 5 to 8 mm. PET scans may or may not show some SUV uptake... but even these areas are hard to judge as cancer or not.

Just pm me if you'd like to discuss further. And just so you know... just because I did chemo, radiation, esophagectomy, and a year of immunotherapy... 4 years ago... doesn't mean I want YOU to do this as well. Each case is dependent on many factors... your age, your stage of EC, type of EC, location or tumor, nearby lymph invasion, other comorbidities, etc. Depth of penetration thru the layers of your esophagus is most important as to what comes next. But if you finished your last treatment 6 weeks ago... surgery should be coming in the next few weeks. Otherwise you will need to be re-scanned.

Gary

My husband is in the exact same situation. He is 82 yrs old and for now has decided to "wait and see"
pending future PET scans. How old are you, if I may ask?

Thanks for the advice, it’s not that I don’t want to do the surgery, it’s that I need to attend a life event overseas in 2 to 3 months, and I am concerned after the surgery I won’t have healed enough to travel by plane for 10 hours, That’s the only issue that’s holding me back. Doctor said it would be OK to do it later but of course I’d like to get it out the way as soon as possible. I also asked if I was an able to have the surgery because of another underlying circumstance, with a spot in the surgery , and of course the answer was yes therefore I think I’ll be OK if I do it at the end of September. I will be monitored in the interim. Thanks Luis

I just turned 63, in great health apart from this C thing. My problem is not the surgery but I’m in a predicament where I need to be totally healthy in September, I’m just looking to postpone it and I’ll have another scan and endoscopy beginning of September. Thanks

Luis, I have read everything I could find since my husband's diagnosis lat October.
It appears that you have to commit one year from surgery to an acceptable return
to freedom of feeding tubes, normalization of eating and bowels and quality of life.
I think it is wise to wait until after the event. Meanwhile, be as good to your body as you can,
so that if after the September event you decide to do the surgery, you can be in your absolutely best condition. A suggestion - look up the website "Smart Patients" and sign up for the esophageal cancer conversations. There are significantly more people posting there and that gives you a broader view of different experiences for this condition, surgery or not. Boa sorte!

Ok Luis... I have no clue what your big event is in September... I'll assume family celebration of some sort. But remember... there is always risk... and even your oncologist has no clue what's going on inside you while you wait. Hopefully your existing EC stays a bit depressed and "dormant"... and no spread takes place the next 3 months. But it is your life were talking about here... and dealing with EC is about doing things in order... to give us our best shot. Could you fly 2 to 3 months after an esophagectomy... well yes... as you'd be recovered from your surgical wounds by then... off any pain meds for sure. But you'd just be starting on your post-op journey... and eating, tummy aches, intestinal discomfort, ass explosions... will all be normal. But hey... toilets always available on long flights. But weight loss, hydration, possibly tube feeding post-op... all are possible. I was playing some golf 2 months post-op.

Ok... so a little roll of the dice on your part, that things will stay the same... but stay active, keep your heart and lungs in good shape, and fatten up all you can til September. Because more weight loss is coming your way. That's a guarantee.

Be well.

Thank you, maybe we’ll play a round one day. May I ask your age? Oh , the event, I’m walking my daughter down the aisle.

I knew it was a biggie. Ok. Acceptable.

I'm 65 now, was 61 when I went thru it all... chemo, radiation, esophagectomy, then a year of immunotherapy.

So... destination wedding? Or going back to the old country for this? Portugal?

What stage were you, appreciate the effort!

Yup, where my family is from, I’m from Gary Player and Ernie Els country .