1. < Esophageal Cancer

Esophageal Cancer: Surgery Or Not?

Posted by rickho @rickho, Feb 19 2:59pm

I just completed my 8 Chemo and 28 radiation treatments with a follow up Pet Scan. My wife and I were excited with the images when compared to the 1st pet scan that showed cancer in the lower 3rd of the esophagus as well as in a couple of limpnodes located in the area. Our radiologist showed us the images and said it showed absolutely nothing now. We felt a EGD with a biopsy would be the next logical step but the surgeon who would be performing the surgery really wasn't receptive to it. She is probably the best in our area and performs a high volume of these surgeries annually. Her comment being "Even if the test comes back clear, the cancer returns 50 % of the time". So now I'm in the position of trying to make a decision to go with the surgery or not. I'm 70 years old, in good health. I'm just struggling with what I should do. I know it's not a easy surgery or recovery. I'm not afraid of the fight, I just don't know if I need to make it

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larryaw | @larryaw | Aug 4 2:23pm
In reply to @colleenyoung "Hi @larryaw, several members like @dsh33782 were treated successfully with chemo and radiation, no surgery. Age..." + (show)
@colleenyoung

Hi @larryaw, several members like @dsh33782 were treated successfully with chemo and radiation, no surgery. Age is an important factor to consider.

How are you doing on chemo and radiation? How many more treatments do you have?

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I’m doing okay, as I guess normal I have good and bad days. I’ve had three chemo infusions with two to go. Fourteen radiation and fourteen to go. Radiation has been the worst making my throat sore. Anyway I will press on and get through this.

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ollusam | @ollusam | Sep 11 6:59am
In reply to @doglover888 "Hi. I HAD esophageal cancer and didn't question for a second whether to have surgery. I..." + (show)
@doglover888

Hi. I HAD esophageal cancer and didn't question for a second whether to have surgery. I did and it was rough in the beginning but I am almost back to my old self. Next week I am having my 3 year checkup. So far, so good. No sign of cancer and my surgeon said he believes I have a 5% chance of it ever returning. I believe that not having the surgery would be foolhardy but then that's me. I rarely think about it.....life goes on. Whatever you decide I wish you the best. Be positive and good luck.

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My husband is 75 years old Dx with T2N0 GE juncture cancer. Pet scan negative for mets no lymph node involvement Esophageal ultrasound shows mass into muscle layer but no lymphadenopathy. Surgery first? chemo later? chemo first? I would hate to postpone surgery at this point for unnecessary pre surgical chemo and radiation. Thoughts?

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ollusam | @ollusam | Sep 11 7:25am
In reply to @doglover888 "Hi. I HAD esophageal cancer and didn't question for a second whether to have surgery. I..." + (show)
@doglover888

Hi. I HAD esophageal cancer and didn't question for a second whether to have surgery. I did and it was rough in the beginning but I am almost back to my old self. Next week I am having my 3 year checkup. So far, so good. No sign of cancer and my surgeon said he believes I have a 5% chance of it ever returning. I believe that not having the surgery would be foolhardy but then that's me. I rarely think about it.....life goes on. Whatever you decide I wish you the best. Be positive and good luck.

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Was it at the GE juncture? Any lymph node involvement? Did you have any pre surgical chemo or radiation?

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sueb007 | @sueb007 | Sep 12 5:20pm

Your surgeon isn't very tactful. Spouse 66 yr just had the surgery in August. He is doing fantastic. Learning what he can eat and how much. Has taken the dogs to do a little hiking. Most say that you are lucky if you can get the surgery as it is the best outcome. Stay positive,stay active and do what you are supposed to do.

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1 reply
ollusam | @ollusam | Sep 12 6:24pm
In reply to @sueb007 "Your surgeon isn't very tactful. Spouse 66 yr just had the surgery in August. He is..." + (show)
@sueb007

Your surgeon isn't very tactful. Spouse 66 yr just had the surgery in August. He is doing fantastic. Learning what he can eat and how much. Has taken the dogs to do a little hiking. Most say that you are lucky if you can get the surgery as it is the best outcome. Stay positive,stay active and do what you are supposed to do.

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Did your spouse need chemo or radiation prior to surgery?

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1 reply
ollusam | @ollusam | Sep 13 4:08am
In reply to @doglover888 "Hi. I HAD esophageal cancer and didn't question for a second whether to have surgery. I..." + (show)
@doglover888

Hi. I HAD esophageal cancer and didn't question for a second whether to have surgery. I did and it was rough in the beginning but I am almost back to my old self. Next week I am having my 3 year checkup. So far, so good. No sign of cancer and my surgeon said he believes I have a 5% chance of it ever returning. I believe that not having the surgery would be foolhardy but then that's me. I rarely think about it.....life goes on. Whatever you decide I wish you the best. Be positive and good luck.

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Did you go for pre-surgical chemo and/or radiation.? That is my dilemma with my spouse. PET scan shows no nodal involvement or metastasis But the mass has invaded the muscle layer of the esophagus so he is T2N0. Should he spend precious time having chemo and radiation and risk the cancer spreading at that time or becoming immune suppressed that his surgery needs to be delayed or just go right to surgery?

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1 reply
carolineward | @carolineward | Sep 13 10:29am
In reply to @dsh33782 "rheuben I'm 79 and was diagnosed with esophageal cancer. I was deemed not a candidate for..." + (show)
@dsh33782

rheuben
I'm 79 and was diagnosed with esophageal cancer. I was deemed not a candidate for surgery to remove cancerous tumor in lower esophagus. I have had 28 days of radiation and chemo. The latest scans show the esophageal cancer is all gone. I'd be happy to answer questions?
Don

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Im 48 oesohgeal cancer but when they went into to do my oesphectomy found microspical cells now I have to so 6 more chemos scan dony know what's after that.

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sueb007 | @sueb007 | Sep 13 7:39pm
In reply to @ollusam "Did your spouse need chemo or radiation prior to surgery?" + (show)
@ollusam

Did your spouse need chemo or radiation prior to surgery?

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Yes he had both. Never sick just fatigued. Ask if chemo, to get an extra bag of fluids. It will keep from getting dehydrated.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Sep 23 12:13pm
In reply to @ollusam "Did you go for pre-surgical chemo and/or radiation.? That is my dilemma with my spouse. PET..." + (show)
@ollusam

Did you go for pre-surgical chemo and/or radiation.? That is my dilemma with my spouse. PET scan shows no nodal involvement or metastasis But the mass has invaded the muscle layer of the esophagus so he is T2N0. Should he spend precious time having chemo and radiation and risk the cancer spreading at that time or becoming immune suppressed that his surgery needs to be delayed or just go right to surgery?

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@ollusam, I can understand your concern about delaying surgery for fear of further spread. Keep in mind that chemo and radiation prior to surgery are treatments that also help stop the spread. By shrinking the tumor prior to surgery, your cancer team may feel that the surgery will be more successful.

It sounds like you have more questions to ask in order to make the decision that is right for your husband and they you can have confidence in the treatment he is getting. I would ask questions like:
- Why do you recommend chemo and radiation before surgery?
- I'm concerned about waiting and fear the cancer will spread if surgery isn't done right away. If surgery is done before chemo and radiation, will the cancer continue to grow?
- What are the risks and benefits of each treatment approach?

@ollusam, has your husband started treatment? How are you doing?

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1 reply
ollusam | @ollusam | Sep 23 1:03pm
In reply to @colleenyoung "@ollusam, I can understand your concern about delaying surgery for fear of further spread. Keep in..." + (show)
@colleenyoung

@ollusam, I can understand your concern about delaying surgery for fear of further spread. Keep in mind that chemo and radiation prior to surgery are treatments that also help stop the spread. By shrinking the tumor prior to surgery, your cancer team may feel that the surgery will be more successful.

It sounds like you have more questions to ask in order to make the decision that is right for your husband and they you can have confidence in the treatment he is getting. I would ask questions like:
- Why do you recommend chemo and radiation before surgery?
- I'm concerned about waiting and fear the cancer will spread if surgery isn't done right away. If surgery is done before chemo and radiation, will the cancer continue to grow?
- What are the risks and benefits of each treatment approach?

@ollusam, has your husband started treatment? How are you doing?

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So after speaking with an oncologist the suggestion was for chemo prior to and after surgery to diminish the risk of cancer cells spreading. It will start in one week. Hopefully he tolerates the chemo well and can have the surgery in December. Thank you for your response. Such a stressful period

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