Newly diagnosed and really confused: Surgery vs Chemo + Radiation

@pliddle
Welcome to the club of esophageal cancer patients. I also had chemo and radiation which eliminated the cancer tumor without surgery. I had jtube also. I like your attitude and hope all goes well. Please let us know how it it going?
Don

Thanks; I will update as things go forward. I have viewed several times a YouTube vid of a study presentation before a Thoracic Physician group where a researcher assessed patient survival data for Stage 2 and 3 Esophageal cancer patients who underwent surgery or who declined. He concluded that those opting against surgical resolution had a 20% shorter survivor time than patients who declined. He was accompanied by a Mayo Clinic senior physician who commented on the quality vs. quantity aspects of patient survival criteria. There clearly is much food for thought in this issue.

@pliddle
Yes, I too studied the survival statistics for esophageal cancer patients. In the end I concluded the statistics are not all that helpful. You have to do some research, ask questions, listen to doctors, make decisions, and pray that all goes well. I will be interested to hear how you get on?
Don

Are the odds greatly improved with the surgery? My husband will be faced with this choice too, provided everything he’s currently about to do goes well. It seems like what the surgeon says he hopes as far as what he’d have to remove is a lot better than what the radiation oncologist is saying. The oncologist agrees with the surgeon. I guess the radiation guy isn’t the one doing the surgery, right? And everything is dependent upon what happens next, so my husband isn’t quite there yet.

@dave4144, welcome. It's your surgery anniversary month. I look forward to your reflection.

How are you doing now? What do you wish you had known? What thoughts do you have for anyone newly diagnosed with esophageal cancer?

Yes... surgery eligibility will be judged with the post treatment scan that shows everything has shrunk... and no distant spread. Local lymph nodes to the solid esophageal tumor are acceptable and don't necessarily make the patient stage 4. And yes... while anything we do... chemo, radiation, esophagectomy, immunotherapy... is not the cure for EC... it is doing a combination of these things that can get us to NED status. NED status is not the same as being cured either. But staying NED for 5 or more years... that is when they'll start saying we are cured. So only the passage of time (and living scan to scan) will tell us if we're cured or not. I'm in my 5th year post-op now... one scan to go in October... and they may cut me loose... no more monitoring. I'm starting to feel optimistic. And yes, of all the things we do, surgery is considered the cure (even though it is not). That's why everything else we do surrounds the surgery... first-line treatments are done in the neoadjuvant setting (before the esophagectomy)... and any treatments we do post-op are called adjuvant treatments. All of these things surround the Main Act... the esophagectomy. Post-op pathology is a big deal... where they examine everything removed during the esophagectomy under a microscope. This includes a close look at the removed esophagus as well as 15 to 40 lymph nodes. This will also dictate adjuvant treatments the patient may get. Be well.

You know how to reach me.

Gary

My surgeon told me that my best outcome would be due to having chemo, radiation and an Ivor Lewis esophogectomy. I was staged 3 locally advanced though. Anyway, you always can get a second opinion. Any responsible doctor would respect that. Good luck to you.