Assume his surgery was in 2024. Quite unusual to have no neoadjuvant chemo treatments before esophagectomy... unless he was a stage 1. So my first question... what did his post-op pathology show? Many positive lymph nodes? Because for him to now show liver mets so soon after esophagectomy is unusual... but only goes to show that initial diagnosis is but a guess... not everything can be seen by scans and EUS.

But systemic chemo is a must now, along with immunotherapy if applicable. Yes... it will usually provide typical sude eggects like nausea, some hair loss, cold sensitivity, loss of taste buds, some neuropathy, etc. If doing Folfox or FLOT, he'll be re-scanned after 4 or so infusions to see how effective his treatments are. Having ctDNA bloodwork analyzed is another way to monitor treatment effectiveness. Hang tough.

Gary