Fit 61 year old man, newly diagnosed with stage III adenocarcinoma

Can I ask the size of the mass? Are you able to swallow? Do they have you on PPIs? What kind of tests have they done so far other than the endoscopy? What did the biopsy say? We’re they able to get past it to get a biopsy of the distal end or just the upper part closer to your throat (even though it’s much further down just saying in comparison to the stomach end).

Hi I also was diagnosed last year with adenocarcinom of the esophagus. So my oncologist and the tumor board put me on the flot program. This consists of 4 treatments of chemo every other week for two months. Then waited five weeks and had surgery. Waited five weeks more then started 4 more treatments of chemo same way every other week for 2 months. With all that said there’s more during this I also had a j tube for feedings. My tumor was big enough that I wasn’t able to swallow food and barely any liquids. I had lost 45 lbs and needed to gain weight for surgery and nutrition as well. Throughout my treatments the one thing I had was positive attitude and I wasn’t going to let cancer define me. Also important my oncologist and my surgical team and all the nurses were awesome!! And my nutritionist also. My wife and sons and sisters in-laws were great support system. It’s been a year now and my scans are clear. I have to eat smaller meals I just add and extra meal everyday. Can eat most foods now but still can’t eat spicy food to well. I am grateful everyday that I can eat and drink again and go on walks and exercise daily. Takes time to put weight back on but getting there. Even though we have the same cancer we all have different journeys through this awful disease. It is scary no doubt but with the right support you can do this. Hope this helps some wishing you the best!! I’m 63 now also. Please any questions feel free to ask. Scott

@lovelexia92 :

Thank you for all this. Here are the details.

Size of the Mass
The report does not provide a specific measurement for the overall size of the mass, but it describes its location and impact:
• The mass is described as a mass-like lesion located in the distal esophagus and extending into the cardia of the stomach.
• The area where the lesion is located is definitely mildly narrowed compared to what would usually be.
• However, the area is not blocked. During the endoscopy, the area was open and large enough for the endoscope to pass through, meaning the opening was more than one centimeter.
• The lesion was described as "friable" and was bleeding upon contact with the scope even before the biopsy was taken.
• The biopsy fragment collected from the esophageal lesion (Specimen 7) measured 0.4 x 0.3 x 0.2 cm.

Tests Done So Far Other Than the Endoscopy
In addition to the EGD performed on October 9, 2025, several other diagnostic tests have been completed, and others are pending or planned:

Completed Tests:
• Laboratory Tests (Blood work): Labs taken during a late September 2025 ER visit showed mild normocytic anemia. This drop in Hemoglobin (from 13.6 g/dL in January to 11.1 g/dL in September) was one of the reasons the endoscopy was ordered, to look for blood leaks.
• H. pylori Testing: A stool antigen test performed in early October 2025 was negative. The stomach biopsy (cardia lesion) also tested negative for Helicobacter pylori.
• PET-CT Scan: This scan was performed on October 23, 2025. The results were available by October 29, 2025, and indicated no evidence of distant metastasis. The PET scan did show a couple of lymph nodes near the esophagus and stomach that were "a little bit bright," which is consistent with possible lymph node involvement.
• Cardiology Workup: EKG and echocardiogram performed in early October 2025 were normal.

Pending or Planned Tests/Steps:
• Endoscopic Ultrasound: While the oncology & GI teams had contemplated an EUS, they have determined that it is not necessary.
• Microsatellite Stability Test: This special test from pathology is pending. The result could potentially change the treatment from chemotherapy plus immunotherapy to immunotherapy alone, although the abnormal result required for this change is quite rare.
• Tumor Board Review: My case was scheduled for today (Monday, October 30th) to be discussed by the surgeons, radiation doctors, and oncologists at a Tumor Board meeting to determine the best plan.
• Genetic Testing: A referral for genetic testing was discussed and deemed reasonable due to the family history of various cancers.

What the Biopsy Said
The pathology report provided a definitive diagnosis:
• The pathology report for the esophageal lesion diagnosis is Adenocarcinoma, poorly differentiated.
• The doctors confirmed that the type of cancer is adenocarcinoma.
• Special testing showed that the tumor cells exhibited high proliferative activity (Ki67 proliferation index is >90%) and were positive for CDX2 and CK7.

Biopsy Location (Distal End vs. Upper Part)
The biopsies were taken from the area of the lesion, which is located at the lower end of the esophagus:
• The lesion was found in the distal esophagus and extending into the top of the stomach (cardia).
• The endoscope was able to slide past the lesion. The doctor confirmed that the area was open and large enough for the endoscope to pass through.
• Because the EGD could pass the lesion and the lesion itself is in the distal esophagus/cardia, the biopsies were successfully obtained from this lower area. The pathology report confirms samples were taken from the "esophageal lesion" and the "cardia lesion (stomach)".

The goal of the upcoming Endoscopic Ultrasound (EUS) is to use specialized advanced endoscopy to see how deep the tumor has invaded the tissue layers, which is a level of detail beyond the initial diagnostic endoscopy.

They have prescribed Omeprazole, which I just started taking (2X/day) yesterday. I have been able to swallow, and still am, but in the past couple of days it has gotten a little uncomfortable. I also have globus sensation a lot of the time now. Dr. ChatGPT says that this is most likely a result of irritation from both acid and the endoscopy/biopsy. (I've never had symptoms of GERD, by the way.)

Thanks for sharing about your diagnosis and treatment plan. I too was scared upon getting the news of having Stage 3 esophageal cancer. At any point in time, I also was mad, depressed and anxious, particularly towards the beginning. I am now about a year from my esophogectomy. Like yourself, I'm relatively young (67) and healthy. Each of us has a unique journey, but resoundingly what seems common for recovery is maintaining a positive attitude. The chemo/radiation treatment I received was successful in shrinking my tumor from 5 cm to nearly nothing. Surgery successfully removed the remaining lesion with clear margins and no evidence of disease. I then started Opdivo immunotherapy 2 months after surgery. All this said, the journey to date has been challenging. I had pericarditis caused by photon based radiation which landed me in the hospital for 5 days. I was in the hospital for 10 days post surgery. My care was excellent, but it was a difficult recovery. At home, my wife was my caretaker and managed my 30 day stint on tube feeding and med delivery. I started eating liquid and then solid foods shortly afterwards. I did well despite losing some weight until month 4 of immunotherapy. Food would not longer pass down my new esophagus into my GI tract. I spent 5 days in the hospital with gastroperesis and lost 15 lbs in a week. Once resolved, I was able to eat again and build up my strength. About 3 months later, I had stomach pain and severe fatigue. It turned out that the Opdivo started attacking my liver so treatment was stopped. I mention all of this as reference for you in your journey. What's key however, is that we're all unique in this process. Your experience could have some similarities, but also will be unique to you. Recovery is not linear, but focusing on your long term health is important. Maintaining exercise, seeking support, relying on your medical team and being grateful as you progress have helped me in my recovery. I'm 67 now, work out vigorously (particularly strength training) 5 times and week, plus still play lousy golf now and then. I've tested clean to date and hope for the same in my January scan. You'll hear it over and over, try to stay positive. You'll have bumps in the road, but being young and healthy gives you a solid foundation to beat this.

Hi. I too was scared. Actually I was terrified.
I was diagnosed with stage 4 at age 61 also. Large adenocarcinoma, size of a big apple and it blocked the oesophagus at the time of discovery. The endoscope had to be forced past it.
You've got a hard journey ahead of you but try to keep well and as fit as you can and you will get through.
I'm 2 1/2 years post surgery now and and doing ok.
Hang in there
Sue/New Zealand

My husband was diagnosed with adenocarcinoma of the GEJuncture he did 4 rounds of FLOT chemo then surgery (minimally invasive IVOr Lewis) then more chemo. A few complications but he is now doing very well. It was a rough year, but doing well now. Treatment at MSK with Dr Jones as his surgeon

My husband was diagnosed with stage 4GEJ adenocarcinoma last Feb 2025. He is being treated at MAYO in Rochester MN. He is part of an ongoing trial FOLFOX.

He had chemo every other week . 4 rounds.

Then proton radiation.

Then surgery.

He was in the hospital 5 days. No feeding tube, luckily had maintained weight.

He is leArning to
Live with his new normal.

We had a perspective throughout our Journey to adapt to the things we could control along the way.
We started eating 5-6 small meals everyday.
I have 2 different choppers that assist me in cooking
We bought an adjustable bed so he got used to sleeping on an incline
He doesn’t have liquids during eating.

I can’t tell you how much this helped us after surgery !! We already were doing so many of the things that would have been changes.
Best of luck on your journey! God bless.