What happens during radiation for esophageal cancer?

Posted by cottonsunflower @cottonsunflower, Mar 9 2:00pm

My husband has stage 3 esophageal cancer diagnosed December of 2023. He began chemo in January of 2024 getting that treatment every other week for over 2 years now. Well now the cancer is slowing growing and affecting his swallowing. Food is getting stuck causing him to throw it back up. The doctor has decided to do radiation for the first time. I was wondering about what happens during radiation. Will his throat swell? I heard it would and there would be scaring. The doctor has mentioned this as well but I am a little worried about it closing up all the way! He said he would have to be on liquids eventually. I see a lot of your stories are chemo and radiation together and I was just wanting to hear about it first hand from someone going through it. Thank you for any insight you can give. he starts on March 23rd.

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ryc | @ryc | Apr 10 9:43am

In reply to @cottonsunflower "@ryc He is having proton radiation. Today is day 10." + (show)

@cottonsunflower
Sending hugs to both of you.

cottonsunflower | @cottonsunflower | Apr 10 10:50am

In reply to @ryc "@cottonsunflower My husband also had proton radiation. He had it for 5 days a week for..." + (show)

@ryc I was wondering when we would see changes. Today is day 10. He is supposed to get 27 treatments, 5 days a week. his swallowing is still pretty bad and I am not sure what to expect going forward.

ryc | @ryc | Apr 10 11:37am

For my husband, things became tougher after the second week of treatments. His ability to swallow became worse and we had to resort to smoothies and soups. Panera Mac and cheese worked for a little bit. After the full course of radiation, he developed a spasm in his chest which made it difficult for him to even swallow his saliva and he required the use of an NG tube and gravity feeding along with IV hydration through his port every day. He wasn't able to tolerate the NG tube, so they changed it into an NJ (nasojejunum) tube which he tolerated much better. He lost about 60 pounds during this time and the palliative care team was wonderful helping with the pain. About three weeks ago (after 82 days of a feeding tube and daily IV hydration) he was able to start eating again. I'm happy to say that he is gaining weight and can eat anything he wants. It's been long road though. The tumor and the lymph nodes in his chest and abdomen have decreased quite a bit. The did not do a scan right away after treatments as they said that the effects of the radiation would not give an accurate picture. We had to wait about 3 months post radiation before having the first scan.

I would recommend Aquaphor and lots of lotion on the areas that are undergoing radiation. We put on the lotion at first and then the Aquaphor on top of the lotion. My husband developed quite a "burn" from treatment on his neck. He also developed a rash on his abdomen (his field was described as the largest they had seen at Mayo). I think there might have been a cream that they recommended for that, but I'll have to check on it.

cottonsunflower | @cottonsunflower | Apr 10 12:28pm

Thank you for all of this information. I want to be prepared for anything.

ryc | @ryc | Apr 10 12:42pm

In reply to @cottonsunflower "Thank you for all of this information. I want to be prepared for anything." + (show)

@cottonsunflower
Please feel free to reach out any time. I didn't find this group until after chemo and radiation, and I felt a little lonely in all of this.

earle | @earle | Apr 11 4:06pm

In reply to @cottonsunflower "@earle he could not have surgery because he had some spots on his liver they thought..." + (show)

@cottonsunflower Makes sense. They would have to rely on chemo and immuno, anyway, so not much point in putting him through a esophagectomy...

leilac | @leilac | 15 hours ago

In reply to @cottonsunflower "Saw the radiation doctor yesterday. My husband will get 27 radiation treatments beginning on the 23rd...." + (show)

@cottonsunflower
Hi
Your husband may have started his treatment now, but just thought id add my experience.
I did 6 weeks of daily radiation, after initial chemotherapy and then esophagus surgery.
My situation was a bit different to many, as my tumour had broken up a bit, so the "new infrastructure " ie-the stomach pulled up to previous esophagus join, is behind the heart, not in front.
Most side effects from this radiotherapy would be a slight itch or burning sensation where it is directed, and fatigue, worsening over time. I didnt get the soreness, but got the fatigue. Its manageable if you expect it. It builds over time, so I didnt notice untill later on when I was really knackered!
Radiotherapy is much less invasive than chemotherapy, as its on the outside of the body. It was definitely the easiest treatment for me, having had the full works, so to speak.
It can affect your heart long-term, and other things,but these are less common, and worth it in comparison to not having it. In his case, sounds like primary treatment so is needed.
Keep talking to the medical team, any side effects etc they can look at and should help where possible.
Best of luck, I wish you and husband all the best x

cottonsunflower | @cottonsunflower | 13 hours ago

Update: Well, today is day 19 of the 27 radiation treatments for my husband. He had a rough week with a lot of nausea and throwing up. He lost 13 pounds this week and 43 for the last 4 weeks. He feels that the tumor is shrinking but between the nausea from the heavy chemo and the pain from the radiation, he just has a hard time eating. Just another week and a half of the radiation and Monday should be his last massive chemo treatment. Then he should go back to his usual chemo routine without radiation. He has nausea meds from the oncologist but he has trouble keeping them down. He also has pills for the pain but they knock him out. The liquid one he got from the radiation doctor looses it potency by the time it gets down the esophagus to where it is needed. It's just kind of a catch 22 any which way he goes. We are praying and just trying to make it through this hoping for a good outcome on the other end. I appreciate you all commenting and giving me support during this time. It helps getting all of the information I can.