My Unique FLOT Treatment

Posted by douglasgb @douglasgb, Feb 23 1:46pm

Thought I'd share my story with the hopes it may help someone. I was diagnosed on 10 SEPT 2025 with stage 3 adenocarcinoma during a scheduled endoscopy. A stent & chemo port was implanted two days later and chemo started on 25 SEPT. My care is covered by the VA and I was presented with two different treatment plans.

My Community Care (VA outsourced care) care plan consisted of 4 rounds of FLOT, surgery then 4 more rounds of FLOT; the VA care (non-outsourced care) plan consisted of 8 rounds of FLOT then surgery.

I had contacted Mayo about options back in September but didn't get my appointment until 03 DEC. By that time, I was 3 weeks post chemo #4 and 4 weeks prior to my scheduled surgery. Upon consulting with Mayo, they recommended that all chemo sessions be complete prior to surgery (same as VA's care plan) as they shared that most patients are unable to complete 4 rounds post surgery-stating who wants to do chemo after major surgery? Made sense to me so I opted to have my surgery with Mayo instead of my local hospital (not going to name them but the care they gave was exceptional).

Long story short, because I changed hospitals, I had 6 weeks and 5 days between chemo sessions #4 and #5. Do I think I could have done all 8 chemo sessions prior to surgery? Very doubtful - the FLOT side effects kicked my tushy. But I'm so grateful for that break. I would recommend any sort of break if it fits your situation. And BIG PROPS to all those that do 8 chemo sessions without a break!!

I am now 2 weeks past my last chemo session and 4.5 weeks pre-surgery. Hope this helps!!

Interested in more discussions like this? Go to the Esophageal Cancer Support Group.

Your profile is days behind mine. I also had 4 treatments over 8 weeks of FLOT. 4-5 weeks rest and recovery then a complicated surgery over two days early Nov. I started my last 4 FLOT treatments end of December and the side effects are kicking my tushy too. BUT I survived all of it. Next week I start monthly Imfinzi immunotherapy by itself. I had been getting it with the FLOT so I’m not sure what new stuff I will go through. My surgery was atypical because of a 2007 gastric bypass. So my surgeons had to be careful and inventive. 11 days 6 ICU 5 regular room. Surgery was laparoscopic robotic so I have a bunch of holes. No feeding tube they started me on liquid diet and then soft foods before discharging me. I made them get me out of bed every day. I had so many IVs it took 3 people to get me out the door. I sat in a chair from 5am to 8pm everyday or took a walk around the floor with my entourage. Lots of fun things happened but I got through it. I spent my 70 birthday recovering. Slowly but surely you will too. The FLOT chemo is harder after operation. Side effects came on faster and lasted longer. Keep us posted on how your recovering. The surgery was advertised as the event that will save my life. Good luck. May the force be with you.

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I had a care team at the University of MN and at Mayo with similar recommendations. I opted to do Mayo's plan of 8 straight FLOT sessions pre-surgery because I didn't want to risk me not getting the final 4 due to energy, strength, determination, etc. I head in for #6 on 2/26. They did say each one could have side effects that get harder and last longer...#5 showed that to be truer than the first four. Developed foot neuropathy which was a bummer, but it comes and goes with my body temperature, so I'm hopeful it won't last. I do ice both hands and feet when getting treatment. Hands have had neuropathy after each one. I'm eagerly counting the days until I am done with chemo (3/26 will be my last one if we stay on track!) and moving into surgery. Dreading surgery but also just ready to put this whole mess behind me. If one can handle FLOT well enough, I do recommend it, though I am getting weary of it. I'm nearly 3/4 of the way done...I can do it, and so can you!

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Hi I also had Flot treatments. I’m 63 started my journey August of 2024 stage 3 esophageal cancer. I couldn’t swallow any food and very little liquids. Had lost 45 lbs muscle. So had j tube put in so I wouldn’t lose any more muscle or weight. So started chemo treatments in October of 24. One every other week for 2 months. I handled the chemo treatments with only a little nausea. Waited 5 weeks then I had Ivory Lewis surgery or robotic surgery. Two surgeons lasted 9 hrs in ICU 1 day 8 days regular room. Had chest tube coming out right side after surgery because they deflated my right lung to take out tumor and 7 inches of esophagus. First couple of days a little rough after surgery. But they had me up and walking the next day. So my work started walking as much as I could and doing breathing exercises. The more I did the better I felt. So 6 days passed then the swallow test to make sure no leaks. It was wild watching myself swallow the liquid. So success with the test now I could have broths and jellos and popsicles also coffee and water. Then started soft foods for couple weeks. Then waited 4 weeks after surgery to have 4 more chemo treatments done. My second round of treatments caused more nausea this time. Same treatment 1 treatment every other week for two months. I did get a little neuropathy from the chemo treatments also. So I walk an exercise to get my stamina and muscle back. So I’ve had two scans since surgery and am cancer free at this time. Now I can eat most foods but spicy foods can be troublesome also chocolate for me. Smaller meals also just make adjustments to what you can handle at one time. We are all different so what’s right for me may be different for you. Also depending on if you have any underlying conditions also can affect how you respond to treatments and surgery. I am truly grateful for all the support I had including all my doctors and nurses and most importantly my family and friends. It makes a big difference if you have a great support system. That’s my journey so far. So keep optimistic and positive. Wishing everyone best wishes you can do this!! Sincerely Scott

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Hi
Well done for getting through FLOT! Its tough for sure. Apparantly one of the most aggressive mix of chemo to hit the cancer hard and fast (breast cancer chemo is done over a longer period).
I did 3 sessions pre-operation. It woukd have been 4, but I had a ore-planned wedding and woukd not have got through it otherwise! They said the chemo was to reduce the tumour, and 3 rapidly did that which was a huge relief. Prior to the chemo, I had to get an urgent nasal feeding tube installed, as I started choking of food, after months of reducing it from severe pain eating.
I got nausea from the chemo, but ironically was saved from actual vomiting, as I was only on the tube the whole time. Got bad diarrhea at the end though, neuropathy which stayed a while, very dry hands and mouth-also from now getting enough water from actual food though,itchy skin, insomnia, that I can recall.
Got the tube out pre-wedding, and was able to eat food finally, thank goodness, was a major treat for my wedding! 2 weeks for that and a wee honeymoon, and I was in the operation.
I got an infected incision in my neck after surgery, so the j tube installed ended uo staying for 6 months! It was a real pain. 3 more operations to try close it and so many dressings and solutions that didn't work. Its very rare apparantly.
I was supposed to get 4 more FLOT, but the nurses were extremely concerned about me doing chemo with an open wound, as the chemicals can swap out of the wound, and woukd have sat un-wiped under the dressing, potentially causing irritation and burning at mildest.
Still, the surgeon thought it was safe, so I tried it. Did 1 session, and then looked in the mirror, and my whole neck wound had re-ooened to a gaping black hole. It was terrifying! I literally prayed for the answer, and knew I shouldn't do anymore.
The tumour was completely removed, and chemo was just in case, they said just di what you can, and oncology said if it comes back, it won't be because you did less chemo. The number is just a tried amount, its not a fail-safe number. Saying that, anyone who can complete it is amazing, and I definitely would have if it had been safe.
I have now got a sealed neck-yay, so can eat. Was 6 months of no food or liquids, even water in my mouth. Thars dry mouth if I ever had it! Had to use false saliva!
Have had my yearly cancer scan and still clear. Neuropathy gone. Just a bit of chest pain, likely from radiotherapy.
I got a stricture, so had a temporary stent which worked wonders and dilations, reduced to 6 weekly now.
Eating normally, exercising and loving life.
The surgery was 100%worth it. Got all the cancer out, and now I can eat and live.
Best of luck x

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