My mother (68) was diagnosed with stage 3 SCC afew months ago , she went on concurrent chemo radiation till beginning of Feb this year. She was weak and couldn't do the surgery after 6 weeks post chemo radiation, we did a pet ct 8th week post treatment and found there was still residual tumor, she also had endoscopy and biopsy which confirmed this.

We met the surgeon 11th week post treatment , and he repeated pet ct and bronhoscopy, which confirmed no fistula,localized disease and resectability. However, my mother failed her pulmonary function test and the surgeon suggested she needs to rebuild her stamina first due to radiation having affected her lungs. They said she needs to do pulmonary physiotherapy and also advised to take weekly nivolumab to control the disease until she can have surgery reassessment within two months.

Two weeks post this, she was unable to swallow for three days and we rushed her to another hospital for dilation, during the endoscopy procedure the endoscopist mentioned he might have seen a tiny fistula but wasn't sure, he wanted to do CT angiography with contract to confirm. But, the next day while putting her on a naso-gastric tube, he said he could visualize the fistula and he was also able to dilate the stricture.

The endoscopist mentioned the fistula is small and he is hoping it will heal on its own within 4 weeks, we are now almost 10 day post this. And her feeding is improving, but there is still a cough now and then.

Considering her disease is localized and technically operable, I'm wondering if the discovery of a fistula changes everything? I haven't spoken to any on-co-surgeon yet, but planning to within a couple of days.

I don't know if anyone has had experience with this.

Thank you