Esophagectomy Surgery No Longer an Option -We Are Lost- Help

After my 28 days of chemo and radiation, an endoscopy and PET scan showed that my cancerous tumor in lower esophagus was completely gone along with cancer in several local lymph nodes. I would follow their recommendation to go back to oncologist for recommendations on possible next steps. One possibility is immune therapy. Here is Mayo Clinic reference about possible next steps:
https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-treatment/art-20047350
Have you researched some of these options yet?

Thank you so much! It's all so overwhelming. He is hesitant to do more chemo, because they could never get the nausea under control. We have an appointment for Monday with the oncologist to discuss options. It's confusing, since we have been working so hard to get to the point where surgery was scheduled and then to be to be told it was off the table because he wouldn't make it through, was tough. Your post is encouraging.

I also had problems with nausea, but they were able to give me Zofran and also before chemo via port they were able to give me anti nausea medicine via the port. I hope they can do that encourage you to continue chemo. I also was discouraged to hear I was not a good candidate for surgery due to my high blood presure and anti heart fibrulation meds. Can you ask about nausea medication options?

Maybe all he has to do now is the follow-up check up with your oncologist.
Because my Oncologist and GI surgeon discussed with me before I did this treatment that if the tumor shrink I don’t need surgery 🤞.
But right now I’m really feeling weak and my last chemo treatment is next week and 3more days of radiation.
I can’t even eat and drink I only getting daily IV HYDRATION.

We plan to ask about the nausea med options. He did have the IV before chemo, and three or four others to take as needed at home, but none of them really took it away. I am absolutely encouraging him to do more chemo. It did shrink his tumor, but didn't take it away entirely.

Prayers for you. Thank you for sharing your difficult story

Thank you all who have replied. The replies got my juices going and gave me a direction to look. We were feeling pretty hopeless and abandoned when the surgeon said he wouldn't make it through surgery, since that's what he had been working for all of this time.
I have found it's not the end. There are other treatments, like more chemo, immunotherapy, etc. out there, and after reading some of the posts in here, and on other threads, it looks like surgery would not have been a good thing for him, even if he had survived it.
We had the j-tube removed and he is almost back to his old self after months of suffering with it. It always hurt, and felt like it was taking up a lot of room. It extended a lot and was always catching on stuff. He's a really active guy and there was so much he couldn't do because of that tube. He really didn't need it, since he could always eat, but he's had it in since Nov.2022 working toward surgery.
We meet with his oncologist next week and right now, I'm thankful his tumor has shrunk enough from treatment that he has no pain, the j-tube is out so he feels good and he's eating normally. Thank you everyone for your stories and information that helped me get back on track!

@nuggetofmine, I thought I'd check to see how you and your guy are doing. Did you and the oncologist determine next steps?

Wow, thanks for checking up on us! His tumor is HER2 positive which opened up more treatment options. He's going to start FOLFOX next week. He's actually looking forward to it in hopes the treatment will shrink the tumor enough so he doesn't need the occasional pain meds. The first round of chemo/radiation in prep for the surgery he didn't get made it so he could eat comfortably and that in itself was life changing. We are optimistic now and no longer lost. Everyone here is so kind.

It ain't over til you say it's over. By all means seek a second opinion. Depending upon the size, location of the primary tumor there may be other options rather than esophagectomy such as POEM, cryoablation and photodynamic therapy. These are newer, lesser known techniques that may not be yet be available in your area. They are generally considered to be palliative rather than curative procedures. They are more tolerable for frailer patients and may provide symptom relief and improved quality of life. Failing that, perhaps a moderately aggressive second line therapy such as FOLFIRI and targeted therapy with an immuno-oncology agent like Keytruda, Opdivo, et al or newer targeted small molecules may be an option. If he has not a genetic analysis of his tumor performed, it should be done ASAP to help in the selection of appropriate therapies.
In the interim, he should keep his J-G tube or have it switched out for a G-tube. Even though he may not have an appetitite, he should try to take in 2000 calories a day thru his G-tube either by bolus administration with syringes or thru an external pump. I'd recommend Nestles Nutren 2.0 that contains 500 calories per 250 ml carton. I would suggest starting him at flow rate of 65 -75 ml an hour and gradually increase it up 100-125 ml/hr if he can tolerate it. It may take a little experimentation to determine his optimal tolerable flow rate for feedings if using a pump. Normal empty stomach volume for an adult male is about 2.5 ounces or 74 ml when relaxed. It can expand to hold as much 1 quart of food. Normal rates of gastric emptying for most liquids is 200-300 ml/hr for men. Emptying rates may vary with the thickness and protein content of the liquids ingested. Also, chemotherapy may significantly decrease the rate of gastric emptying (gastroparesis). Too rapid a rate of infusion may cause bloating and nausea or leakage through the G tube stoma. Nausea and vomiting can be addressed with Zofran, compazine, Xanax, valium and other drugs.
I hope you find this information useful. I wish you and your husband the best of luck.