Well, I can tell you about my 77-year-old husband’s experience, with similar circumstances to your husband. Because cancer in the digestive system runs rampant in his family, he is scoped regularly (both upper endoscopies and colonoscopies). About twelve years ago, he developed Barrett’s Esophagus and had an ablation to remove the tissue at Lahey Clinic. Since then routine scopes (with biopsies) revealed no issues. Then, last February he had an endoscopy that, to the eye, looked good. The doctor told him if the biopsies came back negative, he could return in three years rather than one. I was shocked to learn a few days later that there were some cancerous cells in the cardia area (where the esophagus joins the stomach). Then he too, just as with your husband, had an esophageal ultrasound and subsequent removal of a pea-sized tumor. The doctor felt that he had gotten the entire mass but more biopsies were taken. Unfortunately, they found more cells—he was at Stage 1b.

There were two choices: radiation and chemotherapy or esophagectomy to remove the cancerous portion. Even if electing the former procedures, an esophagectomy might still need to be performed, so we chose the latter. In early June of this year, he had 10-15% of the lower esophagus and about one-quarter of the stomach removed, a pyloroplasty was performed, and he had a j-tube inserted for tube feeding. This is major surgery with the possibility of a significant number of issues. In hubby’s case, the initial hospital stay was increased from the estimated five to eight days to nineteen due to a pneumothorax and possible leak. Once they learned that there was no leak and he began eating soft food, he was released—however, nausea and vomiting issues that he had been experiencing while in the hospital, together with a failure to eat enough continued and he was losing weight so he was re-admitted to the hospital and put back on tube feeding. He remained in the hospital until late-July.

Even ‘though he was home, matters didn’t get any better. He was on enteral feeding for sixteen hours each day and was hardly eating any real food at all because of constant nausea and/or vomiting. He tried every medication under the sun to combat the nausea, all to no avail. He was vomiting every hour all night long. When he wasn’t vomiting, he had dry heaves. He even got a prescription for Dronabinol (synthetic THC) but that made him feel dizzy—or faint—and on one was occasion, he passed out—and still felt nauseous all the time. Since the vomiting was occurring primarily overnight, we thought maybe it was his position while sleeping. But then in early October when he was scheduled for a tube exchange, he had to fast—and that included no overnight enteral feeding and no food by mouth. The next morning we were surprised by the fact that he hadn’t vomited. After the tube exchange, we didn’t resume tube feeding—and still no vomiting (but some nausea still existed). It turned out that he wasn’t tolerating the formula that he had been on for nearly three months. We went to a different formula and the vomiting is much less—and some days not at all.

I’ve read hundreds of anecdotal accounts from people who’ve had this type of operation and all have issues—delayed gastric emptying (which my husband experienced on a couple of occasions), dumping, trouble swallowing, no voice, hiatal hernia complications, nausea and vomiting, no appetite, unable to feel hungry or full, etc., etc., but almost every one of them say that it will take three to six months before you start feeling better—and of course, he’ll have to change the way he eats. My husband, at a little more than five months is still dealing with vomiting (on a reduced basis and most often right after he gets up in the morning) and being unable to tolerate many foods. Food is something else—in hubby’s case, he can tolerate Boost, ice cream, puddings and many soups but his stomach (or what’s left of it) seems to reject most other food items.

Bottom line is that this is a brutal operation with a rough recovery period. In my husband’s case, I think if he had to make the decision again, he might very well have chosen to try chemo and radiation first.