Donna,

I'm not familiar with the surgery-first path. Was this an esophagectomy? If so, it seems as though you husband won't need a lot of radiation to his new "conduit." Not sure where they will be targeting, etc.

My wife had chemo/radiation before her esophagectomy. She almost needed a feeding tube to get through that (due to inflammation), but she did not. Importantly, what helped her avoid the tube was IV fluids, which she could schedule as needed on an outpatient basis, at the infusion center.

She got her J-tube on the same day as her esophagectomy. This was at Mayo/Rochester. Care there was outstanding all around, with one important exception: faulty J-tube insertion. A leak led to a life-threatening infection, which Mayo doctors and nurses intensively managed for several days at her bedside. During this time, the J-tube was first repositioned and then removed altogether. My wife's nutrition plan changed to oral feeding as of then, and she went home a few days later than expected.

She has done well since then with her nutrition and with her adjustment to her new digestive system.

She did have a "recurrence" or metastasis of her cancer on her first at-home scan (4 months or so after her esophagectomy) in two retroperitoneal lymph nodes. So, she's back on chemo and, for the first time, on immunotherapy, as well.

From her experience, I would recommend immunotherapy as early as you can get it. If she had had it earlier, I think she might have avoided the recurrence.

Good luck to your husband and to you.
Dave