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Esophagectomy, why? Or why not?
Esophagectomy... why? Or why not?
From a fellow counselor on our twice-weekly EC Zoom calls. He knows a bit, and assembled this from ChatGpt.
As a 16-year esophageal cancer survivor, I have participated in various esophageal cancer forums for the past 15 years. The most frequently asked question is, “Do I really have to proceed with an esophagectomy?” Could I achieve a similar outcome with chemoradiation therapy and/or immunotherapy? Additionally, concerns about the quality of life after surgery arise.
The answer to the first question is that current statistics indicate a significantly increased long-term survival rate with surgical removal of the tumor and adjacent lymph nodes.
The answer to the second question is that with some minor lifestyle adjustments, quality of life is quite good after a one or two-year period of adjustment and recovery from surgery.
To illustrate the significant difference, I have prepared a chart that compares survival outcomes for surgery versus no surgery, differentiated by esophageal cancer type (as there are variations in treatment results for adenocarcinoma and squamous cell cancer).
Please refer to the chart below.
It is important to note that this chart does not account for patient age and the number of comorbidities. The outcomes for a 78-year-old patient with COPD or cardiac issues compared to a 55-year-old in good general health will differ. Most surgeons will evaluate a patient’s eligibility or disqualification based on age and comorbidities.
While an esophagectomy is not an ideal procedure, most of us who have had surgery are glad we took all necessary steps to ensure long-term remission. As with all aspects of life, we can adapt to the lifestyle changes required after surgery.
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All these facts are great..Being alive is great. I know personally if I had it to do again I definitely wouldn’t have the surgery. The pain from surgery I live with every day has diminished my quality of life to the point where I would quit if it wasn’t for my kids
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2 ReactionsThank you so much for sharing this. I was diagnosed 2 months ago with esophageal and im undergoing chemoimmuno therapy now. It's going ok but I can't stop losing weight. The Lewis surgery is proposed for this summer and the surgery itself and the recovery are overwhelming to me. I have no family that are alive and I'm single with no children. I'm trying to come to terms with the survive at any cost philosophy that the medical establishment goes by. I'm at a crossroads.
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1 Reaction@joelsmith01
First, I'm sorry to hear about your diagnosis and can't imagine dealing with the battle solo. I had my chemo/radiation in August of 24 and my esophogectomy in November 24. I won't lie; the recovery is not easy. I was going to suggest you see if you can meet with a social worker. The Social Worker can hopefully direct to resources like at home care. I personally feel the surgery is the way to go, but I can imagine it's a tough decision for you. I hope things work out for you.
🙏
@lleigh
These are tough decisions. Back in 2019 when I was diagnosed, I was wavering on what I was going to do regarding treatments, etc. My Son finally made my mind up for me when he said “Dad, are you going to fight this like the Man we know you are, or do we have to needlessly watch you die”. I fought like hell. Celebrating 7 years cancer free in June. It hasn’t been easy, but every time I hug my new Grandson, or kiss my new wife, I realize it was worth it.
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8 ReactionsIt's a multi-faction question. I forewent the surgery in favor of chemoradiation alone. My cancer was ECSC, about a third of the way down and was confined to the esophagus. My lymph nodes tested clear. I had seen my ex-wife have the surgery, so I had a reasonable idea of what the recovery would be like. Finally, there was my age, 85 at the time. I opted for MD Anderson, although I have been to Mayo Rochester for another condition. At MDA, you meet with your doctors first. I met with a surgeon, a medical oncologist and a radiological oncologist. I asked the surgeon if he felt the surgery would improve my survival chances. His answer was honest and quick - "No." (given my unique circumstances). My esophagus and nodes now test clear. The aftermath of the radiation was not pleasant. I go in for my 4th dilation on the 19th of this month. I swapped tumor for scar tissue...
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2 Reactions@earle
Cannot disagree with your choices at 85... makes total sense. But each of us has to make our own decisions... based on age, other comorbidities, initial staging, life expectancy and QofLife expected. We have a few on our Zoom calls who had esophagectomies in their 80s... but it is a bit uncommon.
Well done... hope you're having continued good health now... and can remain NED.
Gary