Has anyone had surgery to remove scar tissue?

I am a 3+ year survivor of Stage IV ESCC. I am totally non-PO due to extensive esophageal strictures. I've undergone 10 dilation but my esophagus is now too friable to attempt further dilations as it would repture. I am totally dependent upon my G tube for meds, nutrition and hydration. I was treated with aggressive chemo-radiation to try to control my disease. Unfortunately, one of rarely discussed side effects of radiation therapy for esophageal, throat and head and neck cancers is reactive fibrosis. While radiotherapy kills the cancer, it also produces free radical reactive oxygen species (ROS) and inflammation which cause tissue fibroblasts near the cancer lesion to produce increased amounts of connective tissue. This results in increased tissue stiffness and rigidity as well as strictures. The throat and esophagus may be amenable to dilation but the relief may be temporary as fibrosis and strictures inevitably recur. For severe fibrosis and large strictures, surgery is generally not advisable or effective as the tissue is generally friable and there may be too little viable tissue for effective healing.

This is an unmet medical need for esophageal, throat and head and neck cancer patients. I wish that radiation oncologists, oncologic surgeons and gastroenterologist would explore the use of co-administration of various antifibrotic agents, approved or experimental, to determine whether they might reduce or prevent radiation induced fibrosis and stricture formation.

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I haven’t commented for a while but I wanted to update everyone after almost 4 years in a trachea- no voice for 3 years - remission for 3.5 years from stage 4 laryngeal cancer with radiation and chemo therapy. I am free of the trachea- I am able to talk normal again - I am able to eat normally again. It’s been a miracle- I found the right Drs and they do this all day everyday. I was at the point of giving in to a laryngectomy- I was in pain unable to sleep - unable to talk living in isolation from friends and family but I wanted another opinion. I went to NYU Langone Otolaryngology Assoc - cancer center then worked with the Speach center. I started with Dr Jacobson who referred me to Dr Amin who specializes in Vocal Cords - my first surgery I had 3 surgeons but it works - I had Dr Jacobson - Dr Cosby - Dr Amin - it went on from there - that first surgery was to see what was possible that was in Feb and now in September it looks like I have made it through and it’s a miracle.

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Very good news to hear. Sorry it took so long but at least brighter days ahead. You are a good example of someone taking charge and seeking the results you needed.

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I haven’t commented for a while but I wanted to update everyone after almost 4 years in a trachea- no voice for 3 years - remission for 3.5 years from stage 4 laryngeal cancer with radiation and chemo therapy. I am free of the trachea- I am able to talk normal again - I am able to eat normally again. It’s been a miracle- I found the right Drs and they do this all day everyday. I was at the point of giving in to a laryngectomy- I was in pain unable to sleep - unable to talk living in isolation from friends and family but I wanted another opinion. I went to NYU Langone Otolaryngology Assoc - cancer center then worked with the Speach center. I started with Dr Jacobson who referred me to Dr Amin who specializes in Vocal Cords - my first surgery I had 3 surgeons but it works - I had Dr Jacobson - Dr Cosby - Dr Amin - it went on from there - that first surgery was to see what was possible that was in Feb and now in September it looks like I have made it through and it’s a miracle.

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Here is an image of one. Yes, it just presses right on the opening (is that the stoma?!!)
Like the inner canula, it does hinder breathing, but not as bad as the canula.
When the air is dry, I put one on at bedtime. Usually, around 1:00 a.m. or 2:00 a.m., I remove it. At that point, the humidity is created will cause the mucus to greatly loosen for an easy expel. That is good, because at that time of night, who wants to be cleaning out a tube?
Let me know how it works out for you if you decide to get some.

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@imaginus, you are in my thoughts for a positive outcome. There is so much mucus on a constant basis inside my trach tube, that very little debris gets through. That inner canula was supposed to be there to catch the mucus to prevent clogs (they told me), yet it did the exact opposite. It clogged up all the time making it almost impossible to breathe. So no, I don't wear it, going on years now without incident. The suction machine was a pain, so my ENT showed me how to remove the tube to clean it. He said to me in a surprised tone, "You brush your teeth twice a day, so why wouldn't you clean the tube?" He is a gem! To each his own...It sounds like you may progress to having the tube removed. I am rooting for you. Oh yeah...the HME is like a mini humidifier/filter in itself. Does wonders with an electric bill.

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@imaginus, you are in my thoughts for a positive outcome. There is so much mucus on a constant basis inside my trach tube, that very little debris gets through. That inner canula was supposed to be there to catch the mucus to prevent clogs (they told me), yet it did the exact opposite. It clogged up all the time making it almost impossible to breathe. So no, I don't wear it, going on years now without incident. The suction machine was a pain, so my ENT showed me how to remove the tube to clean it. He said to me in a surprised tone, "You brush your teeth twice a day, so why wouldn't you clean the tube?" He is a gem! To each his own...It sounds like you may progress to having the tube removed. I am rooting for you. Oh yeah...the HME is like a mini humidifier/filter in itself. Does wonders with an electric bill.

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