Newly diagnosed and really confused: Surgery vs Chemo + Radiation

First, my impression is you're in a good place given that the tumor cells are localized and you have both surgery and chemo/radiation as options. I would highly recommend you ask these detailed questions to your surgeon. Is the surgery endoscopic or will they perform an esophogectomy? Big difference between the two. The good thing is you potentially could go the non-surgical route first, monitor and surgery later if warranted. Again, I'm not a Doctor so get some more clarity for your plan from the medical team. Best of luck... you've got this!

Hi suensteve,
My husband (also a Kiwi) had a very similar situation to yours. He had radiation and carboplatin/taxol about a year ago and is now on monthly immunotherapy. Scans are looking good so far. Best of luck to you!

Thank you so much

@kev13168, there are several members who were treated with only radiation and chemotherapy, like @dsh33782. I know it can be confusing and hard to make treatment choices when there are 2 viable optionis. But that is good news that you have options.

Which did you choose: Second surgery or treatment with chemo and radiation?

kev13168 @kev13168,
I had chemo and radiation after doc found tumor in my lower esophagus during endoscopy. They did not want to do surgery as I am 80. But the chemo and radiation worked and my scans are clear now. Let me know if you have questions?
Don

New to Mayo. My esphogectomy was in April, 2020. It had not perforated the esophageal wall but could not been nipped off by upper endoscopy. My oncologist recommended against chemo and radiation before surgery as it would weaken me somewhat. (I am now nearly 81). Also, the beginning of the pandemic informed decision making at that time. Despite a post surgery infection, I survived and treatment and am now cancer free without chemo or radiation. I get CT scans annually to confirm that fact. I hope to post a fuller reflection on the anniversary of my surgery. An esophagectomy is a radical surgery to experience. Sounds like your treatment successfully avoided it. Best wishes.

Surgery was recommended after the chemo radiation in 2022, but I chose not to do the esophagectomy. I was 70 at the time and had another cancer that could come back. I had to go through an endoscopy biopsy w ultrasound every three months for two years to see cancer cells at the microscopic level, as if there is recurrence, it usually happens in the first two years. I am now finished with my third year post treatment, going into my fourth, and so far, no recurrence. That first year after treatment, I travelled and enjoyed life so much, rather than recovering from the surgery. Even with the surgery, there are no assurances the cancer won't come back.

LOVE your outcome! True... life is better not having had the esophagectomy... but statistically your odds improve considerably by removing ground zero after it has been prepared by first-line treatments. I had stage 3 adenocarcinoma... and did it all... chemo, radiation, esophagectomy, and then a year of adjuvant immunotherapy. I am back to normal now... eating, pooping, sleeping, etc. But that first 12 to 18 months post-op kinda sucked!

So good for you! Rolled the dice a bit and so far so good! Keep it up!

Gary

Definitely a tough choice. Since I am now 73 and have had three wonderful years after the chemoradiation, I feel good about my decision. I get a PET scan in two weeks to see what is going on! I'll get my results on the 14th, and no matter what they are, I am leaving for a vacation in Europe two days later. Hopefully, all will be stable. Jodie

This discussion resonates strongly with me. At 78, I am diagnosed with Stage 3 adenocarcinoma, with no apparent spreading beyond 2 layers of esophageal wall and a total blockage of my stomach necessitating a J-Tube and 17 hrs/day nutrition to maintain weight. We are fortunate to live near a comprehensive cancer treatment/research center featuring a highly experienced minimally invasive surgery program. I will start a chemo + radiation regimen in two weeks and will perhaps face the choice of surgery/no surgery others are discussing here. I am very active generally and enjoy home vegetable/fruit gardening on a fairly intensive scale. My best wishes to others who will face/have faced this decision, and especially those who report on their outcomes.