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On long term dialysis, diagnosed with Stage 1/2 oesophageal cancer
I have been on dialysis for 27 years now. During my workup for a kidney transplant, they found a polyp in the GE junction. A biopsy and a Contrast enhanced CT scan revealed a malignant tumour. A PET CT revealed this was early stage and not spread anywhere else. I have portal hypertension and a liver with severe fibrosis due to Hepatitis C which was treated after 12 years with the disease in 2017.
The doctors are considering 3 options:
1. Endoscopic removal - They are planning an Endoscopic Ultrasound to determine the feasibility of removing the tumour endoscopically.
2. Immunotherapy - They have asked the lab to check the biopsy sample for MMR which will let them know the chance of success of Immunotherapy.
3. Surgical removal - Last option as the surgery can be complicated with a lot of bleeding due to the liver issue. Liver decompensation is also a risk with this.
I was wondering if there was anyone here who had a similar problem and what they did and how did it turn out? Anyone on dialysis and a liver issue and oesophageal cancer?
Thanks so much!
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Not being an oncologist or a thoracic surgeon to be capable of weighing your comorbidities against your recent EC dx... I can't really say.
But... in general... even if only stage 1 or 2... whether going thru chemotherapy and radiation first (as I did)... having the esophagectomy is the odds on favorite of never seeing your cancer again (I had this too, plus a year of immunotherapy). If left alone... no doubt it will kill you. I can't say whether that means in 6 months or two years... but it will grow... spread... and it will win. That's why, in general, our tumor boards do what gives us our best chance of survival. Now which is the more pressing issue for you... and which are even possible... the kidney transplant or the esophagectomy or some lesser ablation technique... I'm not sure.
Should ESD or EMR be possible for your stage of cancer... that would surely buy you time. And if it recurs, will most likely stay within the esophagus... with treatments to then begin... or an esophagectomy be done a year or two from now. Could it spread by then... when a recurrence is seen... and you be deemed stage 4 now? Yes, a possibility... but maybe not a probability. And I have no clue, in your current state, what chemoradiation treatments would do to your insides. Seek other opinions if possible. I'm guessing you are not in America.
On Sunday, Jan 19th, at 9am Eastern (2pm in the UK)... we're having a renowned Mayo thoracic surgeon on our free Zoom calls... to talk about esophagectomy surgery. She's no longer with Mayo Rochester and has moved back to Texas (Baylor)... but she's something special! Maybe you come talk to her on our call. She takes on very difficult EC cases... from a surgical standpoint. Let me know and I'll send you the one-touch Zoom link. And 27 years on dialysis... holy cow... is that a world record? How old are you?
Gary
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1 ReactionWow. 27 years on Dialysis. Has it all been Hemodialyses, or some Peritoneal Dialysis. My wife did Peritoneal while waiting for a transplant, and Hemodialysis after the surgery and the transplant failed because of an infection from the surgery.
Good Luck with the EC battle. I was diagnosed in 2019 and went through 7 chemo treatments and 32 radiation treatments and then surgery.