Radiation questions

Hi
I had esophageal cancer in 2022 and had chemo and radiation. After e weeks of treatment my tumor had shrunk 40%. But I had to have a feeding tube for several months due to difficulty in swallowing. After completing treatment things returned to normal and I could swallow normally and the feeding tube was removed. Since then scans showed the esophageal cancer was gone. Please let me know if the radiation works for your dad?
Don

Hello—My case was different in that I didn’t have EC, but an area of dysplastic cells that could have turned into cancer. I had that treated over four years and the result was a stricture that in October started to severely limit my intake by mouth. The esophageal dilation my team had been doing every few months stopped working, and my throat closed up. They decided the only recourse was esophagectomy. In the meantime though, they placed a feeding tube (G-Tube) in my stomach. I had that for a month before the surgery, and it kept me at a healthy weight until surgery. Since esophagectomy usually involves removing part of the stomach in order to construct a conduit for food and liquid, they then placed a tube into my Jejunum (J-Tube), which essentially worked the same way as the G-Tube. I had that for about eight weeks after surgery, then it was removed in doc’s office. I eat normal food now, just have to eat much smaller meals several times a day. I’ve only lost a couple of pounds since the feeding tube was removed, and my weight is more or less stable. I just wanted you to know that there are options for your husband’s nutritional needs.

Hi. I had lots of radiation. It's been 5.5 years now and the only problem I have is small pieces of food getting stuck in the same spot in my throat. I have trained myself to move it up and get rid of it. If I don't my breathing is affected. It sounds awful but I got used to it. It helps to have small snacks in between meals. I used to aspirate at night but it's under control now. He will need a good wedge pillow. My trick is to eat dinner at least 2 hours before going to bed so that the stomach empties. I chew 1.5 Gaviscon tablets right after eating then one more at bedtime. THIS WORKS! Oh yes...he will undergo scopes (throat) to check the esophagus (mine was removed) but it shouldn't shrink. PS. In 2 weeks I see my surgeon and I know I'm cancer free. I'll be waiting that day for him to tell me I'm cured.

Hello from Tasmania, I was diagnosed with stage 3 EC in Feb 2024. The treatment was daily radiation therapy x 24 ( weekends excepted) plus concurrent chemotherapies x 5 - followed by esophagectomy several weeks later. The advice I was given was that responses to radiation were very varied but that the side effects were cumulative. I sailed through the first 20 or so treatments without any problems. Then came severe fatigue where I struggled to do literally anything other than lie on the couch. Some apparently get very sore throats - like swallowing razor blades; not a problem for me. I also had pretty severe mood disturbances, bursting in tears 30 or more times daily for no reason. It took a while to connect that this was due to radiation therapy. A bit of a grind getting through all this but everything returned to normal a few weeks after the treatment was completed. I was then able to travel interstate to visit family before surgery.
There’s no good reason you should expect to react as I did but it’s worth being prepared for some unpleasant side effects. It’s amazing how well you tolerate these problems when your life depends on it. The effects of combined radio / chemo therapies were dramatic in terms of cancer shrinkage which made it all worthwhile. I’ll wish you all the best with your pending treatment. Regards Geoff

I had chemo/radiation in August of 2024. I went to Mayo Clinic because of their expertise, high volume and the proton beam radiation facilities. Medicare had pre-approved proton beam radiation, but then called the day before the start of my treatment and said they would only cover photon beam radiation. Rather than delaying treatment, I started photon beam treatment for four sessions before contracting pericarditis and spending 5 days in the hospital for treatment. By then, our appeals to Medicare for proton treatment were approved. I had 20 plus sessions of proton treatment and very little side effects (some fatigue). My tumor was essentially gone by September, but I went forward with Mayo's recommended treatment protocol and had an esophagectomy on November 1st, 2024. I'm currently cancer free after 16 months since surgery. Moral to the story is photon is older technology and not nearly as precise as proton beam. Best to you and your husband.

I appreciate the comments.

@lionsfan I'll second all that was said. I was treated at MD Anderson. Because of backup while they constructed a new above-ground facility (the cyclotron underneath stayed), I had one week of photon and 4.5 weeks of proton. There is no comparison in the side-effects. IF anyone can get proton, they should. My app for proton was approved immediately, but they wanted to get me started on radiation because my cancer was at a "turning point." It was into the adventitia, but not through it, and was not into either the regional or remote lymph nodes. IOW, it was at a turning point and they wanted treatment of some kind to start immediately. I'm puzzled at your initial refusal from Medicare. I thought they were approving it for all cases routinely...

@earle We are not old enough for Medicare yet. We are just using my work insurance. My husband also has CLL which is in his lymph nodes but they discontinued that treatment when he began this treatment. We go to MD Anderson for follow ups on that. Our local oncologist and MD Anderson stay in touch about his treatment. He had a PET scan a couple of weeks ago and his lymph nodes had shrunk, some significantly. His oncologist believes that was due to the Keytruda he takes. I am not sure what type of radiation he will be getting but now I know to ask. Thank you so much for the information!

Saw the radiation doctor yesterday. My husband will get 27 radiation treatments beginning on the 23rd. I know it will get worse before it gets better, but I am hoping for a good outcome after it all.

@earle Medicare's refusal made no sense, particularly since Mayo Clinic charged the same amount regardless of it being Photon or Proton. It was only through our appeals that they relented. The irony is that Medicare ended up paying for the 5 day hospital stay caused by the Photon caused percarditis.