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Esophageal Cancer: Surgery Or Not?
I just completed my 8 Chemo and 28 radiation treatments with a follow up Pet Scan. My wife and I were excited with the images when compared to the 1st pet scan that showed cancer in the lower 3rd of the esophagus as well as in a couple of limpnodes located in the area. Our radiologist showed us the images and said it showed absolutely nothing now. We felt a EGD with a biopsy would be the next logical step but the surgeon who would be performing the surgery really wasn't receptive to it. She is probably the best in our area and performs a high volume of these surgeries annually. Her comment being "Even if the test comes back clear, the cancer returns 50 % of the time". So now I'm in the position of trying to make a decision to go with the surgery or not. I'm 70 years old, in good health. I'm just struggling with what I should do. I know it's not a easy surgery or recovery. I'm not afraid of the fight, I just don't know if I need to make it
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I had a very similar experience,
I was 72 at the time with esophageal cancer.
The surgeon wanted to preform the operation. The operation was scheduled.
I requested a second opinion which was completed with a EGD & Biopsy. He declared that the operation was not need.
I did not have the operation. That was 16 months ago.
I have ct scans, blood tests EGD regularly scheduled.
So far my cancer is in remission.
Time will tell if this was a good decision.
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7 ReactionsIf you have the operation, what are the odds of a recurrence?
Still 50-50? I can't remember.
My wife had the operation quite successfully and had pCR. We regarded her as NED at that moment.
On her first subsequent scan, 4-5 months later, she had a recurrence (in two retroperitoneal lymph nodes)
So, back to chemo, radiation, and immunotherapy.
My suggestion would be to get on immunotherapy yesterday--as soon as possible and do not extend any waiting periods. By that I mean, if you're going to have the operation, do it as soon as possible, and always get your scans at the earliest date possible.
Idk the answer to your question. Tough call.
Well wishes,
Dave
P.S. Check out SmartPatients.com
Thank you for sharing your experience. I'm wondering if I do get the EGD with a biopsy and it comes back clear of cancer -is there a chance the insurance company could then deny me the option of surgery?I'm certainly hoping the best for you. God willing you remain in remission.
My feeling is that you will not be denied the surgery. It is part of standard of care for your illness.
I was in your box about two years ago. Every situation is different, and I can’t know what’s best for you, but I went for the surgery. It was tough but probably not as bad as advertised. I feel like qualifying for surgery was a gift and I’m so happy I took it. I don’t know what comes next but all good for now. Best to you whatever you do. Keep us posted!
I could have had the surgery (Stage 2-3 squamous cell) after the chemoradiation, but I chose not to: I am 72, my husband and I are living our best life, and I just did not want a year taken out of my life, and his. Having the surgery does not guarantee one will stay cancer free, and for many, the quality of life is not there afterward. I am now 1 7 months away from finishing the chemoradiation, have a PET scan and ultrasound endosocopy w biopsies of each third every quarter, and, so far, no sign of recurrence. Shortly after the decision to turn down the surgery, we booked a 20 day cruise from Lima to Buenos Aires, which we just completed. We were gone almost a month, enjoying Lima before boarding our ship, and then a few days in Buenos Aires when off the ship. It was the trip of a lifetime. My next round of tests will late April. Optimistic. That is my personal decision.
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1 ReactionI would go to Mayo and get the surgery over with. I, too, am 70 and 4 years out I am cancer free…so far. :-). The recovery takes time and you have to learn new eating habits, but it is worth it in my opinion.
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1 ReactionHi. I HAD esophageal cancer and didn't question for a second whether to have surgery. I did and it was rough in the beginning but I am almost back to my old self. Next week I am having my 3 year checkup. So far, so good. No sign of cancer and my surgeon said he believes I have a 5% chance of it ever returning. I believe that not having the surgery would be foolhardy but then that's me. I rarely think about it.....life goes on. Whatever you decide I wish you the best. Be positive and good luck.
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1 ReactionIt’s such a hard decision. My mom (84yrs, T2 N1 M0, no co-morbidities) just decided no for the surgery, but she is older than you. She did chemorad, PET looked clean. Went to Mayo for sonographic endoscope & biopsy (3 sites + lymph nodes, all clean) because local docs didn’t want to investigate further. We hear that the cancer will be back but are hoping for anti-cancer drugs to keep it at bay.
Do you know what is your cancer’s likelihood of responding to targeted anti-cancer drugs?
Here is a study online that shows some of the long-term issues post-surgery by Mayo researcher Shanda Blackmon MD https://www.annalsthoracicsurgeryshortrep.org/article/S2772-9931(23)00306-6/pdf
The others are correct… whatever decision you make, make it wholeheartedly & with enthusiasm & it will be right for you.
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1 ReactionWould you share what type of blood tests they do for monitoring?
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