Esophageal Cancer: Surgery Or Not?

Hello, I started my journey August of 2024 stage 3 esophagus cancer I had flot treatments that’s 4 chemo treatments every other week for two months. Then waited 5 weeks had surgery recovered pretty quickly then another 4 chemo treatments. That ended April 5th 2025 so I eat smaller meals more often. I can eat just about anything just less. I’m 62 another thing that I do is walk tremendous help for me mentally and physically. A positive attitude is everything as I always say you got this!! Wishing you the best. Scott

Hello,
I have been on my journey since my esoph T2B diagnosis on Feb 11 2025.
I am a 64 year old male with no other medical issues. I too have reached on on this site with the same question on surgery or not.
I completed my chemo and proton radiation on June 17. I did decide to have minimally invasive surgery which was done on 07/30/2025.
From reading too much and forming my own idea of the outcome, i expected to feel like i was mulled by a bear after surgery.
I am now 11 days post surgery The truth is the only pain I have is at robotic incision points and the pain is very tolerable and I move around quit well!
My main concern is adjusting to a new norm in eating which will begin in 10 days. I believe ill adapt just fine .
I received my post surgery pathology report just this morning. The results came back better than the diagnosis. Cancer did not make it through the mucosal layer, 15 lymph nodes were removed and they were all clear of cancer .
Surgery or not?
If diagnosed anything greater than stage 1 affecting lymph nodes, i say have surgery. From my research, 12-18 mo after chemo and radiation and the cancer could likely be back and worse .
My greatest of prayers and wishes.
Rick

I wonder where the "10% survival rate" figure came from. It flies in the face of all I've ever read, anywhere, including from survivors. I'm reminded of the old saying that, when you're a hammer, everything looks like a nail...

Hello to all, I had chemo x5 and radiation therapy x23 early 2024 resulting in a very good PET scan result. My surgeon here in Tasmania is very experienced in Ivor Lewis esophagectomies and told me that - 10% survival rate for those who opt out of surgery, PET scans are not sensitive enough to pick up individual surviving cancer cells that may cause a recurrence, if surgery is declined and a relapse occurs, surgery is often no longer an option due to the “unstable” nature of the relapsed tumour - tends to go for lungs, liver and / or bones. I had the surgery in May 2024 and have been feeling pretty good for several months now - minor improvements are still happening. Pathology results from the resected tissue showed no surviving cancer cells. It may well be that for me, surgery was not needed. Unfortunately, I had to have it to get reliable pathology results.
Improvements in treatment and outcomes are happening very rapidly which means it’s a good idea to exercise great care if Googling information re the cancer or treatments or survival statistics. The stakes are very high for the cancer patient and their family and friends and many of us suffer from an information overload at a very stressful time.
Wishing you all the best with your decision and treatment. Geoff

Still EC cancer free! Going on a cruise of the Norwegian fjords August 15. Next PET scan is mid September. Chemoradiation was finished November 2022 and I am so grateful for the healthy and active months since then. Turning 74 in September.

Hi
I was diagnosed last night. I have a cruise planned in three weeks with my son before he heads to boot camp. So many unknowns and questions about going on cruise. I appreciate this post.

It’s a gamble. It’s major surgery with QoL issues for the remainder of your life but, according to my surgeon (in Australia), it confers a fourfold increase in the survival rate. It’s of course good to have a very positive response to chemo / radiotherapy, but PET scans are not sensitive to small groups of surviving cancer cells that are likely to cause a future relapse. I was told that, despite having a very good post chemo PET scan result, if I did not have the surgery, I’d likely lose it as an option. Post surgery, they couldn’t find any living cancer cells in the resected tissue, so it may not have been necessary. Your age may well be a major factor in deciding for or against surgery. Best wishes either way.

I asked that same question down at MD Anderson. The answer was less than satisfying. They said that it depended on where the reoccurrence was located, plus absence of any spread, whether local or metastatic. As I've said before, two main factors in my case were age, 86 later this year, and having watched my ex-wife go through with the surgery. Had I been younger, I might have considered it. The possible extension of life span/QoL in my case just made the tradeoff obvious. I've just left a meeting where one of the attendees has had a brush with cancer and he's far younger than I. He observed that cancer doctors were like all other specialties - they're determined you're going to die of something else first - "not on my watch." I had to laugh, particularly at my age... 🙂

He's only out 2 months as well and shows no signs but wondering if he opts out of surgrey and it comes back will they still do surgrey at that point? Or chemo again? Wondering if this happened to anyone. I think he wants to take his chances going without since the surgrey is so hard.

I think and respect everyone’s situation is unique. Research specific to our situation, reflects a greater percentage for survival past the various data found.

I wish the best wishes, whatever a person chooses for them.

God bless