Esophageal Cancer: Surgery Or Not?

Posted by rickho @rickho, Feb 19, 2024

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

Interested in more discussions like this? Go to the Esophageal Cancer Support Group.

Profile picture for deb005 @deb005

Hello, my husband had Ivor Lewis surgery also, 7 months ago..yes the surgery was rough, initially he held on to his weight reasonably well but has now lost 34lbs…he was tall and thin before his diagnosis so he couldn’t afford to lose any weight at all. He has recently been diagnosed with anorexia as hes struggling to gain any weight. We are booked in to see a surgeon closer to home in 12 days time…hoping he will get him sorted with a Jtube. This is such a struggle and no one has really done anything to help. His gp said he needs to have a protein supplement drink…3 a day but he hates it so will only have 1 daily. I’m praying the surgeon will insist on the Jtube…feeling very worried 😟 he also has dumping syndrome which doesn’t help and I’m finding preparing his meals a nightmare…

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Thank you for sharing. Prayers for you and your husband.

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Profile picture for lionsfan @lionsfan

I meant to say minimally invasive. That's the optomist in me coming out. The incisions were a non-issue, but the overall recovery was difficult.

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Well as it was explained to us by the thoracic sx. Ivor Lewis sx, which is my husbands only sx option due to size and location of mass, is an 8 hr operation needing the assistance of a surgical oncologist. This is the sx he has declined due to recovery and quality of life. Do I agree??? Not my choice. I will honor and stand by his decision
We are 2 FLOT trtmts down 2 to go. Wait 6 wks for a PET then start radiation x 23 days with wkly chemo
So far he his swallowing and eating has improved. We appreciate all the comments and your stories. You are all in our prayers. One day at a time!!!

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Profile picture for gdj @gdj

It wouldn't take my phone when I just tried.

Let's see if this works /

605-484-3319

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Thank you! I appreciate you being willing to talk to them so much! I have passed your number along to my friends and hope you all are able to connect!

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Profile picture for courtney5 @courtney5

Thank you so much for being willing to take the time to speak with them! I apologize, I clicked on your profile and am unable to locate your contact information. Can you tell me how to navigate to your phone number?

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It wouldn't take my phone when I just tried.

Let's see if this works /

605-484-3319

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Profile picture for goldenshadow @goldenshadow

Hi my name is Scott. I have went through EC. I’m 62 my EC started Aug of 2024. Definitely scary at first my oncologist and surgeon were great. Very honest and up front. What made me feel better was that they were a team my case went through a tumor board. They discussed my case decided what treatment would work best for me. Flot treatment was used for me. Started with 4 treatments of chemotherapy every other week for 2 months. Then waited 5 weeks then surgery. Two surgical teams one for the front one for my right side. 9 hour surgery. Both surgeons talked to us in detail about how they would operate on me. I felt very comfortable because they made me comfortable. As in any surgery there can be complications. But I want to live. My determination to live is greater than my fears. My surgery went very well. My stay in the hospital was 8 days. First couple was tough I won’t lie. But once I put the work in breathing exercises and walks around the hospital at least 3 times a day. I got stronger and stronger that’s when I knew I was going to be ok. Also the nurses and doctors were great. They new I was serious about getting better. So after 7 days had my swallow check moment of truth. To see if there were going to be any leaks. There wasn’t any started to begin to drink broths and soups. Second day soft foods for about a week. Then started a little more like sandwiches no steak or chicken yet. But at least I could eat. It had been almost 8 months since I’ve eaten. I had a j tube that long because I couldn’t eat or drink anything. So for me surgery was very important. My surgery was Jan 3rd then waited 5 weeks had 4 more chemotherapy treatments same way every other week for 2 months. Got done April 4th. I feel better every day I take my walks every day. So far so good I get my scan first week of June. Hope this helps. I’m hoping the best for you!! What ever you decide.

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At age 62 I think surgery is a right decision; you hopefully have many years left. I'm considering a different decision at nearly age 79--depending on the outcome of my now-completed chemo/radiation treatment course.

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Hi, yes. My squamous cell tumor (mid-esophagus) had completely gone away after 7 weeks of radiation and 5 weeks of.chemo (carboplatin plus paclitaxel). One of my oncologists said "watch and wait" was not unreasonable. Your friends can also check out the SANO trial in Netherlands. They compared "active surveillance" to surgery after a complete pathological response like I had to chemorad. They found active surveillance was "not inferior " to surgery in their preliminary results.

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Profile picture for esowarrior @esowarrior

I made the decision to NOT have surgery and I am 6 years NED. There are many factors to consider and I am only one person.

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Thank you for your reply. Would you be willing to share a bit more about your experience and what led you to your decision? My friends are trying to get perspectives from both populations (with and without surgery). Thank you for your time, so much!

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Profile picture for courtney5 @courtney5

Thank you for sharing your experience! I hope things continue to move in the right direction for you!

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Thank You!

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Profile picture for courtney5 @courtney5

Hi, I am walking alongside a family who is on this journey of EC. Chemo and radiation is completed and next up is surgery. My friend is leaning towards not having it due to the extreme challenges of life post surgery. They are feeling pretty stuck and discouraged, not knowing how they should proceed. Is there any change you'd be willing to speak with them and share you journey? They are such wonderful people but haven't been able to get in touch with anyone who has experienced what they are potentially about to walk through. Thank you so much for considering speaking with them!

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I made the decision to NOT have surgery and I am 6 years NED. There are many factors to consider and I am only one person.

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Profile picture for goldenshadow @goldenshadow

Hi my name is Scott. I have went through EC. I’m 62 my EC started Aug of 2024. Definitely scary at first my oncologist and surgeon were great. Very honest and up front. What made me feel better was that they were a team my case went through a tumor board. They discussed my case decided what treatment would work best for me. Flot treatment was used for me. Started with 4 treatments of chemotherapy every other week for 2 months. Then waited 5 weeks then surgery. Two surgical teams one for the front one for my right side. 9 hour surgery. Both surgeons talked to us in detail about how they would operate on me. I felt very comfortable because they made me comfortable. As in any surgery there can be complications. But I want to live. My determination to live is greater than my fears. My surgery went very well. My stay in the hospital was 8 days. First couple was tough I won’t lie. But once I put the work in breathing exercises and walks around the hospital at least 3 times a day. I got stronger and stronger that’s when I knew I was going to be ok. Also the nurses and doctors were great. They new I was serious about getting better. So after 7 days had my swallow check moment of truth. To see if there were going to be any leaks. There wasn’t any started to begin to drink broths and soups. Second day soft foods for about a week. Then started a little more like sandwiches no steak or chicken yet. But at least I could eat. It had been almost 8 months since I’ve eaten. I had a j tube that long because I couldn’t eat or drink anything. So for me surgery was very important. My surgery was Jan 3rd then waited 5 weeks had 4 more chemotherapy treatments same way every other week for 2 months. Got done April 4th. I feel better every day I take my walks every day. So far so good I get my scan first week of June. Hope this helps. I’m hoping the best for you!! What ever you decide.

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Thank you for sharing your experience! I hope things continue to move in the right direction for you!

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