Esophageal Cancer: Surgery Or Not?

Posted by rickho @rickho, Feb 19 2:59pm

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.

I am 84 years old and have just turned down surgery. After radiation and chemo, no cancer was seen in the PET scan and was not found after a scope with biopsies. The scope really confirmed my decision to just wait and watch. The surgery would have given me about a 60% chance to not die of esophageal cancer for 5 years. but some say it takes a year to recover from the surgery. I choose to not give that year up, and to hope I will live a few more good years, perhaps dying of something else.
You, the patient have to decide. It's hard, but you have to choose. Gather the best information you can, first, then decide. there is no easy way to do this.

REPLY
@rheuben

I am 84 years old and have just turned down surgery. After radiation and chemo, no cancer was seen in the PET scan and was not found after a scope with biopsies. The scope really confirmed my decision to just wait and watch. The surgery would have given me about a 60% chance to not die of esophageal cancer for 5 years. but some say it takes a year to recover from the surgery. I choose to not give that year up, and to hope I will live a few more good years, perhaps dying of something else.
You, the patient have to decide. It's hard, but you have to choose. Gather the best information you can, first, then decide. there is no easy way to do this.

Jump to this post

rheuben
I'm 79 and was diagnosed with esophageal cancer. I was deemed not a candidate for surgery to remove cancerous tumor in lower esophagus. I have had 28 days of radiation and chemo. The latest scans show the esophageal cancer is all gone. I'd be happy to answer questions?
Don

REPLY

I had the surgery with some reluctance in April of 2023. It is a rough surgery and a tough course of recovery at 68 years of age but not unbearable in my experience. Almost a year later and my EGD yesterday showed me cancer free for the moment. Downside is the brutal bouts of Late Dumping Syndrome that seem to have become more frequent in the last few months and definitely more extreme. Eating is rarely a pleasure anymore and my days of enjoying a good whiskey or glass of craft beer are behind me. On the plus side I've added years with my wife and children and can still enjoy music and books so a more than fair trade off. Both my oncologist and my surgeon made compelling arguments for the surgery without sugar coating the trajectory and for me it was worth it. Good luck with your decision and feel free to reach out with questions.

REPLY
@gooddaughter

Would you share what type of blood tests they do for monitoring?

Jump to this post

Just the standard type of blood test and urine testing.
I also have a immune system problem , minimal change disease”

REPLY

@rickho, I wanted to check back in with you. Did you make a decision about whether to have surgery or not?

REPLY

Hi Colleen,
Had a EGD performed yesterday. Should get the results early next week which will help with the final decision. After reading the pros and cons from the input of others, I know I'd love to avoid it if possible.

REPLY

I was diagnosed April 1, 2023 with adenocarcinoma the the stomach junction at 70 years old, and staged T3N0 at the Mayo Clinic in Phoenix. I underwent 25 proton radiation treatments and 5 Carbo / Taxel infusions once a week. I continued to walk 2 miles a day on the treadmill. The radiation and chemo was a non event and I actually gained 3 pounds. I underwent minimally invasive I-L robotic surgery August 1. I had cryoablation on the chest wall nerves for pain management and never experienced any discomfort. I was up walking the halls the next day after surgery. I was discharged after 7 days and was on a feeding tube for one week until I could get enough calories and protein on my own. I was actually doing water aerobics in the pool 3 weeks to the day after surgery. I have experienced no acid reflux, dumping or restrictions on what I eat. I eat all the ice cream, dairy and sugar I want. I eat filet mignon and lobster for Sunday dinner, albeit it at 5 pm so I have plenty of time to digest before bed. I do not take any stomach acid medication. I bought a Sleep Number bed to sleep on a slight incline and have no issues getting good rest. The only life style change I have made is eating smaller meals more frequently. I still have my happy hour cocktails. I have actually gained 5 pounds since being diagnosed almost a year ago. All this being said, I just wanted to convey to you that a lot of us go through the treatment plan without complications. Nobody writes in social media about those, only their horror stories. Social media is what it is, need I say more? But if you are lucky enough to qualify for the surgery, don't turn it down. This procedure is proven to be a cure for this beast. Even your own doctor says it will come back. PET scans do not pick up the microscopic cancer cells floating around in your lymph node highway. And when it does come back, it's stage 4 and there's not much you can do about it other than battle it with chemo. Sorry for being so long winded, but I want you to know there are some of us that go through surgery reasonably well. Good luck in your decision.

REPLY
@zzonner

I was diagnosed April 1, 2023 with adenocarcinoma the the stomach junction at 70 years old, and staged T3N0 at the Mayo Clinic in Phoenix. I underwent 25 proton radiation treatments and 5 Carbo / Taxel infusions once a week. I continued to walk 2 miles a day on the treadmill. The radiation and chemo was a non event and I actually gained 3 pounds. I underwent minimally invasive I-L robotic surgery August 1. I had cryoablation on the chest wall nerves for pain management and never experienced any discomfort. I was up walking the halls the next day after surgery. I was discharged after 7 days and was on a feeding tube for one week until I could get enough calories and protein on my own. I was actually doing water aerobics in the pool 3 weeks to the day after surgery. I have experienced no acid reflux, dumping or restrictions on what I eat. I eat all the ice cream, dairy and sugar I want. I eat filet mignon and lobster for Sunday dinner, albeit it at 5 pm so I have plenty of time to digest before bed. I do not take any stomach acid medication. I bought a Sleep Number bed to sleep on a slight incline and have no issues getting good rest. The only life style change I have made is eating smaller meals more frequently. I still have my happy hour cocktails. I have actually gained 5 pounds since being diagnosed almost a year ago. All this being said, I just wanted to convey to you that a lot of us go through the treatment plan without complications. Nobody writes in social media about those, only their horror stories. Social media is what it is, need I say more? But if you are lucky enough to qualify for the surgery, don't turn it down. This procedure is proven to be a cure for this beast. Even your own doctor says it will come back. PET scans do not pick up the microscopic cancer cells floating around in your lymph node highway. And when it does come back, it's stage 4 and there's not much you can do about it other than battle it with chemo. Sorry for being so long winded, but I want you to know there are some of us that go through surgery reasonably well. Good luck in your decision.

Jump to this post

Not long winded at all. I truly appreciate you
sharing your success story
I am a T3N1. My surgery would be performed by 2 surgeons performing the Ivor-Lewis esophagectomy which is performed with incisions in the abdomen right side of the chest. We've been told by a different surgeon robotics couldn't be used for my condition. Not sure that would be the case at Mayo but geographically it would be difficult for us anyway. Your ability to eat the way you do is remarkable. Most of the information hasn't been quite as promising. Thank You again for your input.

REPLY
Please sign in or register to post a reply.