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mardigras
mardigras Member Posts: 215 Member
in Esophageal Cancer #1
Hi again everyone,
First thank you all for the support, time, care and prayers, during the most frightening period of my life.
There is a wealth of knowledge here and you also get to hear both sides of the story. A must when trying to make sense of this horrible diagnosis.
One more question, if I may:
If a surgeon offered an OP before any chemo or chemo/rads, what might the consensus of opinion be?
Thanks again everyone. Wishing you all a peaceful day.
Prayers and hugs.
Marci x

Comments

  • chemosmoker
    chemosmoker Member Posts: 501
    #2
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    PRE- and POST-OP Chemo recommendations...
    Marci,
    Based on the CURRENT standard of care and the opinion of the medical community today, it is NOT recommended to do surgery BEFORE doing chemotherapy at least, and sometimes radiation (although NOT always the case with EC if it is strictly at the gastric junction) as well, before doing any surgery.

    I would want not only a second or third opinion, but personally I would be finding another thoracic surgeon PRONTO to do the procedure for me. Go to UPMC if at ALL possible. Hands down.

    This seems to be the the STANDARD of care, unless you are talking about possibly Stage I or early stage II. Otherwise, you risk not only spreading cancerous cells during surgery, but also not shrinking the tumor(s) to a more manageable size, thereby making resection much easier and more successful.

    Also, "clean-up" chemo is HIGHLY recommended AFTER surgery, as it is the ONLY way I have seen people NOT have a recurrence with missing errant cancer cells that wre either missed during surgery, or set free to move through the blood stream, probably the biggest cause of later recurrence (which is actually just the appearance of these cells once they settle and start to grow again, somewhere else).
    But it is still EC if that was the original diagnosis.

    Now I am NOT a doctor, and I have NEVER done any chemotherapy. But after watching the boards for months and reading and learning and talking to oncologists, patients, radiation oncologists, thoracic surgeons, and learning from the MANY wonderful people on THIS board who have been there, done that again and again and again, both WITH and WITHOUT the PRE-OP chemo, this is what I have observed. And let me tell you, I think you will find that those that didn't have the pre-op chemo had or are currently having a recurrence.

    A cancer cell is SO tiny, and it takes over a MILLION cancer cells to make a small spot the size of your tiny PINKY nail! I would not be willing to trust that any human eyes could SEE or be sure in any way that they got all of the cancer. Do it right or die seems to sadly be the reality with EC. Scary. True.
    No point in not facing this head-on and with total honesty.

    That's my input. I look forward to the many more that will follow.
    William should have a lot of good stuff to ad here I hope.

    God bless.
    -Eric
  • dodger21
    dodger21 Member Posts: 85 Member
    #3
    Options
    chemosmoker said:

    PRE- and POST-OP Chemo recommendations...
    Marci,
    Based on the CURRENT standard of care and the opinion of the medical community today, it is NOT recommended to do surgery BEFORE doing chemotherapy at least, and sometimes radiation (although NOT always the case with EC if it is strictly at the gastric junction) as well, before doing any surgery.

    I would want not only a second or third opinion, but personally I would be finding another thoracic surgeon PRONTO to do the procedure for me. Go to UPMC if at ALL possible. Hands down.

    This seems to be the the STANDARD of care, unless you are talking about possibly Stage I or early stage II. Otherwise, you risk not only spreading cancerous cells during surgery, but also not shrinking the tumor(s) to a more manageable size, thereby making resection much easier and more successful.

    Also, "clean-up" chemo is HIGHLY recommended AFTER surgery, as it is the ONLY way I have seen people NOT have a recurrence with missing errant cancer cells that wre either missed during surgery, or set free to move through the blood stream, probably the biggest cause of later recurrence (which is actually just the appearance of these cells once they settle and start to grow again, somewhere else).
    But it is still EC if that was the original diagnosis.

    Now I am NOT a doctor, and I have NEVER done any chemotherapy. But after watching the boards for months and reading and learning and talking to oncologists, patients, radiation oncologists, thoracic surgeons, and learning from the MANY wonderful people on THIS board who have been there, done that again and again and again, both WITH and WITHOUT the PRE-OP chemo, this is what I have observed. And let me tell you, I think you will find that those that didn't have the pre-op chemo had or are currently having a recurrence.

    A cancer cell is SO tiny, and it takes over a MILLION cancer cells to make a small spot the size of your tiny PINKY nail! I would not be willing to trust that any human eyes could SEE or be sure in any way that they got all of the cancer. Do it right or die seems to sadly be the reality with EC. Scary. True.
    No point in not facing this head-on and with total honesty.

    That's my input. I look forward to the many more that will follow.
    William should have a lot of good stuff to ad here I hope.

    God bless.
    -Eric

    Staging
    Eric is right. They only go straight to surgery if it is Stage 0 or Stage 1. Any other stage generally gets chemotherapy / radiation prior to any surgery.
    Danielle
  • Donna70
    Donna70 Member Posts: 852 Member
    #4
    Options
    dodger21 said:

    Staging
    Eric is right. They only go straight to surgery if it is Stage 0 or Stage 1. Any other stage generally gets chemotherapy / radiation prior to any surgery.
    Danielle

    same opinion
    Just agreeing with everyone, unless it is 0 or I it is general consensus that you do pre op chemo and radiation and then surgery. We have seen some sad examples of jumping the gun and doing surgery first, then finding out the EC was much worse. A good EUS ultrasound EGD usually helps greatly in correctly staging EC. take care and good luck!
    Donna70
  • mardigras
    mardigras Member Posts: 215 Member
    #5
    Options
    chemosmoker said:

    PRE- and POST-OP Chemo recommendations...
    Marci,
    Based on the CURRENT standard of care and the opinion of the medical community today, it is NOT recommended to do surgery BEFORE doing chemotherapy at least, and sometimes radiation (although NOT always the case with EC if it is strictly at the gastric junction) as well, before doing any surgery.

    I would want not only a second or third opinion, but personally I would be finding another thoracic surgeon PRONTO to do the procedure for me. Go to UPMC if at ALL possible. Hands down.

    This seems to be the the STANDARD of care, unless you are talking about possibly Stage I or early stage II. Otherwise, you risk not only spreading cancerous cells during surgery, but also not shrinking the tumor(s) to a more manageable size, thereby making resection much easier and more successful.

    Also, "clean-up" chemo is HIGHLY recommended AFTER surgery, as it is the ONLY way I have seen people NOT have a recurrence with missing errant cancer cells that wre either missed during surgery, or set free to move through the blood stream, probably the biggest cause of later recurrence (which is actually just the appearance of these cells once they settle and start to grow again, somewhere else).
    But it is still EC if that was the original diagnosis.

    Now I am NOT a doctor, and I have NEVER done any chemotherapy. But after watching the boards for months and reading and learning and talking to oncologists, patients, radiation oncologists, thoracic surgeons, and learning from the MANY wonderful people on THIS board who have been there, done that again and again and again, both WITH and WITHOUT the PRE-OP chemo, this is what I have observed. And let me tell you, I think you will find that those that didn't have the pre-op chemo had or are currently having a recurrence.

    A cancer cell is SO tiny, and it takes over a MILLION cancer cells to make a small spot the size of your tiny PINKY nail! I would not be willing to trust that any human eyes could SEE or be sure in any way that they got all of the cancer. Do it right or die seems to sadly be the reality with EC. Scary. True.
    No point in not facing this head-on and with total honesty.

    That's my input. I look forward to the many more that will follow.
    William should have a lot of good stuff to ad here I hope.

    God bless.
    -Eric

    Thanks Eric, Danielle, Donna
    Thanks so much all of you for taking the time to reply to my post.
    We are in the uk now getting a second opinion.
    I had a feeling that this would be the answer, but I just wanted some
    reassurance.
    Logically speaking, it would be safer after the cells had been stunted by
    chemo or radio I think. It would be too easy to miss some, i'm sure.
    Thanks again and bless you all.
    Prayers and hugs
    Marci x
  • chemosmoker
    chemosmoker Member Posts: 501
    #6
    Options
    mardigras said:

    Thanks Eric, Danielle, Donna
    Thanks so much all of you for taking the time to reply to my post.
    We are in the uk now getting a second opinion.
    I had a feeling that this would be the answer, but I just wanted some
    reassurance.
    Logically speaking, it would be safer after the cells had been stunted by
    chemo or radio I think. It would be too easy to miss some, i'm sure.
    Thanks again and bless you all.
    Prayers and hugs
    Marci x

    Whats happening next?
    Marci,
    KEEP US POSTED!!! What happened? What's next?
    We're all praying for you now.....

    Eric

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