Cancer Survivors Network

Dear Greg,

I've been out of town and my schedule is filled, as are all others this Thanksgiving week. I'm reading up on posts that I have missed. I thank everyone that has said my posts have helped. I'm glad to hear that because I do have a life and if I thought no one was being helped, I have zillions of other things to do. But I am curious as to why your doctor thought you could not have surgery.

If you have read "Mumphy's" postings. Her husband was Stage IV. He had places that were treated outside of the Esophagus and was recently operated on by Dr. James D. Luketich. Remember I'm not a doctor, but since when is a tumor too far away to do surgery? After all, that's what the chemo is for. Chemo travels throughout the entire body and kills cancerous cells. The radiation zeroes in on the tumor precisely. It is my understanding that "near" other major organs and "in" other major organs makes all the difference as to whether surgery may be possible. My diagnosis was Stage III. I had one swollen lymph node. That's why my diagnosis was EC - T3N1M0. There was lymph node involvement "near" my Esophagus, but there were "no" nodes that had taken up residence in other organs.

Some just absolutely do not want surgery, and that is their choice. I am in touch with a Stage IV that has had chemo but considered inoperable. The husband is still alive a couple of years later now. However, they go to the doctor on regular intervals, and get checked for any changes. He gets some powerful doses of chemo when any change is found. It sets him back for a bit, but then he regains his strength. At times they have questioned why the husband could not have surgery. So right now, they are facing another trying time. So that is the way it has gone, some great periods of time, some down time.

Then there was a close relative of mine with Esophageal Cancer Stage IV who did not have an operation. He passed away within the year. The cancer spread to his liver. One thing I would say for certain, regardless of Stage III or IV, I would now always recommend pre-op chemo and radiation. However, I would also always HAVE A SECOND OPINION. Personally, I would always opt for the operation knowing what I know now. My cancer was located in the Esophagus and only one lymph node was questionable. I am now going into my 7th year since my diagnosis of EC Stage III (T3N1M0). Dr. James D. Luketich from the University of Pittsburgh Medical Center performed the operation. (Minimally Invasive Esophagectomy MIE) on May 17, 2003. My relative lived in "denial" and never wanted to think he would not live through it. He also had a stent placed in his Esophagus, but it "migrated" downward and did not serve the purpose for which it was intended. So there are two completely outcomes. I have read Mumphy's postings. Her husband Al had a very successful surgery by Dr.Luketich as well.

If I have given you something to think about, I suggest you have a second opinion. I didn't have to have a doctor refer me. I simply picked up the phone, called Dr. Luketich and my successful operation is the end of that phone call. My operation was a textbook case with no difficulties. I am in great health today. My operation has not handicapped me in any way. (Except in the types and amounts of food and when I eat them

If all you had was one wayward lymph node that was not found within another major organ, I am at a loss as to why your doctor didn't recommend pre-op chemo/radiation and then surgery. Personally, now that I've learned more about this cancer, I would always recommend pre-op treatments and SURGERY.

I strongly urge that you seek a second opinion. Stages of EC run from 0 to 4. If you are a III, sounds like you would be a candidate. Hey the surgery isn't for sissies, but it's a lifesaver. I'd take my chances "with" the operation rather than "without" one--if I had the choice.

William W. Marshall
AKA "William66"
Virginia Beach, VA 23464

Yes, if you are stage three with especially 1 lymph node involvement, then yes you are definitely a surgery candidate, but if you are stage IV, with many mets, you are not. Yes there are some that have had the operation at stage IV and No there are not any guarantees that it will not come back or spread. As a caregiver of a stage IV patient, with 3 same opinions, stage 3 is definitely a different story then stage 4. many whom have had the operation at stage 3 do extremely well, but unfortunately once you have been diagnosed with stage IV the odds for success change drastically, depending on the involvement. One can be stage IV with limited mets or one can be stage Iv with multiple mets. Stage 3 to stage 4 is a totally different ball game! You must be familiar with your mets and the involvement to understand your circumstance. I wish it was as easy as every body needs to fight for surgery and it will be a success as others have done successfully! What works for one doesn't necessarily mean it will work with all. Also a consideration is that a person might have been diagnosed wrongly. Maybe really not fully a three or a four in staging.

Sherri