Is Surgery after ChemoRadiation Stage III a good idea?

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dlrepic
dlrepic Member Posts: 62
edited March 2014 in Esophageal Cancer #1
Good day,

This is my first time posting. My dad was diagnosed with stage III Adenocarcinoma. He has finished his chemo and radiation and is scheduled to have surgery to remove his esophagus on Dec 8th. The surgeon explained that she will use his stomach to make the connection from the throat to the small intestines.

My dad's question is - Do other patients think that the surgery has been worth it? His father died from esophageal cancer in 1984 at the age of 68. My father is now 69.

Any thoughts/suggestions would be greatly appreciated.

Thanks

Danielle

Comments

  • petals007
    petals007 Member Posts: 23
    #2
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    Hi and welcome!
    Hi Danielle!
    My husband had chemoradiation and then surgery. (he was at stage IIB) They waited 4 weeks after treatment before performing the esophagectomy to let him heal. His doctors suggested that this was the best course of action. They also stated that removal of the esophagus is best as the chances of recurrence is high.
    After the surgery, a little bit of cancer was still there (in the removed sophagus) but the surrounding lymph nodes (the doctor took out 27) were negative.
    No doubt that the surgery is extremely hard and your father has to understand this. But let him know that there are many, many wonderful folks that have survived through the surgery and you learn to adapt to your new system. My husband had his surgery in May of this year and he is progressing very well. Prayer and patience (for us) is key.
    How is your father's overall health?? I think it helped tons that my husband was in really good health and so he's been able to bounce back pretty well.
    Goodluck and keep us updated on how everything is going!
    Jackie
  • Unknown
    Unknown
    #3
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    This comment has been removed by the Moderator
  • Phil_1022
    Phil_1022 Member Posts: 2
    #4
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    If I understand correctly ...
    It is my belief that surgery to remove the tumor is the only possible way to remove the cancerous cells and to provide the best possible chance for longer term survival.

    I am 61 years old and was diagnosed with T3 (Stage III) N0 (no apparent lymph node involvement) EC (adenocarcinoma of the distal esophagus) in early September this year. I had tried to convince the doctors to fast-track the surgery but, instead, they convinced me that it would be best to do a round of chemotherapy with radiation before the surgery to decrease the chance that the cancer might spread in the meantime.

    The recovery time for the least invasive surgery is, perhaps, 6-8 weeks. They were concerned that the cancer might spread during the 3-month window that would be required to schedule and recover from surgery unless we did the chemo first. Also, they suggested that the surgeons would have a better chance of removing all cancerous cells if I also did the radiation before the surgery.

    I have recently completed the 6-week course of chemo-radiation and tomorrow I will be having a post treatment PET/CT scan to see if the tumor has shrunk and also to verify that the cancer has not spread further during treatment. On Dec 8th I will be meeting with the doctors to discuss the test results and hopefully schedule my surgery for mid-December. I have been told that they will also probably suggest another round of chemo following surgery, depending on the prognosis after surgery.

    Best of luck to you and your father. This is also my first post here.
  • dlrepic
    dlrepic Member Posts: 62
    #5
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    unknown said:

    This comment has been removed by the Moderator

    thanks
    Thanks for the quick replys. Dad is a bit over weight, but chemoradiation has helped with that issue. I think he's in pretty good health overall for his age. He had his post chemoradiation PET/CT scans yesterday and is meeting with the surgeon this afternoon. I believe it is the MIE, the way that my dad described it to me. He is seeing, whom we've been told, is the best in Oregon. I hope they are correct. I'm sorry for you and your husband. My husband had late stage metastatic testicular cancer, after 6 months of chemo, he's doing well, but there's always the threat of recurrance. Best of luck to you.
    Danielle
  • dlrepic
    dlrepic Member Posts: 62
    #6
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    petals007 said:

    Hi and welcome!
    Hi Danielle!
    My husband had chemoradiation and then surgery. (he was at stage IIB) They waited 4 weeks after treatment before performing the esophagectomy to let him heal. His doctors suggested that this was the best course of action. They also stated that removal of the esophagus is best as the chances of recurrence is high.
    After the surgery, a little bit of cancer was still there (in the removed sophagus) but the surrounding lymph nodes (the doctor took out 27) were negative.
    No doubt that the surgery is extremely hard and your father has to understand this. But let him know that there are many, many wonderful folks that have survived through the surgery and you learn to adapt to your new system. My husband had his surgery in May of this year and he is progressing very well. Prayer and patience (for us) is key.
    How is your father's overall health?? I think it helped tons that my husband was in really good health and so he's been able to bounce back pretty well.
    Goodluck and keep us updated on how everything is going!
    Jackie

    thanks
    sounds like your husband had the same treatment that my father is. I hope he does as well. Cheers:)
  • dlrepic
    dlrepic Member Posts: 62
    #7
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    Phil_1022 said:

    If I understand correctly ...
    It is my belief that surgery to remove the tumor is the only possible way to remove the cancerous cells and to provide the best possible chance for longer term survival.

    I am 61 years old and was diagnosed with T3 (Stage III) N0 (no apparent lymph node involvement) EC (adenocarcinoma of the distal esophagus) in early September this year. I had tried to convince the doctors to fast-track the surgery but, instead, they convinced me that it would be best to do a round of chemotherapy with radiation before the surgery to decrease the chance that the cancer might spread in the meantime.

    The recovery time for the least invasive surgery is, perhaps, 6-8 weeks. They were concerned that the cancer might spread during the 3-month window that would be required to schedule and recover from surgery unless we did the chemo first. Also, they suggested that the surgeons would have a better chance of removing all cancerous cells if I also did the radiation before the surgery.

    I have recently completed the 6-week course of chemo-radiation and tomorrow I will be having a post treatment PET/CT scan to see if the tumor has shrunk and also to verify that the cancer has not spread further during treatment. On Dec 8th I will be meeting with the doctors to discuss the test results and hopefully schedule my surgery for mid-December. I have been told that they will also probably suggest another round of chemo following surgery, depending on the prognosis after surgery.

    Best of luck to you and your father. This is also my first post here.

    sounds very similar
    I hope that yout PET/CT scans come back with vast improvement. My dad should be getting the results as I write. Best of luck to you. Danielle
  • LivingFaith
    LivingFaith Member Posts: 74
    #8
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    dlrepic said:

    sounds very similar
    I hope that yout PET/CT scans come back with vast improvement. My dad should be getting the results as I write. Best of luck to you. Danielle

    welcome
    Welcome to our little EC family. I'm so happy you found us but so sad you HAD to find us.

    My dad was dx in July 2010 at stage lVb so surgery was not an option, just chemo pallative care. The last 4 months have been pretty much hell but the end is almost near and he will be free.

    Mr. Marshall is like the Godfather and Sherri is like our in-house doctor of this site. I'm sure he will be posting some information. Please read it and all you can here. The information and feedback is priceless. The support and suggestions by everyone have made a tremendous difference in my dad's quality of life, even if the cancer we call "The Beast" is robbing my dad from me.

    Your dad sadly is one of the lucky ones to even be a canidate for surgery. Please prayerfully consider your decision after doing the research.

    Deb
  • Unknown
    Unknown
    #9
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    Phil_1022 said:

    If I understand correctly ...
    It is my belief that surgery to remove the tumor is the only possible way to remove the cancerous cells and to provide the best possible chance for longer term survival.

    I am 61 years old and was diagnosed with T3 (Stage III) N0 (no apparent lymph node involvement) EC (adenocarcinoma of the distal esophagus) in early September this year. I had tried to convince the doctors to fast-track the surgery but, instead, they convinced me that it would be best to do a round of chemotherapy with radiation before the surgery to decrease the chance that the cancer might spread in the meantime.

    The recovery time for the least invasive surgery is, perhaps, 6-8 weeks. They were concerned that the cancer might spread during the 3-month window that would be required to schedule and recover from surgery unless we did the chemo first. Also, they suggested that the surgeons would have a better chance of removing all cancerous cells if I also did the radiation before the surgery.

    I have recently completed the 6-week course of chemo-radiation and tomorrow I will be having a post treatment PET/CT scan to see if the tumor has shrunk and also to verify that the cancer has not spread further during treatment. On Dec 8th I will be meeting with the doctors to discuss the test results and hopefully schedule my surgery for mid-December. I have been told that they will also probably suggest another round of chemo following surgery, depending on the prognosis after surgery.

    Best of luck to you and your father. This is also my first post here.

    This comment has been removed by the Moderator
  • Donna70
    Donna70 Member Posts: 852 Member
    #10
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    unknown said:

    This comment has been removed by the Moderator

    Danielle surgery definitely
    Hi Danielle,
    I was T3N1MO and had my surgery on 12/8/09. It was the Ivor Lewis surgery and I had had chemo and radiation before and had post op chemo afterwards. I was 65 then and after a long recovery period due to the post op chemo and some lung problems, I am doing very well now, can eat well and have the energy to live my normal life. There is no other option in my book, only surgery, it is the only cure for esophageal cancer esp stage III. Now whether your Dad gets MIE which has a much faster recovery period or Ivor Lewis which involved 2-3 incisions and rib involvement, never turn down the surgery, there are so many on this board who were diagnosed too late as Sherri said, her hubby Jim would have given anything for the opportunity to have surgery. So surgery is not an option to most of us, it is a necessity. Good luck, prayers for all,
    Donna70
  • dlrepic
    dlrepic Member Posts: 62
    #11
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    unknown said:

    This comment has been removed by the Moderator

    Good day
    Good day,

    my dad had an appointment with his surgeon yesterday and they have moved his surgery from Dec 8th to Friday, Dec 3rd. I am still waiting for the PET/CT scan results. I have learned that he is having the MIE, but he still said that he'll be in the hospital a couple weeks and then on a feeding tube, is this normal?

    Sorry, I don't know if there is a way just to post a response or if it is specific to a comment - I was replying to each individually, but seemed a bit redundant:)

    Hope everyone has a good day
    Danielle
  • Tina Blondek
    Tina Blondek Member Posts: 1,500 Member
    #12
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    dlrepic said:

    Good day
    Good day,

    my dad had an appointment with his surgeon yesterday and they have moved his surgery from Dec 8th to Friday, Dec 3rd. I am still waiting for the PET/CT scan results. I have learned that he is having the MIE, but he still said that he'll be in the hospital a couple weeks and then on a feeding tube, is this normal?

    Sorry, I don't know if there is a way just to post a response or if it is specific to a comment - I was replying to each individually, but seemed a bit redundant:)

    Hope everyone has a good day
    Danielle

    Welcome!
    Hello Danielle and welcome to you your dad and family to our EC discussion board family. I was a caregiver for my dad. He was dx in 11/08 with EC stage IV, unable to have surgery, could only have chemo and radiation. He had 6 weeks of chemo and radiation, the tumor did shrink, he went into remission for one year. By December 09 he was very sick and had extreme pain in his right side. Long story short, 3 months of living hell, the cancer went to his liver and he passed away on March 9, 2010. Your dad is lucky. He caught the cancer early, and he is able to have the surgery. Surgery is the only way to get rid of this cancer and keep it from coming back. From what I have learned from this wonderful site is that the MIE is the best surgery to have, with the quickest recovery. I believe that the two week hospital stay and the feeding tube are correct. It is much easier to post a new topic, rather than reply to individuals. You can send an individual email to any of us if you wish to. We will be thinking and praying for all of you on 12/3. Keep us up to date. All will be fine, you have done the right thing, and you keep doing your great job as being your dad's caregiver. There is also a great caregiver's discussion board. May God bless you all with the strength and peace you need.

    Tina in Va
  • dlrepic
    dlrepic Member Posts: 62
    #13
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    unknown said:

    This comment has been removed by the Moderator

    question
    Good afternoon William. I just received my dad's PET/CT scan results and there is decreased activity and size, but the tumor is still evident on the scans. We haven't heard from the doctor, I just had the findings faxed to me. Do you know if they will continue as planned with the surgery or do they sometimes opt for another round of chemoradiation? There doesn't appear to be any lymph node involvement. I always find I get more information from other patients.
    Thanks
    Danielle
  • linda1120
    linda1120 Member Posts: 389
    #14
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    dlrepic said:

    thanks
    Thanks for the quick replys. Dad is a bit over weight, but chemoradiation has helped with that issue. I think he's in pretty good health overall for his age. He had his post chemoradiation PET/CT scans yesterday and is meeting with the surgeon this afternoon. I believe it is the MIE, the way that my dad described it to me. He is seeing, whom we've been told, is the best in Oregon. I hope they are correct. I'm sorry for you and your husband. My husband had late stage metastatic testicular cancer, after 6 months of chemo, he's doing well, but there's always the threat of recurrance. Best of luck to you.
    Danielle

    Oregon surgeon
    Hi Danielle,

    My husband and I are in Oregon right now and are at OHSU in Portland to see the surgeon on Friday. I wondered where your father's surgeon is in Oregon, and what his name is. I wish him the very best!

    God Bless,

    Linda
  • dlrepic
    dlrepic Member Posts: 62
    #15
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    linda1120 said:

    Oregon surgeon
    Hi Danielle,

    My husband and I are in Oregon right now and are at OHSU in Portland to see the surgeon on Friday. I wondered where your father's surgeon is in Oregon, and what his name is. I wish him the very best!

    God Bless,

    Linda

    Oregon surgeon
    Hi, Dad's surgeon is Christy Dunst at The Oregon Clinic. Dad's most recent PET/CT showed that the cancer is still active and I worry about them going in while it's active. I would feel better if they'd do another round of chemoradiation prior to surgery, but they all are determined to do it tomorrow. what surgeon at OHSU are you seeing?

    Take care
    Danielle
  • linda1120
    linda1120 Member Posts: 389
    #16
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    dlrepic said:

    Oregon surgeon
    Hi, Dad's surgeon is Christy Dunst at The Oregon Clinic. Dad's most recent PET/CT showed that the cancer is still active and I worry about them going in while it's active. I would feel better if they'd do another round of chemoradiation prior to surgery, but they all are determined to do it tomorrow. what surgeon at OHSU are you seeing?

    Take care
    Danielle

    Surgeon at OHSU
    It is a team of surgeons with Dr. James Dolan who specializes in MIE. They are a high volume cancer hospital with very good successes. I wish the very best to your father and your family. We are right where your family is, getting the petscan results tomorrow and knowing if all is okay for surgery. We do know from the catscan report that the tumor and nodes have shrunk greatly.

    God Bless,

    Linda
  • Unknown
    Unknown
    #17
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    dlrepic said:

    Oregon surgeon
    Hi, Dad's surgeon is Christy Dunst at The Oregon Clinic. Dad's most recent PET/CT showed that the cancer is still active and I worry about them going in while it's active. I would feel better if they'd do another round of chemoradiation prior to surgery, but they all are determined to do it tomorrow. what surgeon at OHSU are you seeing?

    Take care
    Danielle

    This comment has been removed by the Moderator
  • dlrepic
    dlrepic Member Posts: 62
    #18
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    unknown said:

    This comment has been removed by the Moderator

    update
    well, I had just written a book and lost it, so I'll start again:)

    First, thanks for the information. I'm glad to hear of your, and many others, success. Dad is in surgery, but dad and I decided I should work today and come up and see him tomorrow after he's out of ICU. My mom and sister are with him. I'm second guessing that decision, but it will all be ok. Also, I did not recieve the email message.

    Dr Dunst is removing his entire esophagus and using 2/3 of his stomach to make a new connection. I'm very glad to read your success with what seems to be a very similar procedure and hope dad does as well.

    We are no strangers to esophageal cancer, or cancer in general. My grandfather, dad's dad, passed from esophageal cancer in 1984. I would like to see research on family tendancy towards EC. My dad has suffered from GERD for many years and not one doctor ever suggested he have an endoscopy. I also suffer from GERD, I had an edoscopy 6 years ago and was wondering if I should have another. Since more men than women have EC, my PCP has said there is no need. I have suggested to my brother and sister that they have endoscopies because neither one has had one and both have GERD as well. Have you discovered any information pertaining to such studies?

    Thanks again for all your information and advice.
    Danielle

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