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altmanjs
Posts: 1
Joined: Feb 2011

In early May 2010 my father was diagnosed with Stage III(a) adenocarcinoma of the esophagus. He went to the doctor because he was having trouble swallowing his food. As he said, food would "get stuck" and he would have to spend 10-15 minutes clearing it (or waiting for it to go down). As it turns out, this problem was due to a tumor growing in his distal esophagus which was declared to be esophageal cancer after an endoscopy, biopsy, and CT/PET scan.

His reaction was no reaction. He did nothing.

Within the last month he decided to go back to the doctor (9 months after initial diagnosis) who subsequently ordered another CT/PET scan to see if the cancer had metastasized or spread. We got the results of the CT/PET scan yesterday and the conclusion was: "the overall degree of intensity is not any more prominent than the previous examination (5/2010) and may be slightly less prominent." No other abnormalities were found and there was no sign of metastasis.

Some background information: my father is 79 years old (he'll be 80 in July), he doesn't drink, he doesn't smoke, he is of a good weight/height ratio (~160 lbs; 5'7"), and he works out with weights and cardio 5 days per week and has done for the past 50-odd years. He spent most of his life living in New York City but opted for a more low-key retirement in San Antonio, TX about 5 years ago. He lives alone.

From everything I've read online about esophageal cancer, the prognosis seems to be, "If you do nothing you'll be dead in a month!" Its very doom and gloom. In my father's case, its been 9 months with no significant change and no metastasis. I have also read that surgery for this type of cancer is risky and "controversial" and that 10% of patients die as a result of the surgery, not of the cancer.

Can a 79 year old man who is, in otherwise good health, survive aggressive chemo and radiation? What if he does not want to get chemo and radiation (something he has said he is against) and just opts for the surgery? What if he continues to do nothing? What does "slightly less prominent" mean in this situation? That the tumor has shrunk on its own?

I guess I just have a lot of questions and I want to be able to help my dad and be able to give him good information in conjunction with whatever the doctor recommends. Obviously, in the end it is his choice ... but I'm just trying to understand the hows and the whys of the disease and draw some conclusions as to the best course of action.

Thanks.

lifeb4now
Posts: 6
Joined: Oct 2010

Your are right in that its your dads decision-he has to go through the treatment/surgery,either way-you support them and dont judge.
That being said-the getting 'stuck' feeling WILL progress,the opening in the esophagus where the tumor is will get smaller and smaller,first food wont go through and eventually liquids wont go through either. And thats if the cancer hasnt progressed outside of the esophagus.
If you have been reading here,time is of the essence-there are many here who have prayed for the surgery,only to be told it was not an option.No surgery-no cure.I doubt you will find a surgeon who will perform surgery on a patient who hasnt had prior chemoradiation to shrink the mass so that it becomes OPERABLE. They would have to removed considerably more tissue and the recovered time extended. If your dad progresses to stage 4,surgery is not an option and treatment becomes pallitive.
In my husbands case,he opted for a stent placement to hold the esophagus open,thus being able to continue eating solids as he liked.only downside with stent placement is you have to sleep head elevated,as the flap isnt there to stop reflux. Maybe that would be a discussion for you-dad-doctor,if he asbolutely wont go for treatment.
On a final note-my husband is not a smoker/drinker ever,according to my research and all his medical personnnel,adenocarcinoma[lower esoph.] is mainly cause by many years of untreated acid reflux;and the 'upper'squamous cell is more prone to chronic alcohol/tobacco use.IM by no means qualified to access prodicall,but I darn sure haved lived it 24/7 for months and months with no complaints because he still here-with me.

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