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Stent or Radiation?

TomM1956728
Posts: 64
Joined: Apr 2011

Hello,

I wanted to ask for your kind help.

My mother has stage 4 esophageal cancer, and her cancer has spread to multiple lymph nodes near her lungs and tranchea.

Since she was not a candidate for surgery, she was given chemotherapy for about a year.

Unfortunately, however, her swallowing problems became worse and an endoscopy showed that, despite a year of chemo, the tumor was slightly larger than before.

Her oncologist then recommended that she have radiation for 3 weeks only since the goal was to make the swallowing better rather than to cure her.

About 2 months after finishing the radiation, she was given a PET Scan.

After reviewing the PET Scan results, she was told that she had achieved the best results possible, and that many of the cancer cells were dead.

For about 3 months after finishing radiation, she had no problems swallowing. However, over the past month she is once again experiencing some problems swallowing.

Over the past 7 months, she has gradually been losing weight each month, and her weight loss has continued since finishing radiation.

Her oncologist thinks that the reason she is not eating is due to the fact that she still has problems swallowing. He feels that if she swallowed better, her eating would improve.

Her oncologist wants her to have another endoscopy and, based on the results, have a stent placed.

I am wondering if it may be best for her to continue with radiation since the radiation produced such positive results.

Does anyone have any ideas whether it’s best to have a stent or undergo more radiation?

I would greatly appreciate your thoughts and advice.

Thank you for your kind assistance.

Tom

TomM1956728
Posts: 64
Joined: Apr 2011

Thank you so much, William. The information you provided is an eye opener. I didn't know that stents can cause so many problems. I really feel sorry for Ray and what he had to go through. How sad and unfortunate.

If my mother's eating problems don't improve, I will definitely look into getting her a feeding tube rather than a stent. Thank you for the link to the J-tube information. That was very helpful.

Tom

TomM1956728
Posts: 64
Joined: Apr 2011

Thank you, Sherri, for the information you provided. I had no idea that my mother could not have any more radiation done. I was hoping that since she had only 3 weeks of radiation, she could have more radiation done in the future if she has problems again.

I think your idea that we need to find out why she's having swallowing problems is a great idea. I think that getting the endoscopy could probably help determine the source of the problem.

I was totally unaware that an esophageal stretch could be done. That is great to know.

Thank you for your kind help.

Tom

Ladylacy
Posts: 457
Joined: Apr 2012

We found out that you can have radiation in the same spot again. My husband was diagnosed with laryngeal cancer in July 2010 and underwent 35 radiation treatments. Surgery was in March 2011. Then in April 2012 he went in to have a procedure to have a TEP inserted and the surgeon found a tumor right below his stoma (said it was at the cervical of the esophagus -- cancer). He did then a PET/CT scan and no spread was found. He underwent and just finished up with 35 radiation and 7 chemo treatments. The radiation was in basically the same spot as the first radiation treatments. Also I had an Aunt who passed away in October 2011 from EC and she underwent radiation treatments twice for EC.

As far as trouble swallowing, we had to see the speech therapist today and we were told that if you don't swallow your muscle will deteriorate and many patients don't swallow after radiation due to the soreness in the throat and esophagus. She told my husband to swallow, swallow, swallow. As of now he relies on a PEG tube for his nourishment but they want him to try to swallow liquids and soft foods. He is three weeks out of radiation. He will have a modified swallow test to see what is going on.

Radiation does a job on you and it continues. Our surgeon did tell us that Joe could possibly need to have his esophagus stretched again. Our hopes is that the radiation didn't close off the back of his throat like it did the first time. That would be hard to open and it was explained that they would have to go in below the esophagus and then up the esophagus to try and open it. But with the tissue being so fragile right now, it couldn't be done anytime soon nor would I want it done.

Sharon

TomM1956728
Posts: 64
Joined: Apr 2011

Sherri, it seems it is possible to have radiation, though from what you mentioned, it often may not be the best choice. Like you say, apparently, it depends on the radioligist and facility.

In my mother's case it may possibly be okay since the cancer has spread outside of the esophagus, and radiation was given to her only to improve the swallowing rather than cure the cancer. That's they gave her radiation for only 3 weeks.

The chemo stopped the cancer outside the esophagus from spreading. However, after a year of chemo, the tumor in the esophagus had become somewhat larger which is why they gave her radiation.

I guess every radiologist is different and every patient responds differently.

Thank you once again for your kind response and kindassistance.

Tom

TomM1956728
Posts: 64
Joined: Apr 2011

Thank you so much, Sharon. I know my mother will be happy to hear that since radiation has helped her and has not given her as many side effects as chemo did.

I sure hope your husband's swallowing improves. I know that radiation usually has strong side effects so I hope that it didn't close off the back of your husband's throat.

It's so important that he eat well, since I know my mother is getting very weak from not being able to eat. She has started to take the Boost drink twice a day and that has helped.

Thank you once again for your kind response and helpful information.

Tom

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