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Is any other treatment available aside from Chemo/radiation?

TomM1956728
Posts: 64
Joined: Apr 2011

Hello,

I wanted to ask for your kind help again.

My mother is 87 years old, and has esophageal cancer. According to her oncologist, the PET Scan showed that the cancer existed in lymph nodes along the trachea (windpipe) and near the lungs.

My mother’s cancer was diagnosed about a year and a half ago.

For about a year, she received chemo. Throughout this period, the cancer never spread.

However, since the chemo was causing difficulties for her, she stopped having chemo.

She then had radiation for 3 weeks in order to improve her swallowing.

The radiation produced great results since many of the cancer cells in the esophagus were killed or became dormant.

However, my mother stopped treatment a while back.

She stopped having chemo about 7 months ago, and her radiation treatment stopped 6 months ago.

The oncologist did another PET Scan recently which showed that, despite not receiving treatment for 7 months, the cancer has not spread.

However, the PET Scan showed that the cancer in the esophagus had become more active.

The oncologist started chemo again this week. This time instead of receiving Leucovorin, Oxaliplatin and 5 FU, she was only given Leucovorin and 5 FU.

However, my mother is already having serious difficulties with side effects and does not want to continue with chemo.

I think she is having more difficulties with chemo than before partly due to the fact that the chemo she received for about a year and the radiation have made her very weak.

Also, over the past nine months, she gradually lost about 15 pounds. She has no appetite and eats very little.

The oncologist thinks her loss of appetite is due to the cancer, and believes that as the chemo knocks down the cancer, her appetite will improve.

However, I think it is mostly due to her depression. Aside from this dreadful disease, she has no friends or social contacts and is very isolated and lonely.

I wanted to ask 3 questions.

1. Can’t the oncologist try something else aside from chemo which makes my mother ill?

I have read on the internet about being tested for the HER-2 gene and about a drug named Tarceva that can sometimes be effective. Would that help?

Is there anything aside from chemo that could be tried?

2. I don’t have the slightest understanding of medicine so I don’t dare ask the oncologist this question.

Can they try to remove a small portion of the tumor from the esophagus? (Not the esophagus but a small bit of the tumor).

I know that would not be a cure, that the cancer cells would continue to remain in the esophagus, etc.

But perhaps that would improve her swallowing, and remove some of the cancer cells so that she may not need to have chemo done for another six months or so rather than on a regular basis.

3. Has anyone tried any anti-depressants? If so, can you kindly let me know what has worked for you?

I would greatly appreciate hearing any advice, information or ideas.

Thank you very much for your kind help!

Tom

Bermudagirl
Posts: 120
Joined: Jun 2012

your mom is 87? I know how difficult chemo and radiation have been on a 58 year old man, I can't even imagine how challenging it would be for your frail, elderly mother. William just posted an excellent article on the merits of continuing chemotherapy. You may want to read it just for some insight. I don't pretend to have an answer for you, and I recognize that it is a difficult decision for you, but ask lots of questions prior to making that call. My very best wishes to you and your mom.

TomM1956728
Posts: 64
Joined: Apr 2011

Thank you for your kind response.

Yes, chemo and radiation are very, very tough.

I did read William’s post regarding the merits of continuing chemo and the material he posted gave me a lot to think about.

I will certainly ask a lot of questions and try to do a lot of research prior to seeing if my mother wants to stop chemo.

Thank you once again for your thoughts and assistance. God bless.

Tom

jaycc
Posts: 130
Joined: Jul 2012

Don't be afraid to ask you doctors questions. They are human too, so asking them questions helps them as well. bring them in on paper if you like, and read them off to the doctors on the phone and/or at the appointment.

Stopping chemo is a very tough question, I wish I could make it easier for you. You and your Mom are in our prayers

TomM1956728
Posts: 64
Joined: Apr 2011

Thank you for your kind response.

I usually get very nervous and anxious when I’m in the doctor’s office so I will definitely write down my questions this time.

Thank you once again for your thoughts and response. God bless.

Tom

stephikindred's picture
stephikindred
Posts: 153
Joined: Mar 2012

Hi Tom,
I am so sorry your mon has to go through all this. I think the depression is awful and my mom who is also stage 4 and she has been on Paxil and that has really helped her. She is calmer than me most of the time. I don't think there is any other treatment at this stage other than chemo and that stuff can be hard on the body after extended use because the side effects are cumulative. When it comes to surgery my understanding is they don't do it in most cases unless they believe it can be cured. I think the cancer is just so aggressive that there would be minimal positive results to justify it, but it would not hurt to ask. I was told that even targeted radiation is not viable in many instances because once there is spread it just doesn't make sense to remove it in one area given the risks of damage to other vital organs near the esophagus (heart, lungs) while it will still contine to spread. Chemo was the only option offered to us because they advised the chemo attacks cancer everywhere at once. Unfortunately the chemo attacks healthy cells as well.

Although I can't advise on two of your questions but I can say we have experience with an anti-depressant and it has worked for us. I hate to hear your mom is lonely and depressed. I hope you can spend some time with her. She has really done well for quite a while without chemo and this surprises me but just reinforces that everyone responds differenly to the disease and the drugs.

Best of luck to you,
Stephanie

TomM1956728
Posts: 64
Joined: Apr 2011

Hello Stephanie,

Thank you for your kind response.

Sorry to hear that your mother, like my mom, is also a stage four patient. It’s so difficult when you know in advance that there is no cure.

Thanks for letting us know about Paxil. That is something that I know my mother will want to try since she is feeling very depressed.

My mother initially had chemo for about a year or so. However, since she was having problems swallowing, they did an endoscopy and found that, despite getting chemo for a year, the tumor had become slightly larger.

So they gave her only 3 weeks of radiation to help decrease her swallowing difficulties. The radiation helped a lot and the PET Scan done after the radiation showed that many of the cancer cells were dead or dormant. Her swallowing improved for about 5 months.

But her swallowing problems started again and the latest PET Scan shows that the cancer cells in the esophagus are active again.

Thank you once again for your kind response and for sharing your thoughts. I wish you and your mother much luck and hope your mother is able to eat well and maintain her weight as that seems to be a major problem for my mother and most stage 4 patients. God bless.

Tom

stephikindred's picture
stephikindred
Posts: 153
Joined: Mar 2012

Hi Tom,
Thanks for sharing the information about your mom's radiation and I'm glad she has done well for so long. Perhaps my mom can get radiation if she can no longer swallow. I'm just glad that her trusty j-tube has helped her maintain her weight since she really can't eat each much anymore although she sure wishes she could!

I appreciate your kind words and wish the same for you and your mom!
Hugs,
Steph

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