73yr old dad choosing esoph surgery

Tgrabert

I am very new to the site and THANK GOD for all of you here.

Dad had Stage 3 esophagus tumor discovered in Dec09 and it has not spread and was treated with Chemo/Radiation, Cisplatin therapy and now the tumor is barely visible. The surgeon told him today he can go through more therapy and rid the rest with a chance of it coming back in 6-8 months or have surgery with a 40% chance to make it through the surgery.
Did he hear this right? 40% meaning the survival rate of the procedure itself?

He is awaiting some pre-op tests over the next week. He has to go off his blood thinner for 7 days which is never good for him with leg blockings in his past so many times needing surgery. He does not want to lose his legs or die on the table, but he is convinced nothing is worse than the chemo. He went through a yo-yo of dehydrating and magnesium loss suffering depression and nausea and head pounding that kept him going back in for mag IV fluids and he does not want to relive that.
I know that only he can decide what is best for him, but has anyone else in his age range survived this surgery and remain cancer free, and nausea free?

I am 31 and plan to be the only one to show up for his procedure and aftercare as we all live away from him. He has been so alone, with me or my brother coming in a couple weeks at a time when he is most ill. Feeding tube surgery was a couple months ago and a huge help to finish his therapy treatment although he still dehydrated couple times a month from magnesium loss. He is bored out of his mind, had no retirement planned and living day to day in a boring house with no company. I cannot get him involved with any groups or activities besides prayer healing so any advice or answers would be very appreciated. I am not giving up even if that means he should try breastmilk!

BMGky

Surgery or chemo
There are others on this site more knowledgeable. It sounds as if your Dad has some additional health issues that impact surgery outcome percentages. May husband had his surgery a few months shy of age 71. He had an invasive surgery. He continues to recover and had excellent results. There are minimally invasive procedures that might be less traumatizing but you do need to be at a specialized cancer center. I was concerned about his being alone after surgery. The recovery is lengthy and challenging. Is he a veteran. I have seen some veterans being helped by VA hospitalization. If he opts for surgery, please have a post op plan in place as he will need support. Whatever his decision, I hope it turns out well for him.

paul61

Is a Minimally Invasive Surgery an option?
Hi,

You did not say how old your father is or what stage his EC is. It sounds like he has some underlying health issues to deal with but I have read of many people in their 70's and 80's who have had positive outcomes from surgery.

I would investigate the option of having a Minimally Invasive Esophagectory (MIE). This type of surgery is much less stressful on the body and has an easier recovery time. If you look at the posts by "William" on this site you will find a wealth of information about the surgery and contact information for surgeons that do the surgery.

Tell us more about your dad;

What stage is he?
How old is he?
What are his underlying health issues?
Where are you located?
Where and when was he diagnosed?

Given this information we can make suggestions on resources and information that may help find the best treatment options for your dad.

In terms of your dad being alone for recovery, some options may be;

Home nursing care
Local Cancer support groups
Extended care facilities

Your surgeon's office should be able to help you with information about these.

Best Regards,

Paul Adams
AKA "paul61"
McCormick, South Carolina

unclaw2002

Hi,
My fater is 78 and was
Hi,

My fater is 78 and was diagnosed in Dec with Stage III, T3, N1, MO and has undergone chemo and radiation and is weighing the options of surgery.

Before anything else get a second opinion at a cancer hospital that specializes in EC. Let me begin by saying that according to the statistics I have reviewed if you get a traditional esophageal surgery and are over 70 and have the surgery done at a facility that isn't a cancer specialty hospital specializing in esophageal cancer and with a surgeon who isn't an expert doing these surgeries on a frequent basis, that yes you face that type of morbidity rating. Now alternatively if you have surgery at a cancer center specializing in esophageal cancer from a surgeon experienced in the procedure then the morbidity rates drop to under 5%.

If the doctor is only giving you a 40% chance of making it through surgery I think I would be looking for another opinion.

My father is looking at the MIE as Paul described above. The doctors don't feel that he would be able to survive the traditional surgery (my dad has controlled diabeties and high blood pressure).

Where has he been getting treatment and what other options have you explored. Let us know so we may be able to provide some information.

Best,
Cindy

tammylouhay

I am so sorry to hear that
I am so sorry to hear that you father is also suffering with this terrible disease.

My own father is 70 and was just diagnosed in April. He was not given the option of seeing an oncologist, but was first referred to a surgeon. He opted to immediately have the big surgery.I was terrified and had presented him with tons of info about the minimally invasive surgery. It was his understanding that this was not an option for him. I was concerned that perhaps it was that his doctor didn't perform that type of surgery, but both he and my mom were quite insistent that my dad's tumor was too large for minimally invasive. I had also urged him to request an oncologist prior to surgery, but he was told that they would have him see an oncologist after his surgery.

My dad also suffers from diabetes and COPD (emphysema).

I truly did not expect him to survive the surgery, and was really hoping that he would opt not to have it. My sister called a couple of hours into his surgery and I panicked, expecting the worst. Sadly they discovered that his cancer was also in lymph nodes and liver, and did not proceed with trying to remove the tumor.

Knowing nothing about cancer, this surprised my a little as they determined that his esophagus was 90% blocked, so I don't quite understand why they wouldn't have attempted to remove that anyways, but they didn't, simply sewed him back up.

Three days later I got the call to come (mom and dad are in Calgary) and I am in Vancouver as his kidneys were failing and all of his vitals signs were bad. I met my mom and the rest of my sibblings at the hospital and we spent the next 7 days watching my dad get stronger. After 2 weeks in hospital, he was well enough to go home. Now he is about to start 10 days of radiation. He has lost a fair amount of weight, and is really tired. He and my mom try to get out at least once a day, but I know that it is very tiring for him, and I am so grateful that my mom and sister are in Calgary with him.

It is amazing how much better he is now, than he was immediately following the surgery. Without finishing it (they were in a couple hours of the anticipated 8 hrs) he endured so much.

You are wise to seek advice on surgeons and facilities. My challenge has been that my dad is a very determined person with his own opinion. I have told him that if he were one of my children, we would be doing this differently. I strongly believe that a clinic that specializes in EC and a surgeon who has lots of experience are your best bet.

I would love to see he and or my mom having these conversations here, but so far no luck. I am finding it so helpful just to know that there are others, who are experienced and have amazing survival stories to share.

If your father decides to opt for surgery, I wish him the very best possible outcome, and whatever happens, I wish you peace, as it is really up to him to choose. I know how difficult it is to have to watch from the sidelines.

My prayers are with you and your father.

Tammy

chewbacca

esophagus surgury
Hi Im 70 had esophagus out in 2005 min evasive surg gave me 50 50 chance but im here and glad i went thru the surgury even tho it was hard

Unknown

This comment has been removed by the Moderator

Tgrabert

unknown said:

This comment has been removed by the Moderator

Thank you ALL for the replies
He is 73 and lives south of New Orleans and going to Oshners Hospital. I do not think this is a cancer specialty surgeon, but they told him they have done most of these procedures for the area of all the surgeons to choose from. (Not sure if that was a selling statement-he does not usually ask for proof). The surgeon was highly recommended by all his other doctors so he wants to go for it. He did tell me today they are going to attempt the laproscopic first, and if unable they would do the longer surgery at that time, so I was glad to hear that.

He had a Stage 3 tumor that was 5cm long attached where the esophagus meets the stomach. I am not sure of the correct terminology as you all use. Like some of you described, he had hiccups and heartburn he did not tell the doctor for a long time. He only described he was falling asleep at the wheel when going to work and back and taking alot of naps. Finally, he started getting food caught and told the doctors. She chemo treatments have shrunk it to where they said it is now barely even visible. When they operated in March for his feeding tube, they did look around at liver, etc.. and said it has not spread to their knowledge.

His biggest fear is that he has to be on blood thinner always even though his heart is in good shape. He had a triple bypass years and years ago. He also had about 6 sucessful surgeries due to blockages in his legs. The doctors say everytime that this can lead them to one day amputate if things go wrong, so his fear of being off the blood thinner for 7 days pre-op is understood.

I asked him to go to Houston TX where my brother lives, but he cannot do it financially and does not want to burden anyone as well, so I doubt I can get him looking for other surgeons.

I am so happy to hear from you all that had the surgery and are happy it is done. I shared some of the stories you guys wrote with him and it really seemed to give him confidence this is a good decision. THANK you all for being here for people like me. I know you have lifted us in prayer and what a difference it is making! We pray for all of you.

I will stay connected to this forum and look forward to learning so much more.

God Bless!
Trisha

Tgrabert

chewbacca said:

esophagus surgury
Hi Im 70 had esophagus out in 2005 min evasive surg gave me 50 50 chance but im here and glad i went thru the surgury even tho it was hard

THANK YOU
Thank you so much for the reply. I appreciate it more than you know. It makes it real and hopeful, that you understand. It is good to see people helping reach out to others in the same boat. God bless you!

Tgrabert

tammylouhay said:

I am so sorry to hear that
I am so sorry to hear that you father is also suffering with this terrible disease.

My own father is 70 and was just diagnosed in April. He was not given the option of seeing an oncologist, but was first referred to a surgeon. He opted to immediately have the big surgery.I was terrified and had presented him with tons of info about the minimally invasive surgery. It was his understanding that this was not an option for him. I was concerned that perhaps it was that his doctor didn't perform that type of surgery, but both he and my mom were quite insistent that my dad's tumor was too large for minimally invasive. I had also urged him to request an oncologist prior to surgery, but he was told that they would have him see an oncologist after his surgery.

My dad also suffers from diabetes and COPD (emphysema).

I truly did not expect him to survive the surgery, and was really hoping that he would opt not to have it. My sister called a couple of hours into his surgery and I panicked, expecting the worst. Sadly they discovered that his cancer was also in lymph nodes and liver, and did not proceed with trying to remove the tumor.

Knowing nothing about cancer, this surprised my a little as they determined that his esophagus was 90% blocked, so I don't quite understand why they wouldn't have attempted to remove that anyways, but they didn't, simply sewed him back up.

Three days later I got the call to come (mom and dad are in Calgary) and I am in Vancouver as his kidneys were failing and all of his vitals signs were bad. I met my mom and the rest of my sibblings at the hospital and we spent the next 7 days watching my dad get stronger. After 2 weeks in hospital, he was well enough to go home. Now he is about to start 10 days of radiation. He has lost a fair amount of weight, and is really tired. He and my mom try to get out at least once a day, but I know that it is very tiring for him, and I am so grateful that my mom and sister are in Calgary with him.

It is amazing how much better he is now, than he was immediately following the surgery. Without finishing it (they were in a couple hours of the anticipated 8 hrs) he endured so much.

You are wise to seek advice on surgeons and facilities. My challenge has been that my dad is a very determined person with his own opinion. I have told him that if he were one of my children, we would be doing this differently. I strongly believe that a clinic that specializes in EC and a surgeon who has lots of experience are your best bet.

I would love to see he and or my mom having these conversations here, but so far no luck. I am finding it so helpful just to know that there are others, who are experienced and have amazing survival stories to share.

If your father decides to opt for surgery, I wish him the very best possible outcome, and whatever happens, I wish you peace, as it is really up to him to choose. I know how difficult it is to have to watch from the sidelines.

My prayers are with you and your father.

Tammy

THANK YOU
Yes, my dad had the same symptoms and is a big tough one as well. He was 90% blocked as well and the chemo made it shrink in just a few months. He aslo has emphasymia for many many years. They have much in common. Thank you for taking the time to reach out to me Tammy. This is appreciated so much that you would share all these details. I wish your dad many years to come without any suffering as well. God Bless you and your family!

Tgrabert

unclaw2002 said:

Hi,
My fater is 78 and was
Hi,

My fater is 78 and was diagnosed in Dec with Stage III, T3, N1, MO and has undergone chemo and radiation and is weighing the options of surgery.

Before anything else get a second opinion at a cancer hospital that specializes in EC. Let me begin by saying that according to the statistics I have reviewed if you get a traditional esophageal surgery and are over 70 and have the surgery done at a facility that isn't a cancer specialty hospital specializing in esophageal cancer and with a surgeon who isn't an expert doing these surgeries on a frequent basis, that yes you face that type of morbidity rating. Now alternatively if you have surgery at a cancer center specializing in esophageal cancer from a surgeon experienced in the procedure then the morbidity rates drop to under 5%.

If the doctor is only giving you a 40% chance of making it through surgery I think I would be looking for another opinion.

My father is looking at the MIE as Paul described above. The doctors don't feel that he would be able to survive the traditional surgery (my dad has controlled diabeties and high blood pressure).

Where has he been getting treatment and what other options have you explored. Let us know so we may be able to provide some information.

Best,
Cindy

Thank YOU Cindy
Thanks for sharing all this information openly. I really do appreciate it. After reading, I asked my dad and he said they are going to attempt the MIE first, so that was a relief. My dad does not have diabetes to complicate things, so extra prayers are sent for yours. It is very interesting to see how much people did not tell us at the doctors offices that you all are teaching me. He is going to Oshner's in New Orleans and going to have a date any time now. His pulmonary pre-ops tests are all done today and we wait by the phone. I will learn all I can. Stay in touch.

God Bless,
Trisha

Tgrabert

BMGky said:

Surgery or chemo
There are others on this site more knowledgeable. It sounds as if your Dad has some additional health issues that impact surgery outcome percentages. May husband had his surgery a few months shy of age 71. He had an invasive surgery. He continues to recover and had excellent results. There are minimally invasive procedures that might be less traumatizing but you do need to be at a specialized cancer center. I was concerned about his being alone after surgery. The recovery is lengthy and challenging. Is he a veteran. I have seen some veterans being helped by VA hospitalization. If he opts for surgery, please have a post op plan in place as he will need support. Whatever his decision, I hope it turns out well for him.

THANK YOU
No, he is not a veteran. Please thank your dad for his service from me. It is good to hear of his successful operation and recovery. Thank you for the advice. He told me today they are going to attempt the MIE first. I will try to see if I can get him to move in with me out of state or connect him with a good support system. So far, I was able to find a neighbor with caretaking experience as her mother had breast cancer and recovered. She seems to be sent like an angel in the middle of this and available for his aftercare. I pray your dad continues to do well and you all stay strong through this. Thank you for thinking of me and responding.

God Bless!!
Trisha

Tgrabert

paul61 said:

Is a Minimally Invasive Surgery an option?
Hi,

You did not say how old your father is or what stage his EC is. It sounds like he has some underlying health issues to deal with but I have read of many people in their 70's and 80's who have had positive outcomes from surgery.

I would investigate the option of having a Minimally Invasive Esophagectory (MIE). This type of surgery is much less stressful on the body and has an easier recovery time. If you look at the posts by "William" on this site you will find a wealth of information about the surgery and contact information for surgeons that do the surgery.

Tell us more about your dad;

What stage is he?
How old is he?
What are his underlying health issues?
Where are you located?
Where and when was he diagnosed?

Given this information we can make suggestions on resources and information that may help find the best treatment options for your dad.

In terms of your dad being alone for recovery, some options may be;

Home nursing care
Local Cancer support groups
Extended care facilities

Your surgeon's office should be able to help you with information about these.

Best Regards,

Paul Adams
AKA "paul61"
McCormick, South Carolina

Thank you
He is 73, he was dx at Stage 3, he has good heart now but suffers blockages now and then without blood thinners. He is in New Orleans area and going to Oshners where he was originally diagnosed after test workups. I am going to try to talk him into coming to live with me in Kentucky after recovery. He of course, wants to be home where we were all raised and is a southern man for sure. I have found a stay at home mom two doors away from him that has cancer experience with her mom. She has been great and I think God sent her for us. I am working in Anderson SC right now. My company replaces roofs from hail/wind damaging storms and we work with insurance adjusters for homeowners to get claims settled. I have to say SC has the nicest people I have met in the whole country. I wish I lived here for good. Thank you so much for reaching out to me.

God Bless!!
Trisha

Tina Blondek

chewbacca said:

esophagus surgury
Hi Im 70 had esophagus out in 2005 min evasive surg gave me 50 50 chance but im here and glad i went thru the surgury even tho it was hard

Hey There Chew!
Nice to see
Hey There Chew!
Nice to see you posting and sharing your wonderful experience and knowledge! Hope to see you on csn chat soon!
Tina

unclaw2002

Tgrabert said:

Thank you ALL for the replies
He is 73 and lives south of New Orleans and going to Oshners Hospital. I do not think this is a cancer specialty surgeon, but they told him they have done most of these procedures for the area of all the surgeons to choose from. (Not sure if that was a selling statement-he does not usually ask for proof). The surgeon was highly recommended by all his other doctors so he wants to go for it. He did tell me today they are going to attempt the laproscopic first, and if unable they would do the longer surgery at that time, so I was glad to hear that.

He had a Stage 3 tumor that was 5cm long attached where the esophagus meets the stomach. I am not sure of the correct terminology as you all use. Like some of you described, he had hiccups and heartburn he did not tell the doctor for a long time. He only described he was falling asleep at the wheel when going to work and back and taking alot of naps. Finally, he started getting food caught and told the doctors. She chemo treatments have shrunk it to where they said it is now barely even visible. When they operated in March for his feeding tube, they did look around at liver, etc.. and said it has not spread to their knowledge.

His biggest fear is that he has to be on blood thinner always even though his heart is in good shape. He had a triple bypass years and years ago. He also had about 6 sucessful surgeries due to blockages in his legs. The doctors say everytime that this can lead them to one day amputate if things go wrong, so his fear of being off the blood thinner for 7 days pre-op is understood.

I asked him to go to Houston TX where my brother lives, but he cannot do it financially and does not want to burden anyone as well, so I doubt I can get him looking for other surgeons.

I am so happy to hear from you all that had the surgery and are happy it is done. I shared some of the stories you guys wrote with him and it really seemed to give him confidence this is a good decision. THANK you all for being here for people like me. I know you have lifted us in prayer and what a difference it is making! We pray for all of you.

I will stay connected to this forum and look forward to learning so much more.

God Bless!
Trisha

Trisha,
My dad was treated
Trisha,

My dad was treated at Oschner in New Orleans as well, if you can call it that. He went to Sloan in NY to get a second opinion and the doctors at Sloan changed the treatment plan Oschner had come up with. You are correct Oschner is not a speciality cancer hospital with an expertise in EC. In fact many of the things I have learned and questions asked were not answered by the Oschner docs. Indeed I believe that they misdiagnosed my dad for over a year of swallowing complaints and if they knew what they were doing would have perhaps caught this cancer at an easier treatment stage. I tried everything possible to get my dad to have his treatment elsewhere - to no avail.

But now after chemo and radiation the cancer may have spread and my dad wants to get his second opinion and probably the treatment elsewhere he hasn't developed much confidence in the docs there.

If there was any way you could get your dad in the car and drive across the swamps to Houston, I would highly recommend you do that.

Does you dad have regular medicare or that horroble Humana HMO they push at Oschner? He may have to fight to go to MD Anderson but it would be worth it. Also, if his concern is housing in Houston the hospital social worker could probably help, the ACS has assistance, there are hotels that offer free or deeply discounted rooms to patients receiving cancer treatment and I am sure MD Anderson has programs although I don't know specifically what is available there.

Don't make a decision about your dad's life based on finances and at the least he should get a second opinion a couple of days in Texas, driving back and forth.

As to his treatment --- he almost died from the care he received at Oschner. And then there was the indifference of the oncologist which was horrible. As to their expertise - if there aren't many surgeries done in the area then it isn't hard to have done most of them. I have no idea what statistic they are referring to, but ask Oschner how many MIE's have been done there, how many they do a week - a month? And to top if off the oncologist doesn't have much of a personality and a pretty horrible bed side manner.

If you have any questions please email me on this site and I will be happy to speak with you.

Best,
Cindy