Coronary Stents, Blood Thinners and Esophageal Cancer Surgery

hopper52

I was diagnosed with EC on 04/07 and have made a couple of posts. I appreciate the support and prayers of everyone on this site. A special thanks to William who advised me of the MIE surgery. To summarize, after all the tests, PET/CT/EUS I have diagnosed as Stage II (T3N0M0) with radiation and chemo starting within the next couple of weeks to be followed by surgery, which leads me to my current question or perhaps a better word is quandry.

I had three drug eluding stents put in my right coronary artery in Dec 2010. Standard procedure for drug eluding stents is to have a year long regimin of aspirin and Plavix (a platelet inhibitor). Stopping Plavix prior to the 1 year mark could result in stent thrombosis (blood clot) and a heart attack. However, I can not have surgery without getting off the Plavix. It's already had an impact to my treatment. The doctor who did the initial endoscope and the one that did the EUS agreed to do the procedures without me coming off, but the cardiologist's refusal to let me come off has already resulted in not being able to have a mediport implanted for my chemo. My oncologist says he has an alternative to the 5FU "fanny pack" and that we can work around that using other drugs. However, I've read about the J-tube which has been recommended by so many on this site and don't think I could have one put in because of the Plavix issue. My biggest concern is the surgery......I'm sure the doctor won't perform the surgery if I can't come off the blood thinners and I don't feel it's a good idea to wait until December to have the surgery. I know the chemo and radiation are supposed to "kill" the cancer but I see repeated posts of post surgery cancer cells after chemo and radiation. So do I stop the Plavix for the surgery and take a chance of a major heart attack or wait until the year is up to have my EC surgery done? I've researched this and found that South Korea has a clinical trial going on to see if 12 months is necessary or if 6 months is suitable. Unfortunately the trial doesn't end until 2014.

Just curious if anyone on the site has had any experiences with this problem and could offer any feedback/advice.

Unknown

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hopper52

unknown said:

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MY THOUGHTS EXACTLY
Worry must work...I've found that over 99% of the things I worry about never happen so it must work.

Seriously, though, my thoughts are in line with what you're saying. I'll cross the surgery bridge when I get to it. Jesus said "don't worry about tomorrow, tomorrow will take care of itself, today has enough trouble of it's on (paraphrase)". I'm just taking this thing one day at a time. Have another EUS this coming week to mark the tumor for the radiation, meet with my chemo oncologist to discuss the alternative chemo treatment since I can't stop the blood thinners to have a port installed. I also get my radiation simulation where they make my "mold" for my radiation treatments. The eating thing is sporadic as far as getting food stuck. I'm just trying to force myself to eat as much as I can......I had lost about 12 lbs over the last 3 months but have gained 3 or 4 back. And I haven't even tried the "Krispy Kremes in the blender" trick yet.

The reason I made the post is to see if anyone had any experiences in this matter. I did find a little information on the colorectal cancer postings.

Thank you, William, for your tremendous support and valuable input on this forum and the insight that you've provided so many people. May God continue to bless you.

hopper52

unknown said:

This comment has been removed by the Moderator

MY THOUGHTS EXACTLY
Worry must work...I've found that over 99% of the things I worry about never happen so it must work.

Seriously, though, my thoughts are in line with what you're saying. I'll cross the surgery bridge when I get to it. Jesus said "don't worry about tomorrow, tomorrow will take care of itself, today has enough trouble of it's on (paraphrase)". I'm just taking this thing one day at a time. Have another EUS this coming week to mark the tumor for the radiation, meet with my chemo oncologist to discuss the alternative chemo treatment since I can't stop the blood thinners to have a port installed. I also get my radiation simulation where they make my "mold" for my radiation treatments. The eating thing is sporadic as far as getting food stuck. I'm just trying to force myself to eat as much as I can......I had lost about 12 lbs over the last 3 months but have gained 3 or 4 back. And I haven't even tried the "Krispy Kremes in the blender" trick yet.

The reason I made the post is to see if anyone had any experiences in this matter. I did find a little information on the colorectal cancer postings.

Thank you, William, for your tremendous support and valuable input on this forum and the insight that you've provided so many people. May God continue to bless you.

Unknown

hopper52 said:

MY THOUGHTS EXACTLY
Worry must work...I've found that over 99% of the things I worry about never happen so it must work.

Seriously, though, my thoughts are in line with what you're saying. I'll cross the surgery bridge when I get to it. Jesus said "don't worry about tomorrow, tomorrow will take care of itself, today has enough trouble of it's on (paraphrase)". I'm just taking this thing one day at a time. Have another EUS this coming week to mark the tumor for the radiation, meet with my chemo oncologist to discuss the alternative chemo treatment since I can't stop the blood thinners to have a port installed. I also get my radiation simulation where they make my "mold" for my radiation treatments. The eating thing is sporadic as far as getting food stuck. I'm just trying to force myself to eat as much as I can......I had lost about 12 lbs over the last 3 months but have gained 3 or 4 back. And I haven't even tried the "Krispy Kremes in the blender" trick yet.

The reason I made the post is to see if anyone had any experiences in this matter. I did find a little information on the colorectal cancer postings.

Thank you, William, for your tremendous support and valuable input on this forum and the insight that you've provided so many people. May God continue to bless you.

This comment has been removed by the Moderator

hopper52

Chemo Experts???
Okay, I had to forego the mediport due to my platlet medication (Plavix). Orginially the oncologist was going with Cisplaten and 5FU. Since I cannot do the 5PU because of the port issue he's going to go with 2 regimens of Carboplatin and Taxol (Think I have the name right). I'm starting radiation (25 treatments) on May 23 with the chemo on day 1 and again three weeks later. Anyone with experience with either of these two drugs. It looks like taxol is pretty serious stuff.

linda1120

hopper52 said:

Chemo Experts???
Okay, I had to forego the mediport due to my platlet medication (Plavix). Orginially the oncologist was going with Cisplaten and 5FU. Since I cannot do the 5PU because of the port issue he's going to go with 2 regimens of Carboplatin and Taxol (Think I have the name right). I'm starting radiation (25 treatments) on May 23 with the chemo on day 1 and again three weeks later. Anyone with experience with either of these two drugs. It looks like taxol is pretty serious stuff.

chemo
My husband is the ec survivor and he had the 5fu and cisplatin. I am a 12+ yr adv ovarian cancer survivor that received carbo and taxol. I responded very well to the chemo, but it is strong. 5fu is too! The biggest side effects I had from this combination was hearing loss in one ear and neuropathy to this day. I take medication daily for it and it helps. I'll take that as I am still alive! I hope this helps.

Linda

Unknown

hopper52 said:

Chemo Experts???
Okay, I had to forego the mediport due to my platlet medication (Plavix). Orginially the oncologist was going with Cisplaten and 5FU. Since I cannot do the 5PU because of the port issue he's going to go with 2 regimens of Carboplatin and Taxol (Think I have the name right). I'm starting radiation (25 treatments) on May 23 with the chemo on day 1 and again three weeks later. Anyone with experience with either of these two drugs. It looks like taxol is pretty serious stuff.

This comment has been removed by the Moderator

marielle

Hello Michael –
I have posted here and the past. I still visit the site and had to respond when I saw your inquiry for feedback.
To briefly summarize -
My husband was diagnosed with EC in November 2008 – T1NOMO, Stage I / borderline Stage II with squamous cell , located at the GE junction. He received chemo (Cistplatin / 5-FU) with concurrent radiation. Total of 4 rounds of chemo. Overall, he tolerated it well but had to be hospitalized twice due to his heart issues while on chemo. The tumor was totally eradicated after treatment. He was not a surgical candidate due to major heart issues and being on blood thinners. If he had the operation, it would have been too risky, including an MIE.
To date, he is fine and still NED. He is monitored very closely and now his check-ups are every six months. The doctors are confident that he has beaten this with treatment alone. Each patient is different and not everyone can sustain the surgery, as it is a huge recovery process. It is great if you can have the surgery, but many cannot due to other health concerns.
Take one phase at a time and confer with your doctors, as they are the experts. Also, trust your own instincts and do the research.

Best regards,
Marielle