70 year old father eshogeal surgery

pam716

My almost 70 year old father was diagnosed about 3 weeks ago T3N0M0 esophageal cancer and is scheduled for surgery on Thursday. He has diabetes, kidney disease, and cardiovascular disease. Is there anyone who has had the surgery that had other chronic illness? I keep telling myself that they would not suggest the surgery if they did not think that he would survive but I am not sure if that is the case.

ritawaite13

Hi Pam
I'm sorry to hear of your Dad's diagnosis but encouraged that he's at an operable stage. Several on here are at Stage IV (including my husband) where surgery is not an option. I'm quite new here myself but I'm sure many more experienced patients and caregivers will weigh in shortly and give you some great advice. You've definately come to the right site here. There are many people on here who are more knowledgable than some of the medical people we encounter on this road. I'm sure they will tell you to make sure your dad is at a good place where they do this surgery more than just occasionally. They will ask you if he's having MIE or Ivor Lewis surgery. As far as your dad's other health problems, I think they'll become secondary as he fights EC. Best wishes to you and your dad as you go forward.
Rita

chemosmoker

Wishing your DAD great success...
Pam,
I would just want to know that the surgeon doing your dad's EC surgery is an EXPERT thoracic surgeon who does many of these types of surgeries a WEEK, not a few, or a few a year. THAT would scare me allot.

He is lucky to be a stage III and able to have surgery.
I am not as I am a stage IV.

I have some concerns though;
I am sure they feel he is a candidate for surgery if they are offering it to him. There are many levels of wellness with all of the other conditions that you listed him as having, just like cancer, like stages, so maybe they do not feel that his other conditions are so bad that he would not be olkay handling this too. Surgery is the ONLY option to SURVIVE from EC, so if he is a candidte, then doctors know this, and must feel that he will live through not only this, but through his other hadicaps as well?

How "ill" is he, as far as his heart and kidneys and all? Diabetes alone can be a killer for the kidneys, and so can Chemo. I noticed you didn't mention any chemo or radition? Are they not planning to do any of those FIRST, or afterwards?

The BIGGEST question I and many other would ask would be WHAT CANCER CENTER is your dad being diagnosed and treated at? THAT alone can make all the difference in surviving this cancer.

I am sorry to hear that your dad is facing this horrible beast, on top of already being so burdened with health issues. I will add both of you to my prayer list.

May God bless you and carry you both through this journey, and may your dad fair well.

Please, post more information when you can and feel free to ask many questions. There are SO many great people on this board that can offer so much good advice and names of doctors that can do this surgery successfully. There are ONLY a handful sadly. Welcome to our group and glad you found the board!

-Eric

unclaw2002

Pam,
Please tell us a little
Pam,

Please tell us a little more. The standard proticol for Esophageal Cancer treatment of folks at stage III - is first chemo and radiation (usually 2 to 3 cycles) a follow up scan and then surgery and perhaps clean up chemo. Where is he being treated, who is his doctor, and what type of surgery are you considering.

Now one of the most important questions, although your dad has some other health issues, as most people who are older do what is the state of his general health. Is is active? Is he engaged in life? My dad was 78 when he was diagonosed and had type II diabeties and high blood pressure --- those health conditions were important consideration especially in choosing chemo agents because some are harder on the kidneys than others. And he had healing issues because of the diabeties. But those things alone would not have stopped the option of him having surgery, what kept him from having surgery is that the cancer spread to his liver. Everyone is an individual and everyone reacts to everything differently. And as I get older 70 doesn't seem so old anymore

As to your question will he survive - no one knows the answer but I would say that the doctor's must have a reasonable chance of thinking he would survive surgery. That being said, good enough is not good enough with Esophageal Cancer and Eric is right --- you need to be at a cancer center specializing in Esophageal Cancer with a surgeon who performs these surgeries on a daily basis. This is complex and delicate surgery.

Good luck,
Cindy

BMGky

My husband was diagnosed
My husband was diagnosed just before his 70th birthday. His medical history included Type II diabetes, well controlled; previous quadruple by-pass with subsequent incision hernia repair. He had some extra weight on him which helped him during treatment as he had a food tube and ate nothing by mouth for 5 months prior to surgery.

I am interested they are operating so quickly. My husband had chemo/radiation treatment [which was hard on him] before he had the surgery. I think there are some on here who have likewise had surgery prior to chemo/radiation; however, except in circumstances that might require a different approach, the current thinking seems to be chemo/rad before surgery. Yet, physicians know what is best under the presenting patient's medical condition.

I echo the encouragement to have the surgery by knowledgeable, experienced, frequent performers of either the MIE (best if your father is a candidate) or an Ivor Lewis [more invasive with more challenging recovery, but doable. This is what my husband had.)

It would be helpful to know where your father is being treated and his surgeon's name. Others who have received treatment can relate their experiences and/or offer suggestions for a second opinion.

Sorry you had to find us, but you'll find this site to more helpful than those scary, statistical sites that build anxiety. This is the Cancer Survivor's Network. When those are given the opportunity for surgery with EC, there is a hope of survival. There are several on here who have survived more than 5 years. My husband is post surgery 18 months and his last scan showed no evidence of disease.

Good luck. BMG

paul61

No chemotherapy prior to surgery??
Pam,

There are a number of survivors here that have had surgery with other medical issues. If your father is a candidate for a minimally invasive esophagectomy; an MIE may be preferable from a recovery perspective.

But, like others here, I am curious why they are not doing chemotherapy prior to surgery? I can tell you, as a survivor who ended up doing post surgery chemotherapy, that chemotherapy is much harder post surgery.

In my case, they thought I was T2N0M0 and went directly to surgery with no prior chemotherapy. The post surgery pathology showed active cells in one of the lymph nodes removed. I ended up doing chemotherapy while recovering from surgery.

I would ask your father’s medical team why they are not using the US standard of care (which is a tri-modal approach that includes chemotherapy, radiation, and then surgery).

And of course as others recommend, best results come from major cancer centers that perform many of these complicated surgeries each year.



Best Regards,

Paul Adams
McCormick, South Carolina

DX 10/22/2009 T2N1M0 Stage IIB
12/03/2009 Ivor Lewis
2/8 through 6/14/2010 Adjuvant Chemo Cisplatin, Epirubicin, 5 FU
3/14/2011 CT Scan NED

Life may not be the party we hoped for, but while we are here we might as well dance!

paul61

No chemotherapy prior to surgery??
Sorry, Duplicate post.

pam716

BMGky said:

My husband was diagnosed
My husband was diagnosed just before his 70th birthday. His medical history included Type II diabetes, well controlled; previous quadruple by-pass with subsequent incision hernia repair. He had some extra weight on him which helped him during treatment as he had a food tube and ate nothing by mouth for 5 months prior to surgery.

I am interested they are operating so quickly. My husband had chemo/radiation treatment [which was hard on him] before he had the surgery. I think there are some on here who have likewise had surgery prior to chemo/radiation; however, except in circumstances that might require a different approach, the current thinking seems to be chemo/rad before surgery. Yet, physicians know what is best under the presenting patient's medical condition.

I echo the encouragement to have the surgery by knowledgeable, experienced, frequent performers of either the MIE (best if your father is a candidate) or an Ivor Lewis [more invasive with more challenging recovery, but doable. This is what my husband had.)

It would be helpful to know where your father is being treated and his surgeon's name. Others who have received treatment can relate their experiences and/or offer suggestions for a second opinion.

Sorry you had to find us, but you'll find this site to more helpful than those scary, statistical sites that build anxiety. This is the Cancer Survivor's Network. When those are given the opportunity for surgery with EC, there is a hope of survival. There are several on here who have survived more than 5 years. My husband is post surgery 18 months and his last scan showed no evidence of disease.

Good luck. BMG

70 year old father espogeal surgey
Thank you so much for all the response. I must have gotten the staging confused because the surgeon said they think he may be in between a stage I and II. The surgeon said that this was on the border of current treatment guidelines concerning chemo and radiation pre-surgery. The oncologist did not seem too keen on doing the chemo pre surgery. The pet scan did not show any nodal involvement but the surgeon did say that after surgery it is not uncommon to have the staging upgraded. My father had a triple bypass 15 years ago and has stage 3 kidney disease. His diabetes is in control and his labs have been stable for a number of years. He is currently anemic and did receive 5 iron infusions within the past 2 weeks. He seems pretty weak to me because of the anemia. He is being operated on at Abbott Northwestern Hospital in Minneapolis. They seem to have a team approach that is similar to the Mayo Clinic. His surgeon is Casandra Anderson and every single one of his doctors seems to say to go ahead with the operation.They are going to try to do minimally invasive surgery but will not be using the davinci because of scar tissue. He also had surgery on his liver when he was 18. I know he is lucky to be given the opportunity for the surgery I just worry that complications from the surgery will take his life. He is normally a fighter but I think that right now this seems insurmountable and there is a alot of fear.

birdiequeen

My husband when straight to
My husband when straight to surgery, i.e. no chemo or radiation. He was Stage I, possibly the standard of care is different depending on the stage. He also had Type II Diabetes but they monitored his sugar levels in the hospital post surgery. He is 50 and doing very well to date. He lost 70 lbs and no longer is on diabetes medication, and in a lot of ways feels better today than he did before surgery, due to the weight loss.

TerryV

Boss' father had no chemo preSurgery
My boss' father was diagnosed as a Stage II over 15 years ago. He received only radiation then surgery. Chemo was not deemed necessary at his stage, nor did he require post-surgery chemo. He is more than 15 years NED.

My husband as a Stage 3, T3N1M0, had 28 radiations and 2 weeks of in-patient chemo pre-surgery. He was blessed to receive a clean path following surgery, so no post-surgery chemo for him.

It must be that different stages have varied approaches to resolution. If you have concern that your father may not be receiving the best approach, 2nd opinions are always recommended. 3rds if you need it

Terry
Wife to Nick, age 48
dx T3N1M0 05/19/11
THE 09/08/11

Pghmomma

TerryV said:

Boss' father had no chemo preSurgery
My boss' father was diagnosed as a Stage II over 15 years ago. He received only radiation then surgery. Chemo was not deemed necessary at his stage, nor did he require post-surgery chemo. He is more than 15 years NED.

My husband as a Stage 3, T3N1M0, had 28 radiations and 2 weeks of in-patient chemo pre-surgery. He was blessed to receive a clean path following surgery, so no post-surgery chemo for him.

It must be that different stages have varied approaches to resolution. If you have concern that your father may not be receiving the best approach, 2nd opinions are always recommended. 3rds if you need it

Terry
Wife to Nick, age 48
dx T3N1M0 05/19/11
THE 09/08/11

Hello and welcome,

not a great place to welcome you too but you will be loaded with great info and you will here lots of great stories.

First off, Im sorry to hear about your dad. My dad was DX around thanksgiving of 09 at stage 3. He was seen at Presby by Dr.Luketich. What a great man If I do say so myself. When they saw my dad he was having issues keeping things down. When for a couple tests then the GI dr set him up with an appt right away with Dr. L. Dr.L saw him and said that they were going to do surgery first to remove the tumor because they didnt feel like waiting with chemo because it could of turned into stage 4 very very quickly. So the set up for him to have the MIE surgery done Dec 6th 2009. In the mean time he went for a 2nd opinion because he wanted to know if he should really have chemo/radition first. They told him to go stright for surgery. He did and recovered well. Had a leak after words spent another wk in the hospital but came home for new years and was doing great. Went back to work and was keeping his weight up. He went thur chemo afterwards and did great with someset backs. He then came down with a fever april 1st of 2010. He was put in the hospital to recover cause they told him he had fluid in the lungs. Well he never did make it out of the hospital. Come to find out they were treating him for pnenioua (sp?) which he didnt have. He had a leak which they did not dectect and which caused him to have ARDS which is a complete whiteout of your lungs and basicaly your body ends up shutting down little by little. But If he was here today he would have been doing great and living a GREAT life!

Keep your head up and stay strong
Tina