What to Expect.....Endoscopy Squamous Cell

Wife of patient 50378

Dan fininshed Chemo/Radiation. Side effects were minimal during treatment, afterward some hair loss and undescribable pains here and there. His Esophagus is still very sore from the Radiation, his stricture opened up for awhile and was able to eat(somewhat) instead of drink his meal. Now 7 week after treatment, his esophagus …is closing up again….. Back to liquids. This would probably mean scarr tissue right.. not tumor growth?

When he was initial tested for Esophageal Cancer they were not able to move the scope pass the stricture.. I am afraid this may be the case next week.

Any thoughts?

Sal
Wife of Patient (Dan)
T3N1M0 Squamous Cell

Unknown

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JaneO

Similiar situation
Sal,
Jack recently ended (12-9-11) his first treatment which inclued EOX and Xeloda daily. Within a week he began complaining that swallowing was becoming a problem. The PET on Dec 14th showed the lymph nodes were no longer hot, but the tumor still was. We began planning the next treatment plan and found an excellent onc at Dana-Farber in Boston. This process took several weeks and by last Sunday Jack's throat was closing up so much that he got food stuck. We ended up at the ER last Sunday. He was admitted because he couldn't even drink liquids. We are still here, but getting out tomorrow. A J-tube was put in yesterday. The surgeon said the esophagus is very restricted. He couldn't get the tube down to put in the J-Tube so they went in through his belly. He now has four new "holes" in his belly. Jack is now scheduled for radiation/chemo next week and we are hopeful that will open the area up enough to eat again. He is on a liquid diet also and the tube is there to supplement his nutrition until after radiation. Jack will continue chemo for up to a year. They told us the tumor didn't necessarily get bigger (it was just still hot), chemo needs to keep killing as many cells as possible. Don't panic! All the doctors here were not so concerned. They believe the treatments are still on course and Jack really needs to keep going. The holidays did not help any either..it dragged the weeks out.
Jane
Caregiver to Jack (T3N2M1)Dx July 2011

Wife of patient 50378

what questions to ask?
I had a conversation with the Onco nurse. I asked many questions and stated my concerns. Shortly they after, the Dr. Called Dan scheduled the Endoscopy for this Wednesday, the Pet and CT scan were already scheduled for the 17th. She explained to Dan that after all results are in there will be a serious discussion regarding his treatments including surgery.

William, I strongly believe that if Dr. stresses sugery will save his life, Dan will have the surgery. I believe 1. Dan is afraid of dying during surgery, I have explained he has no other health issues to complicate surgery. 2.The life changes after surgery, my answer; better then the alternative. 3. he is afraid of having the surgery then having a reocurrence... a valid concern, but without the surgery... he will more than likely have a reocurrence and move to the stage IV zone.

Jane, I thought that after radiation/chemo the stricture opens then the esophagus restricts again for a SHORT period of time?

Another questions after Chemo/Radiation; most have a complete response? Meaning that the tumor has shrunk and no sign of cancer?

What is a partial response?...Tumor shrunk but cancer is still active? With a partial response is surgery still an option?

What if there is no sign of cancer cells and tumor has not shrunk 50%?

Maybe we should also revisit feeding tube discussion with dr. Dan is very motivated to sustain his weight but is losing ...slowly

I want to know what questions to ask.

Thank you William for your imput.
And you too Jane, you are in my prayers.
Sal

TerryV

Wife of patient 50378 said:

what questions to ask?
I had a conversation with the Onco nurse. I asked many questions and stated my concerns. Shortly they after, the Dr. Called Dan scheduled the Endoscopy for this Wednesday, the Pet and CT scan were already scheduled for the 17th. She explained to Dan that after all results are in there will be a serious discussion regarding his treatments including surgery.

William, I strongly believe that if Dr. stresses sugery will save his life, Dan will have the surgery. I believe 1. Dan is afraid of dying during surgery, I have explained he has no other health issues to complicate surgery. 2.The life changes after surgery, my answer; better then the alternative. 3. he is afraid of having the surgery then having a reocurrence... a valid concern, but without the surgery... he will more than likely have a reocurrence and move to the stage IV zone.

Jane, I thought that after radiation/chemo the stricture opens then the esophagus restricts again for a SHORT period of time?

Another questions after Chemo/Radiation; most have a complete response? Meaning that the tumor has shrunk and no sign of cancer?

What is a partial response?...Tumor shrunk but cancer is still active? With a partial response is surgery still an option?

What if there is no sign of cancer cells and tumor has not shrunk 50%?

Maybe we should also revisit feeding tube discussion with dr. Dan is very motivated to sustain his weight but is losing ...slowly

I want to know what questions to ask.

Thank you William for your imput.
And you too Jane, you are in my prayers.
Sal

Not sure how many of these I can answer, but I'll try....
Hey Sal!

Glad to hear you think Dan will take surgery if Doc recommends it. Got to tell you - Nick had zero doctor/hospital experience in his adult life (a few as a kid) and was terrified of the whole cancer thing. There wasn't anything about treatment or surgery to give him a feeling of comfort. But, like you say, the alternative to not having surgery is worse. And he finally came to realize that. He had hopes that the doctor would come out and say "we've killed it, no surgery needed" - but he knew better. And he went into surgery terrified of going under the anestesia. At least he had a new fear to focus on, right? LOL We are now 4 months past surgery and life IS good. Almost a pre-cancer normal, even. There have been a few necessary changes in activity levels - Nick tires easily yet - and while his diet has not changed, his plate size has. That's not a worry either, we all benefit from better eating habits.

On to your questions

Another questions after Chemo/Radiation; most have a complete response? Meaning that the tumor has shrunk and no sign of cancer?
I believe that most that I've seen list themselves as surgery candidates have had a complete presurgery response to rads & chemo. There have been a few that required post surgery chemo, but thankfully not as many as received a clean path.

What is a partial response?...Tumor shrunk but cancer is still active? With a partial response is surgery still an option?
Gosh, I don't know the answer to this.

What if there is no sign of cancer cells and tumor has not shrunk 50%?
Is this possible? I thought if the cancer was killed, the tumor shrank.

DO revisit the feeding tube idea. We hated the durn thing - it was our visible sign of Nick's cancer, but it was a "nice to have" when Nick needed it.

Gosh, I would have thought I might be able to answer more than one of your questions. I'm sure others will chime in for you.

Love & Hugs,

Terry

jss2011

TerryV said:

Not sure how many of these I can answer, but I'll try....
Hey Sal!

Glad to hear you think Dan will take surgery if Doc recommends it. Got to tell you - Nick had zero doctor/hospital experience in his adult life (a few as a kid) and was terrified of the whole cancer thing. There wasn't anything about treatment or surgery to give him a feeling of comfort. But, like you say, the alternative to not having surgery is worse. And he finally came to realize that. He had hopes that the doctor would come out and say "we've killed it, no surgery needed" - but he knew better. And he went into surgery terrified of going under the anestesia. At least he had a new fear to focus on, right? LOL We are now 4 months past surgery and life IS good. Almost a pre-cancer normal, even. There have been a few necessary changes in activity levels - Nick tires easily yet - and while his diet has not changed, his plate size has. That's not a worry either, we all benefit from better eating habits.

On to your questions

Another questions after Chemo/Radiation; most have a complete response? Meaning that the tumor has shrunk and no sign of cancer?
I believe that most that I've seen list themselves as surgery candidates have had a complete presurgery response to rads & chemo. There have been a few that required post surgery chemo, but thankfully not as many as received a clean path.

What is a partial response?...Tumor shrunk but cancer is still active? With a partial response is surgery still an option?
Gosh, I don't know the answer to this.

What if there is no sign of cancer cells and tumor has not shrunk 50%?
Is this possible? I thought if the cancer was killed, the tumor shrank.

DO revisit the feeding tube idea. We hated the durn thing - it was our visible sign of Nick's cancer, but it was a "nice to have" when Nick needed it.

Gosh, I would have thought I might be able to answer more than one of your questions. I'm sure others will chime in for you.

Love & Hugs,

Terry

partial response
This info is direct from hubby's onc. The goal is a complete response ( best case scenario)
however in most cases there is a partial response. The goal is to shrink tumor as much as possible before surgery and reduce node involvement.

Hope this helps.

Julie

Donna70

jss2011 said:

partial response
This info is direct from hubby's onc. The goal is a complete response ( best case scenario)
however in most cases there is a partial response. The goal is to shrink tumor as much as possible before surgery and reduce node involvement.

Hope this helps.

Julie

Sal just a little hope about stricture
Hi Sal,
Don't see many squamous cell patients on this board. I had a terrible time after radiation and chemo to eat or swallow much and had to have NG tube put in before surgery just to have enough nutrition to survive the surgery. My stage was T3N1MO. But wanted to give you some hope, my friend has Stage IV lung cancer and is surviving 3 yrs with that diagnosis, but what I wanted to tell you, she got radiation in the same area of the chest that those of us with squamous cell get it right over the breasts and sternum. She has been stretched 3-4 times because the radiation there gave her so much damage she gets strictures from that radiation. So maybe it is the radiation side effect or maybe a tumor. I will be praying it is inflammation and scar tissue and not tumor. I got a PET scan before my surgery and it was all clear to go ahead with the surgery, the long involved one, they found all the tumor destroyed the original bad node destroyed but one of the 19 nodes removed was positive so had post op chemo. Still here over 2 yrs later so, hoping your hubby can get the surgery. Also my first pet scan lit up like a Xmas tree, but did not show the tumor or node a lot of false positives. There is always hope. take care will keep you all in my prayers,
Donna70