DCF Regimen for locally advanced Esophagal cancer
Hi,
My father is diagnosed with esophagal cancer- with poorly differentiated squamous carcinoma in middle one third and lesions in lower one third of esophagus.
The doctor has recommended for chemotherapy before surgery evaluation . and he is suggesting DOcataxel, cisplastin and 5-FU for three cycles.
what are the chances of positive response to this regimen.
\Please suggest.
Thanks
Comments
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Helpful info for you & your Dad
·
· Swetha:
Perhaps I should begin with a “good news report”. My husband, William W. Marshall, now 78 years of age, was diagnosed with Adenocarcinoma at the GastroEsophageal junction. (EC T3N1M0). He was 65 at the time. He underwent the following chemo/radiation regimen prior to his Ivor Lewis MINIMALLY INVASIVE ESOPHAGECTOMY at the University of Pittsburgh Medical Center (UPMC) on May 17, 2003. His only symptom was a hiccup. We vowed that if he lived through this, that we would help as many people as possible to understand more about this cancer. It has been a real joy to be able to help oh so many in the years that have followed.
His “neo-adjuvant” (Pre-op) treatment consisted of Carboplatin and 5-FU via a medi-port, together with 25 sessions of radiation. At the completion of this pre-op treatment, the cancer had been totally eradicated. However, surgery was still necessary to be certain that no cancer was left in his body. Fast forward to today, he has now entered the 14th year of remission with no evidence of disease (NED). We are indeed blessed.
Husband’s treatment schedule:
· Week 1 ~ (02-10-03) Chemo 96-hr. continual infusion of Carboplatin/5-FU (Fanny pack)
· Weeks 2, 3, and 4 ~ (02-17-03) 5-day-a-week radiation treatment. (No CyberKnife equipment (targeted radiation) in this area in 2003, but now we do have one in our Tidewater area.)
· Week 5 ~ Combination radiation plus SECOND chemo continuous 96-hr. infusion (Fanny pack)
· Week 6 ~ (03-17-03) Final week of radiation.
· Repeat PET Scan on 04-28-03 ~ results - COMPLETE ERADICATION OF TUMOR in Esophagus and the 2 affected lymph nodes
Surgery was scheduled approximately 3 weeks later after successful pre-op treatment. Radiation does cause scar tissue, so the sooner the surgery after the pre-op treatments—the better.
You leave much unsaid about the “stage” of your father's cancer, his age, symptoms, present state of health, etc. Are we to assume that he has already undergone all the “preliminary” tests to ascertain the exact stage and infiltration of this cancer?
Please note this link to know the “workup” that should be done prior to recommending a prescribed treatment.
Here is a brief analysis of my husband’s treatment schedule after a thorough workup. Furthermore, I would always suggest a SECOND OPINION by a reputable cardio-thoracic surgeon who performs multiple Esophagectomies during a year.
2. http://www.webmd.com/cancer/features/cancer-when-do-you-need-a-second-opinion-and-why?page=2
And even further, I would suggest the best surgery to have is a Minimally Invasive Esophagectomy. It was first introduced in the mid-1990s by Dr. James D. Luketich at the University of Pittsburgh Medical Center, and is the surgery of choice at UPMC.
There are so many things you need to know that one cannot begin to enumerate them here. But this should give you some idea of how to inform yourself about the best treatment going forward for your Dad. While you didn’t mention radiation, studies have shown that “tri-modal” treatment consisting of chemo/radiation plus surgery have produced the best outcomes.
I surely hope that everything will go well for him, and that he, too, can be a “poster child” for Esophageal Cancer. It is a wicked cancer, but there are survivors.
Wishing you and your Dad all the best,
Loretta Marshall
(William’s wife - currently in treatment for Stage IV Ovarian Cancer)
P.S. Below are web links that will help you to understand the drugs and their side effects. I highly recommend CHEMOCARE.COM for a thorough understanding of the drugs your father will be taking.
I would highly recommend this web link for a more complete understanding of the drugs you mention, their efficacy, and side effects.
3. http://chemocare.com/default.aspx
All three of these drugs are given by infusion. The first thing my husband had implanted was a “medi-port”. This is far superior to having to search for a vein each time a treatment is given.
4. https://www.youtube.com/watch?v=FvgEaDVCKfA
Informational video explaining Esophageal Cancer
5. https://www.youtube.com/watch?v=ei4cOvFIqPY
Another informational video re Esophageal Cancer
6. https://www.youtube.com/watch?v=mFboj87THJE
Dr. James D. Luketich at University of Pittsburgh Medical Center, Pioneer of the Ivor Lewis Minimally Invasive Esophagectomy. Dr. Luketich has modified this surgery even more. The surgery consists of Band-Aid cuts instead of major incisions. He now makes the incision where the diseased Esophagus is removed, further down on the right side of the chest. This has made a major difference in reducing potential damage to the Pharyngeal or Laryngeal nerves, which can pose a problem at times.
7. http://chemocare.com/chemotherapy/drug-info/docetaxel.aspx
Docetaxel
(doe-se-TAKS-sel)
“Trade name: Taxotere®
Chemocare.com uses generic drug names in all descriptions of drugs. Taxotere is the trade name for docetaxel. In some cases, health care professionals may use the trade name taxotere when referring to the generic drug name docetaxel.
Drug type: Docetaxel is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as a "plant alkaloid," a "taxane" and an "antimicrotubule agent." (For more detail, see "How this drug works" section below)…”
8. http://chemocare.com/chemotherapy/drug-info/cisplatin.aspx
Cisplatin
“Trade Names: Platinol ®, Platinol®-AQ
Other Name: CDDPDrug Type:
Cisplatin is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Cisplatin is classified as an "alkylating agent." (For more detail, see "How Cisplatin Works" section below).
What Cisplatin Is Used For:
· Used to treat testicular, ovarian, bladder, head and neck, esophageal, small and non-small cell lung, breast, cervical, stomach and prostate cancers. Also to treat Hodgkin's and non-Hodgkin's lymphomas, neuroblastoma, sarcomas, multiple myeloma, melanoma, and mesothelioma….”
9. http://chemocare.com/chemotherapy/drug-info/fluorouracil.aspx
Fluorouracil
Trade Name: Adrucil ®
Other Names: 5-fluorouracil, 5-FUDrug type:
Fluorouracil is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Fluorouracil is classified as an "antimetabolite." (For more detail, see "How Fluorouracil Works" section below).
What Fluorouracil Is Used For:
· Colon and rectal cancer.
· Breast cancer.
· Gastrointestinal cancers including: anal, esophageal, pancreas and gastric (stomach).
· Head and neck cancer
* Hepatoma (liver cancer).· Ovarian cancer.
· Topical use (cream or solution) in basal cell cancer of the skin and actinic keratoses. -see document Fluorouracil (cream).
----------------End of references---------------
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