Detailed info re Esophageal Cancer from start to finish including stages and statistics~from "Cancer

LorettaMarshall
LorettaMarshall Member Posts: 662 Member
edited December 2016 in Esophageal Cancer #1

Below my name are some “startling” facts and statistics.  It is just something that should be considered once you have heard the words, “You have Esophageal Cancer!” 

 What do I know, you might ask?  For starters, after a couple of months of one pesky HICCUP each time my husband took his first bite of food, I decided that we should go to the doctor to see why this might be happening.  Our internist said it was no doubt gastric in nature, and that we should make an appointment with a Gastroenterologist.  A what?  We had never heard the word, and we surely didn’t know how to pronounce “Endoscopy”!  But our doctor set up an appointment that very day.  Two days later, my husband, William Marshall, had the Endoscopy.  The nurse instructed me to not let him drive, and after about 12 hours he should be okay.  So we went home not knowing when to expect a report, and dumb enough about it all, not to know what questions to ask!  But boy have we wised up since then. 

 The day after the Upper Endoscopy, not to be confused with an Ultrasound Endoscopy, our phone rang about 2:30 P.M. in the afternoon.  We were both at our computers, and I answered the phone.  The conversation went something like this.  “Mrs. Marshall, this is Dr. Ryan.  I do wish your husband had stayed around yesterday.  I needed to talk with you.  Your husband has CANCER!”  After I caught my breath, and picked my heart up off the floor, I said, “Esophageal—Squamous—how do you spell it?”  This was the beginning of a whole new era in our life.  We had never heard of Esophageal Cancer although we were informed enough to know that the Esophagus was a part of the human anatomy.  This began a whole series of appointments and scans and tests performed by people whom we had never met before! 

At first we were so naïve that when we were told my husband first needed to have pre-op (neo-adjuvant) chemo and radiation to shrink and/or kill the tumor, we immediately ruled OUT chemo.  To us chemo and death were closely related.  In our “uninformed” state, we said, “Well chemo is out.  That stuff will kill you.  We’ll just go to the doctor and have it cut out!” Mind you this was the perfect example of “uninformed” thinking.

Our surgeon begged and pleaded with us to please consult an oncologist, and not to rule out the chemo/radiation treatment first.  And so in a good-will gesture toward our surgeon, we said, “Okay we’ll go to see the oncologist because we don’t want to appear uncooperative!”  Well, even after visiting the onc and being told that clinical trials had shown that those who have the tri-modal treatment and have the pre-op treatments first tend to have better outcomes, we remained hell-bent on not having the chemo.  But after further prayer and a bit of research, we agreed to take the surgeon and oncologist’s advice. 

 It’s difficult for me to make a long story short, but he is a survivor now entering his 14th year of survival, even though we know recurrence is always a possibility.  We asked our oncologist, “Should we be saying William is healed?”  Our oncologist said, “I’d prefer you say that you are in REMISSION.”  And so that’s what we say, and so far there has not been any problems or recurrence.  He still gets regular checkups twice yearly by his oncologist.  We can’t recommend neo-adjuvant chemo/radiation and then an Ivor Lewis Minimally Invasive Esophagectomy highly enough if that is what one’s doctor recommends.  Please don’t think you have the “luxury of a wait-and-see” attitude.  This cancer can be deadly, and it can move rapidly. 

And by all means, have a SECOND opinion.  My husband’s final diagnosis was, Adenocarcinoma at the Gastroesophageal (GE) junction.  It was staged “T3N1M0”--meaning that the cancer had already penetrated all four muscular walls of the Esophagus and had infiltrated 2 lymph nodes.  “T3” is considered an advanced Stage.  And because we know that others will be as shocked as we were to learn that they have been diagnosed with Esophageal Cancer, this “Cancer.net” link is one that gives a good understanding of what can be expected when cancer enters their world. 

 My own experience was that I had no prior symptoms to think that I had a problem.  After “accidentally” but actually “providentially” discovering a small knot on the left hand side of my abdomen just below the belt, I went to the doctor thinking I had a hernia.  A CT at the Emergency Room would “enlighten” me as to the real problem.  Try on a Stage IV Peritoneal Carcinomatosis for starters.  Then a Second Opinion and exploratory surgery would also reveal that cancer was in my ovaries as well.  So much for my ability to diagnose my own condition.  Stage IV is terminal and only “The Great Physician” knows the whole story.  That was in November of 2012.

 In an effort to help others who are trying to figure out how long they are going to live after a cancer diagnosis, speaking as a Stage IV Cancer patient myself, that is something known only to God.  However, we do have “statistics” to use as a guideline to help us make the very best decisions and to seek out the very best doctors while we are still alive on this earth!  So here are a couple of different sections from the “Cancer.net” site which I’ve found to be so easily understood and always “up-to-date”.

 So allow me to just post them here to give you an idea of the “urgency” with which anyone having an Esophageal Cancer diagnosis should proceed.  By all means get a “second opinion” rather than trying to “second guess” how things will turn out, please!  Just like no two people have the same fingerprints, neither are all hospitals the same, and definitely not all thoracic surgeons have the same set of skills!

Incidentally, this is the first day of winter.  Some of my relatives in Michigan who have already had multiple snows would say, “Oh Really?”  So let me wish all of you a Merry Christmas.  It’s still good to be alive, even though not cancer free. 

 Loretta Marshall, Peritoneal Carcinomatosis/Ovarian Cancer, Stage IV, diagnosed 11-2012….


  • And the wife of William Marshall, diagnosed at age 65, (2002) with Esophageal Cancer, Stage III, (T3N1M0).  He had neo-adjuvant chemo/radiation and then a successful Minimally Invasive Ivor Lewis Esophagectomy (MIE) by Dr. James D. Luketich at the University of Pittsburgh Medical Center, May 17, 2003.  Currently we are enjoying and celebrating William's 14th year of survival without a recurrence, although recurrence always remains a possibility. 

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  1.  http://www.cancer.net/cancer-types/esophageal-cancer/overview

 This gives an overview of Esophageal Cancer in particular.

 “…Cancer begins when healthy cells change and grow uncontrollably, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread. Esophageal cancer, also called esophagus cancer, begins in the cells that line the esophagus.

 Specifically, cancer of the esophagus begins in the inner layer of the esophageal wall and grows outward. If it spreads through the esophageal wall, it can travel to lymph nodes, which are the tiny, bean-shaped organs that help fight infection, as well as the blood vessels in the chest and other nearby organs. Esophageal cancer can also spread to the lungs, liver, stomach, and other parts of the body…”

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2.  http://www.cancer.net/cancer-types/esophageal-cancer/statistics

 “Esophageal Cancer: Statistics

 Approved by the Cancer.Net Editorial Board, 10/2015 - ON THIS PAGE: You will find information about how many people are diagnosed with this type of cancer each year.  You will also learn some general information on surviving the disease. Remember, survival rates depend on several factors. To see other pages, use the menu on the side of your screen.

 This year, an estimated 16,910 adults (13,460 men and 3,450 women) in the United States will be diagnosed with esophageal cancer.

It is estimated that 15,690 deaths (12,720 men and 2,970 women) from this disease will occur this year. Esophageal cancer is the seventh most common cause of cancer death among men.

 The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. The 5-year survival rate for people with esophageal cancer is 18%. 

 However, survival rates depend on several factors, including the stage of the cancer when it is first diagnosed.

 The 5-year survival rate of people with cancer located only in the esophagus is 40%.

  The 5-year survival rate for those with disease that has spread to surrounding tissues or organs and/or the regional lymph nodes is 22%.

  If it has spread to distant parts of the body, the survival rate is 4%.

 It is important to remember that statistics on how many people survive this type of cancer are an estimate. The estimate comes from data based on thousands of people with this cancer in the United States each year. So, your own risk may be different.

  Doctors cannot say for sure how long anyone will live with esophageal cancer. Also, experts measure the survival statistics every 5 years. This means that the estimate may not show the results of better diagnosis or treatment available for less than 5 years.

   Learn more about understanding statistics.

  Statistics adapted from the American Cancer Society's publication, Cancer Facts & Figures 2016.

 The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by this disease. Or, use the menu on the left side of your screen to choose another section to continue reading this guide.”  

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 3.   http://www.cancer.net/navigating-cancer-care/cancer-basics/understanding-statistics-used-guide-prognosis-and-evaluate-treatment

 “Understanding Statistics Used to Guide Prognosis and Evaluate Treatment

 Approved by the Cancer.Net Editorial Board, 03/2016

 One of the first questions people diagnosed with cancer may ask is, “what’s the chance of survival?” Understanding survival statistics becomes very important. A doctor can use them to estimate a patient’s prognosis, or chance of recovery, and determine treatment options. Read below to learn how.

 Estimating how long people live after a cancer diagnosis

 Researchers usually give survival statistics as rates. The rates describe the percentage of people with a specific cancer type who will be alive a certain time after diagnosis. Survival rates can describe any given length of time. However, researchers usually give cancer statistics as a 5-year relative survival rate. The rate describes the percentage of people with cancer who will be alive 5 years after diagnosis. It does not count those who die from other diseases.

 Sometimes, researchers calculate survival statistics to include all people with a specific cancer type. The stage of cancer doesn’t matter. Researchers call this an overall rate.

 Example: The 5-year relative survival rate for women with cervical cancer is about 68%. This means that about 68 out of every 100 women with cervical cancer will be alive 5 years after diagnosis.

 Researchers calculate other survival statistics for specific cancer stages. The stage indicates the tumor’s size. It also describes whether and how far the cancer has spread. Survival statistics can vary by stage.

 Example: The 5-year relative survival rate for early-stage cervical cancer is 92%. This means that 92 out of every 100 women with early-stage cervical cancer will be alive 5 years after diagnosis.

 Calculating how many people are cancer free or have cancer that’s not growing or spreading

 Five-year relative survival rates include people in remission. Remission is the temporary or permanent absence of disease. The rates also include those still in treatment. Disease-free survival (DFS) statistics and progression-free survival (PFS) statistics are more specific survival statistics. Doctors often use them to evaluate cancer treatments.

DFS rates refer only to the percentage of people who are in complete remission after finishing treatment.

 PFS rates describe the percentage of people who don’t have new tumor growth or cancer spread during or after treatment. The rates include those whose disease responded completely or partially to treatment. They also include those whose disease is stable. That means the cancer is still there but not growing or spreading.

 Determining prognosis

 Another question people often ask after a cancer diagnosis is whether the doctor can successfully treat the disease. Doctors use survival statistics to make prognosis predictions.

 Example: The overall 5-year relative survival rate for testicular cancer is 95%. Therefore, a doctor may tell a man diagnosed with the disease that he has a favorable prognosis.

 Similar to survival statistics, prognosis also depends on the stage of the cancer at diagnosis.

 Example: If doctors detect colorectal cancer early, the 5-year relative survival rate is 90%. For advanced stage colorectal cancer that’s spread to distant parts of the body, the rate drops to about 13%.

 Evaluating treatment options

 Doctors often use 5-year relative survival rates to evaluate and compare different treatment options. They consider the 5-year relative survival a good indication that:

  •  The cancer is responding to treatment, and
  • The treatment is successfully extending the life of the person with cancer.

 Survival statistics help doctors decide which treatments provide the most benefit to people with cancer. The statistics also help them decide whether the benefits outweigh any of a certain treatment’s risks, such as unpleasant side effects. Learn about making decisions about cancer treatment.

 The concept of “cure”

 Doctors generally consider cancer cured after they treat the disease and it doesn’t return. The concept of “cure” is hard to apply to cancer. Sometimes undetected cancer cells can remain in the body after treatment. The cells can cause the cancer to return later. Doctors call this a recurrence or relapse. The medical community considers many cancers “cured” when doctors can’t detect cancer 5 years after diagnosis. However, recurrence after 5 years is still possible.

  Points to remember

 Statistics are estimates that describe trends in large numbers of people. Doctors  can’t use statisticsto predict what will actually happen to an individual.

  • Survival statistics for different cancer types, cancer stages, age groups, or time periods can vary greatly. Ask your doctor for the most appropriate statistics based on your individual medical condition.
  • Ask your doctor to explain any cancer-related statistics that seem unclear.
  • Researchers base five-year survival statistics on patients doctors treated at least 5 years ago. The statistics may not reflect the latest treatment advances.
  • Survival statistics give doctors useful information when they decide among treatment options. However, statistics should be only one factor in a complete treatment plan designed for your individual situation.

 Statistics adapted from the American Cancer Society's publication, Cancer Facts & Figures 2016, and the National Cancer Institute Surveillance Epidemiology and End Results (SEER) database.

 More Information

 Understanding Statistics Used to Estimate Risk and Recommend Screening

 Understanding Cancer Risk

 Survivorship”

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