What happens when the pathology report after surgery shows cancer in lymph nodes (1 or 2) and throug

Carey-Ann

My husband has EC and undergone radiation and chemo and just had the minimally invasive surgery and also had 47 lymph nodes removed. We were hoping things were all behind us, but just saw the pathology report taking from the biopsey provided during surgery time. Even though the catscan in advance of the surgery showed Jeff was clear, the report shows that there are 1-2 lymph nodes with cancerous invasion and also that the cancer had gone through the wall of the esophagus (T3) . What happens now. Has anyone survived after lymph nodes showing invasion after chemo and radiation pre-surgery? if so what was your next course of treatment. He is 44 years old and we have two young girls. Help!

Deathorglory

Hello Carey-Ann

Hello Carey-Ann,

There's hope from where you guys are and from even worse spots.  There's a regular poster here, Paul, who was in a very similar spot.  He had additional chemo and has successfully beaten the cancer back.  I'd expect him to respond to you here.  I had essentially the same treatment, but for different reasons.  I had chemo/radiation, then surgery, then bonus chemo.  I had apparently had a complete response to the chemo/radiation as shown by the surgical pathology.  I still did a six month course of bonus chemo because I was young (41) and we wanted to be as aggressive as possible to hopefully give me decades of additional life, not months or years.  The chemo was the same, but much stronger than with the radiation.  It sucked, but it gave me the best chance for long term survival, so we willingly did it. 

 

I mentioned that there's hope from even worse spots than you're in (not that what you're facing is all good & jolly) because even with my apparently successful, extremely aggressive treatment I still had a recurrence.  My recurrence was a couple of years later (I was 44) and in a lung (stage IV).  I was given 7-8 months and told to get my affairs in order sooner, not later.  That was 2011 and I'm still here and still testing clean.  This disease is being more and more successfully treated every year.  The process still sucks, but there's legitimate hope for ultimate success.  

Believe me, I know just how much you hate where you are, but there isn't reason to give up hope.  It can be beaten.  Hopefully you guys are the next ones to beat it back.

Best wishes,

Ed

paul61

Follow up chemotherapy should be ordered

Hello Carey-Ann,

I was in the same situation as your husband after surgery. Prior to surgery I was assured that all scans showed no cancer outside of my esophagus and that the tumor had not penetrated the esophageal wall. After my surgery I was assured everything looked great, clear margins, all the lymph nodes that have been removed looked normal, just sending some to pathology as a precaution.

Then the pathology report came back. Of the 30 lymph nodes removed one of them showed signs of active cancer. Weather they find one or twenty the potential risk is the same. Once active cancer cells enter the limbic system they can travel anywhere in the body.

So after six weeks to recover from surgery; (I had “open” Ivor Lewis surgery with some complications related to a hospital acquired infection), I began six rounds of chemotherapy with Cisplatin, Epirubicin, and Fluorouracil (5-FU). I have to admit chemotherapy after surgery was difficult. I was weak from surgery and was still learning how to eat with my new digestive system. But after the first couple of difficult rounds of chemotherapy I learned some lessons that make the remaining cycles easier.

First, if you husband has a feeding tube, keep the tube until chemo is completed. It is much easier to maintain weight and hydration with the support of the feeding tube. Second, schedule IV hydration two days after his infusions. Dehydration is a common result of chemo and along with dehydration comes nausea and fatigue.

I am blessed to say that I am still here eight years later, and back to doing the things I enjoy with the people I love.

I know doing additional chemo is the last thing he wants to hear, but I am glad I did everything I could to assure a long term remission.

Best Regards,

Paul Adams

McCormick, South Carolina

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
Eight Year Survivor

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

 

PaulT

Follow up Chemo

Carey-Ann,

I was diagnosed stage IV in August 2015 with local and distant lymph nodes involved and I have been showing no evidence of disease NED for over 2 years now. It is not uncommon for the pathology report to show lymph nodes involvement and cancer still in the esophagus. We all hope to have a clean pathology report after a esophagectomy but showing traces of cancer in the primary site and nodes is quite to common. That's why we get the surgery, even though we show a clean scan we go thru all this just to make sure we do everything possible to make sure the cancer is gone. In your husbands case, the surgery was needed as he still had active cancer and now the cancer is removed. Having the surgery was a good thing for your husband and now he needs to recover some and then demand that he gets clean up chemo just to make sure you you kill any traces of cancer that may be floating around. Wishing you guys the best and I also was 44 when diagnose.

CancerEclipse

Carey-Anne, So sorry for Jeff

Carey-Anne, So sorry for Jeff's situation and the pressure and tension that's putting on your household at this point. I hate it that you are both so young and must deal with this crazy stuff. Most have recommended taking the chemo, and I've got nothing negative to say about that. No one has mentioned however, how diet and supplements can help as well and that would be my recommendation. I'm an integration medicine guy after my experience I'll send you some more information about that. I'm 74 years old and dealt with EC for 3 years and am now cancer free according to my last CT Scan and blood tests.

Dave

Carey-Ann

Deathorglory said:

Hello Carey-Ann

Hello Carey-Ann,

There's hope from where you guys are and from even worse spots.  There's a regular poster here, Paul, who was in a very similar spot.  He had additional chemo and has successfully beaten the cancer back.  I'd expect him to respond to you here.  I had essentially the same treatment, but for different reasons.  I had chemo/radiation, then surgery, then bonus chemo.  I had apparently had a complete response to the chemo/radiation as shown by the surgical pathology.  I still did a six month course of bonus chemo because I was young (41) and we wanted to be as aggressive as possible to hopefully give me decades of additional life, not months or years.  The chemo was the same, but much stronger than with the radiation.  It sucked, but it gave me the best chance for long term survival, so we willingly did it. 

 

I mentioned that there's hope from even worse spots than you're in (not that what you're facing is all good & jolly) because even with my apparently successful, extremely aggressive treatment I still had a recurrence.  My recurrence was a couple of years later (I was 44) and in a lung (stage IV).  I was given 7-8 months and told to get my affairs in order sooner, not later.  That was 2011 and I'm still here and still testing clean.  This disease is being more and more successfully treated every year.  The process still sucks, but there's legitimate hope for ultimate success.  

Believe me, I know just how much you hate where you are, but there isn't reason to give up hope.  It can be beaten.  Hopefully you guys are the next ones to beat it back.

Best wishes,

Ed

Thank you

Thank you

Carey-Ann

PaulT said:

Follow up Chemo

Carey-Ann,

I was diagnosed stage IV in August 2015 with local and distant lymph nodes involved and I have been showing no evidence of disease NED for over 2 years now. It is not uncommon for the pathology report to show lymph nodes involvement and cancer still in the esophagus. We all hope to have a clean pathology report after a esophagectomy but showing traces of cancer in the primary site and nodes is quite to common. That's why we get the surgery, even though we show a clean scan we go thru all this just to make sure we do everything possible to make sure the cancer is gone. In your husbands case, the surgery was needed as he still had active cancer and now the cancer is removed. Having the surgery was a good thing for your husband and now he needs to recover some and then demand that he gets clean up chemo just to make sure you you kill any traces of cancer that may be floating around. Wishing you guys the best and I also was 44 when diagnose.

Thank you

Thank you

mmochnal

"mop up Chemo"

Carry-Ann:

    My pre surgery Pet showed no actiity in any of my lymph nodes (4 were originally lit up) or my tumor. I had Surgery on Dec 12 and pathology showed great margins, but tumor shrunk by only %40 and still had 2 nodes with residual disease. I am being treated at MSK and my surgeon said I must either get more chemo or a clinical trail with Immunotherapy as the nodes are a "giant red flag" in her words. My original treatment was 9 weeks of carbo/taxel and 28 radiation treatments. I am now in the middle of 6 rounds of what they call Dox( Docitael/Oxciliplatian/xeloda) it is kinda of a modified Folfox and my Dr says based on his data more effective with less side effects. I am told the brute force of a systemic regimine like this is my best shot of killing off any microscopic cells that may have leaked out. I was also told that if you are going to get post surgery chemo it should be started withing 6-8 weeks of surgery and the reason it does not happen is many people are not recovered and strong enough to tolerate so soon after surgery. Like your husband I am in my 40's and the new chemo regiment is harder, but tolerable.