Friend newly diagnosed at age 39

Wedad

Hi everyone,

Last week a close friend diagnosed with esophageal cancer at the gastroesophageal junction. He is 39 yrs old and have a long history with GER. He doesn't live in the US. The problem is his doctor recommended chemotherapy only without radiotherapy but when I read about esophageal cancer all treatment options should be chemoradiotherapy in combination. His doctor said since he has no metastasis adenocarcinoma no need for radiotherapy and after chemotherapy he needs surgery. Any one has been treated with only chemotherapy before surgery? please advice we feel lost. 

Deathorglory

Sorry to Hear About Your Friend

Hello,

I was 40 my 1st go around with EC.  Same deal as your friend...years of brutal, untreated GERD.  Adenocarcinoma at the gastric junction.  Sounds like they haven't staged him yet, but I was stage III, which is as bad as you can get without metasasis.  I was treated with chemo-radiation and then an esophajectomy.  And I've still had two recurrences.  As far as I know, that trimodal treatment is the gold standard.  I suppose there could be specifics to your friend's case that makes his doctor's recommendation correct, but radiation, chemo & surgery is the recommended treatment for most similar cases.  I'd ask the doctor very directly why he feels that the gold standard of care is not right for your friend.  These are the things that come up when someone hasn't done everything they can do to find a top of the line hospital with top docs.  That is the single most important thing your friend can do to be in control of his situation.  

Hope everything goes as well as possible,

Ed

Wedad

Deathorglory said:

Sorry to Hear About Your Friend

Hello,

I was 40 my 1st go around with EC.  Same deal as your friend...years of brutal, untreated GERD.  Adenocarcinoma at the gastric junction.  Sounds like they haven't staged him yet, but I was stage III, which is as bad as you can get without metasasis.  I was treated with chemo-radiation and then an esophajectomy.  And I've still had two recurrences.  As far as I know, that trimodal treatment is the gold standard.  I suppose there could be specifics to your friend's case that makes his doctor's recommendation correct, but radiation, chemo & surgery is the recommended treatment for most similar cases.  I'd ask the doctor very directly why he feels that the gold standard of care is not right for your friend.  These are the things that come up when someone hasn't done everything they can do to find a top of the line hospital with top docs.  That is the single most important thing your friend can do to be in control of his situation.  

Hope everything goes as well as possible,

Ed

Thank you for your reply I

Thank you for your reply I really appreciate it. We are so confused about the doctor opinion so tomorrow he is going to a different doctor to discuss the treatment plan. Yes he is not staged yet and still waiting for PET scan results. His CT scan shows 2-3 lymph nodes close to the esophagus.  

Wedad

Deathorglory said:

Sorry to Hear About Your Friend

Hello,

I was 40 my 1st go around with EC.  Same deal as your friend...years of brutal, untreated GERD.  Adenocarcinoma at the gastric junction.  Sounds like they haven't staged him yet, but I was stage III, which is as bad as you can get without metasasis.  I was treated with chemo-radiation and then an esophajectomy.  And I've still had two recurrences.  As far as I know, that trimodal treatment is the gold standard.  I suppose there could be specifics to your friend's case that makes his doctor's recommendation correct, but radiation, chemo & surgery is the recommended treatment for most similar cases.  I'd ask the doctor very directly why he feels that the gold standard of care is not right for your friend.  These are the things that come up when someone hasn't done everything they can do to find a top of the line hospital with top docs.  That is the single most important thing your friend can do to be in control of his situation.  

Hope everything goes as well as possible,

Ed

If you don't mind could you

If you don't mind could you please tell me about the location of the tumor my friend has it at the gastroesophageal junction? And when you had it and how long was the chemo/ radiotherapy treatment course?

Deathorglory

Wedad said:

If you don't mind could you

If you don't mind could you please tell me about the location of the tumor my friend has it at the gastroesophageal junction? And when you had it and how long was the chemo/ radiotherapy treatment course?

Hello

Hello,

The location of your frien's and my tumor at the gasttroesophageal junction means that it is at the very bottom of the esophagus where it enters the stomach.  This is a very common location for adenocarcinomas because it is where stomach acid gets into the esophagus from GERD.  Years of that can cause cancer.  I had my 1st go around with EC in 2008 and was stage III.  In 2011 I had a recurrence in a lung which was obviously stage IV.  My 2rd time was in a lung again and was stage IV again.  That was 2018/2019.  My 1st time was when I had the trimodal treatment.  It was five weeks of radiation 5X/week  for 25 doses and six rounds of accompanying chemo (Carboplatin & Taxol).   The chemo was at a lower dose b/c it was supposed to be an activating dose for the chemo.  After the chemo/radiation, I was given a little while to rebuild my strwngth for the surgery.  After the surgery, I did a bonus course of the same chemo, but at full strength.  

Hope that answers your questions,

Ed

Wedad

Deathorglory said:

Hello

Hello,

The location of your frien's and my tumor at the gasttroesophageal junction means that it is at the very bottom of the esophagus where it enters the stomach.  This is a very common location for adenocarcinomas because it is where stomach acid gets into the esophagus from GERD.  Years of that can cause cancer.  I had my 1st go around with EC in 2008 and was stage III.  In 2011 I had a recurrence in a lung which was obviously stage IV.  My 2rd time was in a lung again and was stage IV again.  That was 2018/2019.  My 1st time was when I had the trimodal treatment.  It was five weeks of radiation 5X/week  for 25 doses and six rounds of accompanying chemo (Carboplatin & Taxol).   The chemo was at a lower dose b/c it was supposed to be an activating dose for the chemo.  After the chemo/radiation, I was given a little while to rebuild my strwngth for the surgery.  After the surgery, I did a bonus course of the same chemo, but at full strength.  

Hope that answers your questions,

Ed

Thanks a lot for your reply.

Thanks a lot for your reply. I really appreciate it. Your answer gave me so much hope!