Esophageal cancer diagnosed

LisaMK1

About My dad:  He is 78 and healthy as an ox.  He has been taken care of my mom through her heart conditon the last two years and mom is on the mend.  She had the TAVR procedure during Covid and recovered like a champ.  She is a strong lady.  She just got her eye surgery and is able to drive now.  I remember after we got the phone call waiting for my mom's surgery he said he needs a vacation well BANG then a cancer diagnosis. Back to my dad he had a little bit of trouble swallowing and had the sensation of food being stuck at his breastbone area.  He had it about two weeks on and off and finally a trip to the ER and the 29th we get the diagnosis of an Esophageal tumor located in the distal area.  We met with the medical oncologist April 1st, EUS in WVU on the 7th, the port was installed the 9th, Chemo training 13th and Radiation oncologist and PET scan tomorrow the 14th.

Esophageal Ultra Sound: The EUS showed stage 3.  The beginning of T3 and N1 and nothing showed at the organ level.  The DR said that they could put a splint in and it would help.  Right now he is on a pureed diet.  We have been keeping him up on calories and protein so he doesn't lose any weigh.  He is about 25-30 pounds overweight.  I have been told the PET will show if it has spread outside.  We are staying positive and praying that it has not spread.  The good news going into this is my dad is very healthy, no heart, blood pressure or diabetes issues.  He does have a a hernia issue that he was scheduled to take care of but then this happened.  He has just been amazing through all of this and you want to talk about positive...he is off the chart with a FIGHT mentality.  A little humor he is a dedicated Washington Football fan so you know he has HOPE for just about anything. Seriously he is my Superman!

Chemo training: Today when we met with the nurse in reference to chemo training we found out that dad was going to be on Carboplatin and Paclitaxel 1x week for 6 weeks.  She mentioned radiation 5 to 7 days a week for 5 to 6 weeks.  We will know more tomorrow when we meet with the radiation oncolocgist.  BTW there is only 1 radiation oncologist in the area.  I was taken back when she said daily for 5 to 6 weeks.  

Personal:  I have been trying to educate myself as much as I can so that I can keep my parent's informed and make sure that they understand what is going on and what may happen.  Believe me, I am praying that he sails through this because each person reacts differently BUT chemicals are chemicals and radiation is radiation so there is that... With this being said I have read through all the material and honestly I am nervous.  So many things that can happen.  The good thing is my job allows me to be flexable and that I can stay with my parents to help them out and help monitor my dad in case. 

Questions:  Shoud I get a 2nd opinion with an Esophageal Cancer specialist?  SHould I be concerened that there is only 1 radiation DR in the area?  When do the side effects happen?

Does that sound like a lot of radiation?  I am sure there will be more but these come to mind.

Thank you!

Deathorglory

Hello Lisa

Hello Lisa,

I'm sorry that you find yourself here.  I'll just offer some information about your questions. 

A second opinion is usually a good idea.  The single most important thing you can do is to make sure that your father is being seen by good doctors at a good hospital.  This isn't a sprained ankle that can be equally treated by the hospital down the street.  You want your father to be seen by people who deal with EC for a living.  Only having one radiation oncologist in your area wpuld give me concern.  Half of all doctors are below average and only having one to choose from doean't let you comparison shop. 

The side effects of the chemo and radiation are cumulative, meaning they build up over time.  The first doses of radiation I had were completely free of side effects, it was only after it built up that they became noticeable.  The chemo side effects may be noticeable more immediately.  Being cumulative also means that it'll take a little while for the effects to wear off as the stuff exits his system slowly.  One good thing is that, at least when I had chemo/radiation, the chemo is at a lower dose when it is combined with radiation, so that the side effects are lessened.  For example, I didn't lose my hair when I did chemo/radiation, but I lost every last hair on my body when I did the full stregnth chemo by itself.  

The radiation schedule that I've seen most folks put on is five or six weeks at five times per week.  Seven days a week seems like a lot.  But I'm sure that there's a reason for that.  I'd ask about that.  

I would also ask what they're saying about surgery.  A very common treatment plan calls for chemo/radiation followed by an esophagectomy.  It is pretty major surgery, but it is also generally the best way to make sure there's no cancer left.  The surgery is usually part of the plan for folks who have caught the cancer before it has reached stage IV and spread.  

Hopefully, everything goes as smoothly and successfully as possible for you guys.  It's awesome that your work is flexible, your Dad will need some extra care and support and it seems like your mother has her hands full with her own medical stuff.

Best Wishes,

Ed

LisaMK1

Deathorglory said:

Hello Lisa

Hello Lisa,

I'm sorry that you find yourself here.  I'll just offer some information about your questions. 

A second opinion is usually a good idea.  The single most important thing you can do is to make sure that your father is being seen by good doctors at a good hospital.  This isn't a sprained ankle that can be equally treated by the hospital down the street.  You want your father to be seen by people who deal with EC for a living.  Only having one radiation oncologist in your area wpuld give me concern.  Half of all doctors are below average and only having one to choose from doean't let you comparison shop. 

The side effects of the chemo and radiation are cumulative, meaning they build up over time.  The first doses of radiation I had were completely free of side effects, it was only after it built up that they became noticeable.  The chemo side effects may be noticeable more immediately.  Being cumulative also means that it'll take a little while for the effects to wear off as the stuff exits his system slowly.  One good thing is that, at least when I had chemo/radiation, the chemo is at a lower dose when it is combined with radiation, so that the side effects are lessened.  For example, I didn't lose my hair when I did chemo/radiation, but I lost every last hair on my body when I did the full stregnth chemo by itself.  

The radiation schedule that I've seen most folks put on is five or six weeks at five times per week.  Seven days a week seems like a lot.  But I'm sure that there's a reason for that.  I'd ask about that.  

I would also ask what they're saying about surgery.  A very common treatment plan calls for chemo/radiation followed by an esophagectomy.  It is pretty major surgery, but it is also generally the best way to make sure there's no cancer left.  The surgery is usually part of the plan for folks who have caught the cancer before it has reached stage IV and spread.  

Hopefully, everything goes as smoothly and successfully as possible for you guys.  It's awesome that your work is flexible, your Dad will need some extra care and support and it seems like your mother has her hands full with her own medical stuff.

Best Wishes,

Ed

Thank you so much for the

Thank you so much for the information.

He will start next week with chemo/rad on Weds.  I am still waiting to here from the  Rad DR about the PET scan.  I am praying it is good news.  

LisaMK1

Allergic reaction to Taxol

Dad started his chemo last Weds.  It came to a screeching halt about 5 ml into the drip.  He woke from a premed Benedryl nao with excrutating backpain and chest discomfort.  They flushed it immediately.  He passed out and did not have control of his bladder.  They monitored him for hours in the ER and he did not want to miss his first rad appointment so they let him proceed.  the next day they administered the carboplatin w RT.  No reaction and everything went ok.  The DR spoke with me and said that they will not be trying the Taxol again because his reaction was very severe.  he consulted with the pharmacist and they are going to start him on Taxel Tere which is a sister or cousin drug to Taxol.  Very nervous about it.  Any information would be helpful.  TY

Deathorglory

Sorry

Sorry Lisa, have no knowledge of that one.  There's a lot more active people on a site called Smartpatients.  Maybe someone there can help.  

Best Wishes,

Ed