Oncologist and Thoracic Surgeon Seem to Disagree

mhsjcurry

I was diagnosed with a cancerous nodule in my esophagus in January 2024. It was removed via EMR in April.

The pathology report indicated that the cancer cells were moderately to poorly differentiated and there had been lymphatic vascular invasion. I met first with my thoracic surgeon who said given my condition, data indicated that the chance of recurrence was 20% or less. He could do an esophagectomy or we could stay under tight surveillance... Imaging and endoscopy every three months. I feel as though he felt that the Esophagectomy was not necessary at this time.

I met with my oncologist yesterday, and given the two high risk factors of the cell differentiation and the vascular invasion plus the fact that I'm relatively young - 49 - she felt that the Esophagectomy was the best option. She said that this was also the recommendation of the tumor board - of which my surgeon is a part. The surgeon confirmed to me today that that was the board's conversation, but he reiterated the fact that given the intensity of the surgery and recovery that surveillance was an equally viable option, especially given the possible recurrence rate.

I'm paralyzed as to what to do. I certainly want to reduce the chance of recurrence as much as possible, but I also don't want to have a surgery if it's unnecessary, nor do I want the recovery. BUT, I also don't want to need the surgery down the road and need additional treatment because I waited and chose surveillance.

Ugh.

Any advice or similar experiences? Thanks in advance.

Brentmcw

I understand your paralysis and frustration. I was diagnosed with Stage 3 and had the Ivor-Lewis procedure performed and have survived for 3 years. I still have dilations performed about 4 times a year, but that’s really a minor inconvenience in light of the other realities. Feel free to email me if you’d like to talk. You aren’t alone in this.