Surgery vs Radiation Chemo Or?

HobbsDoggy
HobbsDoggy Member Posts: 276
in Esophageal Cancer #1

I had neck cancer 8 years ago.  Now I have a small spot (1 cm) on upper esophagus.  My doctor thinks radiation chemo is possbile, maybe not full treatment dose, but not sure. The cancer has not spread.

If I cannot have radiation they may cut out the cancer on the back of my esophagus, a 1 cm spot, and replace it with a flap of my skin from my arm.  I don’t think this is quite as an effective of a “cure” as radiation and chemo.  Anyone know about this?  Anyone had experience with this?  I am on the head and neck discussion board which is what I am familar with, but those on here may be able to help with my current esophagus issue, it is sort of between neck and esophagus.  My ENT is coordiating my care.

Although older I am in good health otherwise and my doctor seems to think I have a very good chance at another 10 years.  I guess this new deal is not a recurrence so that's good, why this new spot show up I have no clue.  Cancer shows no mercy and hates us all equally.

Very scared here any thoughts will help even if its caution.

Comments

  • paul61
    paul61 Member Posts: 1,392 Member
    #2
    I have never heard of that surgical approach

    Hi Hobbs,

    I am sorry you find yourself here. Cancer is a bummer that is for sure.

    I have never heard of the surgical approach your are describing. I had the traditional Ivor Lewis surgery for esophageal cancer, where they remove a large section of the esophagus and then resect the stomach to for a connection between the remainder of the esophagus and the small intestine. That is MAJOR surgery. It sounds like this new approach may be much less invasive. I have also heard of endoscopic mucosal resection where they use an endoscope to remove a layer of the esophagus lining.

    Of course there are a number of people who have had success with just chemotherapy or immunotherapy for early stage cancer that is confined to the inner layers of the esophagus.

    I assume they have done a PET scan or a CAT scan to insure the cancer in question is encapsulated in your esophagus?

    If it were me I would want to discuss the potential for EMR with my gastroenterologist.

    Wishing you the best of luck as you move forward.

    Best Regards

    Paul

  • HobbsDoggy
    HobbsDoggy Member Posts: 276
    edited April 2020 #3
    I Wonder If I Understand

    I am starting to think I do not have a clear picture of my cancer.  My ENT explained my cancer to me and I am starting to think that I did not understand him correctly.  I am starting to think I need a more clear expination of exacdtly where it is and what it is.  The way he expained it is that it is in my neck, lower part so not sure I fully get it.  I have an appoint with him tomorrow and will get a fuller picture.  Thanks for your input.  Will post what zi find out and ask for more input from the group.  Thanks!!!

  • skidog
    skidog Member Posts: 74 Member
    edited April 2020 #4
    HobbsDoggy said:

    I Wonder If I Understand

    I am starting to think I do not have a clear picture of my cancer.  My ENT explained my cancer to me and I am starting to think that I did not understand him correctly.  I am starting to think I need a more clear expination of exacdtly where it is and what it is.  The way he expained it is that it is in my neck, lower part so not sure I fully get it.  I have an appoint with him tomorrow and will get a fuller picture.  Thanks for your input.  Will post what zi find out and ask for more input from the group.  Thanks!!!

    Hobbsdoggy...

    Can you bring someone with you to your appointment to help take notes? if not, do you have a smart phone that you can record the conversation and listen to it when you get home? It's tough to hear everything the docs say when you are anxious. good luck and Im hoping for the best for you.

  • HobbsDoggy
    HobbsDoggy Member Posts: 276
    edited April 2020 #5
    Yes About Notes

    Good ideas.  It is a phone video conference and and my wife will be listening and she can take notes, good idea, thanks!  I will write out my questions.

    Another question for the group is the only type of surgery that you all  know of is replacing the esophagus?  Thanks!

  • Deathorglory
    Deathorglory Member Posts: 364 Member
    edited April 2020 #6
    The common surgery for

    The common surgery for esophageal cancer is an esophagectomy.  In that, the bulk of the esophagus is removed and then they fashion a new esophagus out of your stomach.  I asked my surgeon, "And then what are you going to use make me a new stomach?"  His answer was that there is no new stomach.  And, yes, that leads to a whole host of side effects.  It's why an esophagectomy is major, BFD surgery.  It's still worth it for a large chunk of EC patients.  

  • HobbsDoggy
    HobbsDoggy Member Posts: 276
    #7
    Thanks for the Info

    I am getting that picture.  I am also getting to think I am not understanding what my doctor told me.  He was clear that he was talking a patch.  I have an appointment with him tomorrow and will have some questions based on what I learned on here for him.  I think I have some hybrid of what everyone here is talking about.  I am grateful for the information, now I know what to ask.  Thanks All!!

  • R2021
    R2021 Member Posts: 2
    #8
    To have Hiatel Hernia surgery or not, Is it woth the risk

    Early in the year I was diagnosed with esophagus cancer and went thru chemo and radiation which worked. Unfortunately, I have a Hiatal Hernia which I am told that without fixing that there is an 80% the cancer will return. Since the surgery for this is major and I am 75 years old I am trying to determine if I should go through the pain and life adjustments of the surgery or do nothing and just run out the clock. My main goal is to have the longest period of quality of life and minimize the suffering. I cannot get a clear answer from the folks who are treating me (obviously for legal reasons) anyone familiar with this?

  • paul61
    paul61 Member Posts: 1,392 Member
    #9
    R2021 said:

    To have Hiatel Hernia surgery or not, Is it woth the risk

    Early in the year I was diagnosed with esophagus cancer and went thru chemo and radiation which worked. Unfortunately, I have a Hiatal Hernia which I am told that without fixing that there is an 80% the cancer will return. Since the surgery for this is major and I am 75 years old I am trying to determine if I should go through the pain and life adjustments of the surgery or do nothing and just run out the clock. My main goal is to have the longest period of quality of life and minimize the suffering. I cannot get a clear answer from the folks who are treating me (obviously for legal reasons) anyone familiar with this?

    I assume we are not talking about an esophagectomy

    Hi R2021,

    I assume we are not talking about an esophagectomy here but instead surgery to pull the herniated portion of the stomach back through the diaphram, tightening the opening, and repairing any damage to the esophagus. I have had an esophagectomy with gastric pull up which is a much more invasive surgery than a hiatal hernia repair. It did take me some time to recover but if I had an option to significantly reduce my risk of developing esophageal cancer (as I did), I would definately persue it. 

    Have you considered Endoluminal fundoplication?

    Endoluminal fundoplication is a newer procedure, and it’s a less invasive option. No incisions will be made. Instead, your surgeon will insert an endoscope, which has a lighted camera, through your mouth and down into the esophagus. Then they’ll place small clips at the point where the stomach meets the esophagus. These clips can help prevent stomach acid and food from backing up into the esophagus. Recovery should be rather quick. 

    Regards,

    Paul

Discussion Boards