Radiation or Stent?

JaneE2366
JaneE2366 Member Posts: 289 Member
edited March 2014 in Esophageal Cancer #1
Hello All, Looking for some advice. Charlie started his new chemo regime a couple of weeks ago. This time it is Taxol and Carboplatin. (His May PET Scan showed some activity in the esophagus and stomach.....so he is no longer in remission.) He started to have some difficulty getting food down. We are hoping the chemo shrinks the tumor again. When we started the new chemo treatment, the dr suggested, in addition to the chemo, radiation to shrink the tumor. We thought, GREAT....let's do this. So we had an appointment with the radiation oncologist yesterday and he told us what he would be doing...also the pros and cons. When we went for the 2nd week of chemo, on Thursday, the oncologist also suggested we check out having a stent placed in the esophagus. (He has a similiar patient to Charlie who just opted for the stent instead of radiation.) So we have an appointment on the 26th to see a GI dr to find out about having a stent. The decision will be up to us. Our oncologist says when the stents work, they are great....but there is not guarantee it will work. I have read many nightmare stories about the stents migrating....falling.....then you need surgery to retrieve them. After hearing about those stories, Charlie is leaning towards the radiaion. Radiation won't be a picnic either. The radiation oncologist told us the swallowing could get worse before it gets better.
So I guess I am wondering if there is anyone out there that has had a successful stent placement. Charlie has never had radiation either....so I am wondering what the effects of radiation to the esophagus are. I have been doing my research on line....but it is always good to hear from someone that has actually had the experience.
Keeping you all in my prayers.
Stay strong,
Jane

Comments

  • BMGky
    BMGky Member Posts: 621
    #2
    Radiation or stent
    I probably shouldn't respond as I have no idea as to an answer. You may have had other posts that talked about prior treatment. The reason I replied is to say, at diagnosis, my husband was never given the option of a stent even though he had great problems swallowing due to an infection that occurred during chemoradiation. A j-tube was inserted. Although we had our problems with it, it was very necessary and helped him regain strength for his surgery. Has your husband had a j-tube and has he had surgery. Are you going through a cancer center rather than individual specialists. There are many major centers as well as excellent small centers for cancer. We used a private center that is in an area of strong medical facilities. It is staffed with knowledgeable and experienced doctors who work as a team, not as a board, and co-ordinated all of my husband's treatment. So, I guess I'm wondering if your doctor thinks a jtube would benefit him?
  • Unknown
    Unknown
    #3
    This comment has been removed by the Moderator
  • JaneE2366
    JaneE2366 Member Posts: 289 Member
    #4
    BMGky said:

    Radiation or stent
    I probably shouldn't respond as I have no idea as to an answer. You may have had other posts that talked about prior treatment. The reason I replied is to say, at diagnosis, my husband was never given the option of a stent even though he had great problems swallowing due to an infection that occurred during chemoradiation. A j-tube was inserted. Although we had our problems with it, it was very necessary and helped him regain strength for his surgery. Has your husband had a j-tube and has he had surgery. Are you going through a cancer center rather than individual specialists. There are many major centers as well as excellent small centers for cancer. We used a private center that is in an area of strong medical facilities. It is staffed with knowledgeable and experienced doctors who work as a team, not as a board, and co-ordinated all of my husband's treatment. So, I guess I'm wondering if your doctor thinks a jtube would benefit him?

    Thanks
    BMGky,
    Thanks for the reply. Charlie was dx March 2009. He never experienced trouble swallowing so there was never a need for a j-tube. He lost weight but it was due to not having an appetite after chemo. He is stage iv so surgery is not an option. We are being treated at a hospital that is affiliated with Moffitt in Tampa, FL. His swallowing now is not bad enough that he needs a j-tube. We are trying to get it under control before we get to that point.
    Thanks again.
    Jane
  • JaneE2366
    JaneE2366 Member Posts: 289 Member
    #5
    unknown said:

    This comment has been removed by the Moderator

    Thanks Sherri
    Thanks Sherri. The more I read, the more I think radiation is the way to go. Happy to hear Jim had no problem with the radiation and we will keep the esophageal stretch in mind. Do you know what kind of radiation Jim had.....I think Charlie will have Intensity Modulated Radiation Therapy....but I have to verify that on Monday.
    Even though both his oncologist and the radiation oncologist stressed that radiating the esophagus would not change his prognosis, we both still feel better getting those cancer cells in the esophagus zapped.
    Stay strong,
    Jane
  • faye082
    faye082 Member Posts: 14
    #6
    I would give radiation a shot!
    Hi Jane,

    My Dad's radiologist told him that he would definitely have trouble with swallowing towards the end of his radiation. she also told him he would very likely need pain pills to be able to swallow during radiation as his esophagus would feel very tender and "like a sunburn." As it turned out though, Dad never felt that, never had trouble or pain in swallowing, and never needed any pain meds to help him through. (and he ate like normal) Everyone is different and responds to treatment differently. Charlie would likely benefit greatly from the radiation, It really helped shrink my Dad's tumor and i think it's definitely worth a shot before going with a stent.
    Prayers coming your way! :)
    faye
  • Unknown
    Unknown
    #7
    JaneE2366 said:

    Thanks Sherri
    Thanks Sherri. The more I read, the more I think radiation is the way to go. Happy to hear Jim had no problem with the radiation and we will keep the esophageal stretch in mind. Do you know what kind of radiation Jim had.....I think Charlie will have Intensity Modulated Radiation Therapy....but I have to verify that on Monday.
    Even though both his oncologist and the radiation oncologist stressed that radiating the esophagus would not change his prognosis, we both still feel better getting those cancer cells in the esophagus zapped.
    Stay strong,
    Jane

    This comment has been removed by the Moderator
  • Tina Blondek
    Tina Blondek Member Posts: 1,500 Member
    #8
    faye082 said:

    I would give radiation a shot!
    Hi Jane,

    My Dad's radiologist told him that he would definitely have trouble with swallowing towards the end of his radiation. she also told him he would very likely need pain pills to be able to swallow during radiation as his esophagus would feel very tender and "like a sunburn." As it turned out though, Dad never felt that, never had trouble or pain in swallowing, and never needed any pain meds to help him through. (and he ate like normal) Everyone is different and responds to treatment differently. Charlie would likely benefit greatly from the radiation, It really helped shrink my Dad's tumor and i think it's definitely worth a shot before going with a stent.
    Prayers coming your way! :)
    faye

    Hi Jane and Charlie
    So nice
    Hi Jane and Charlie
    So nice to hear from you. My dad had xeloda chemo and radiation for 6 wks for his ec, and he did very well. The radiation did not bother him at all. A year later, dad had trouble swallowing due to scar tissue from the radiation. He had an esophagus stretch, which did not do much. Two weeks later, he was put in the hospital with the mets to the liver. The drs could not get down his esophagus with the camera to check his liver, so they put in a stent. Dad had no trouble with the stent, it worked very well to open up his esophagus, and make eating much easier. He also had to have a stent put in his bile duct of his liver. My dad's esophagus was blocked with scar tissue, not the tumor. The tumor was not visible. If Charlie's is blocked with a tumor, I would suggest radiation to shrink the tumor. Then the radiation will cause scar tissue, then he can get the stent put in!! Phew! that is a lot to deal with! You guys are pros at this, so not to worry. Keep up the good work. Prayers will follow you daily. Keep in touch.
    Tina
  • JaneE2366
    JaneE2366 Member Posts: 289 Member
    #9
    Tina Blondek said:

    Hi Jane and Charlie
    So nice
    Hi Jane and Charlie
    So nice to hear from you. My dad had xeloda chemo and radiation for 6 wks for his ec, and he did very well. The radiation did not bother him at all. A year later, dad had trouble swallowing due to scar tissue from the radiation. He had an esophagus stretch, which did not do much. Two weeks later, he was put in the hospital with the mets to the liver. The drs could not get down his esophagus with the camera to check his liver, so they put in a stent. Dad had no trouble with the stent, it worked very well to open up his esophagus, and make eating much easier. He also had to have a stent put in his bile duct of his liver. My dad's esophagus was blocked with scar tissue, not the tumor. The tumor was not visible. If Charlie's is blocked with a tumor, I would suggest radiation to shrink the tumor. Then the radiation will cause scar tissue, then he can get the stent put in!! Phew! that is a lot to deal with! You guys are pros at this, so not to worry. Keep up the good work. Prayers will follow you daily. Keep in touch.
    Tina

    Faye & Tina
    Thank you both for your replies. Can't tell you how much we appreciate all the info.
    Stay strong,
    Jane
  • unclaw2002
    unclaw2002 Member Posts: 599
    #10
    JaneE2366 said:

    Faye & Tina
    Thank you both for your replies. Can't tell you how much we appreciate all the info.
    Stay strong,
    Jane

    Jane,
    My father had a
    Jane,

    My father had a horrible experience with the stents. As he started radiation the tumor started to shrink and then the stent fell into his stomach causing intense pain. Then they let the situation drag on and he was unable to drink or eat and entered the hospital dehydrated and very weak - he had to have surgery to remove it from his stomach and then inserted another stent. He did not have a j-tube --- just when he started to bounce back from the first surgery he began having trouble eating again (he thought it was because of the radiation and he said it was like his esophagous had a sunburn and he complained again and was in pain etc. -- they gave him lydicane to swallow to numb the esophagous. Well he once more was unable to eat or drink and in terrible pain. Another weak without food waiting to operate because yes the stent fell into his stomach again. This time I spoke to my mother and insisted that she ask for a J-tube because at this point my dad way delirious --- mom came through and the doctors agreed to insert a J-tube when they removed the stent and we said thanks but no thanks to a third stent.

    If you go the stent route if you don't have a j-tube I would highly recommend getting one when the stent is inserted. If you have problems you can get nutrition and hydration and even medicine through the j-tube. And even if it doesn't fall into the stomach it may be that because of the radiation it will be too painful for Charlie to eat or drink. If you have any questions let me know.

    By the way my dad thought that if he had the j-tube it would limit him somehow or be admitting defeat but now he realizes that the importance of nutrition and hydration trumps vanity or fear of the feeding tube.


    Good luck with whatever you decide.

    Best,
    Cindy
  • JaneE2366
    JaneE2366 Member Posts: 289 Member
    #11
    unclaw2002 said:

    Jane,
    My father had a
    Jane,

    My father had a horrible experience with the stents. As he started radiation the tumor started to shrink and then the stent fell into his stomach causing intense pain. Then they let the situation drag on and he was unable to drink or eat and entered the hospital dehydrated and very weak - he had to have surgery to remove it from his stomach and then inserted another stent. He did not have a j-tube --- just when he started to bounce back from the first surgery he began having trouble eating again (he thought it was because of the radiation and he said it was like his esophagous had a sunburn and he complained again and was in pain etc. -- they gave him lydicane to swallow to numb the esophagous. Well he once more was unable to eat or drink and in terrible pain. Another weak without food waiting to operate because yes the stent fell into his stomach again. This time I spoke to my mother and insisted that she ask for a J-tube because at this point my dad way delirious --- mom came through and the doctors agreed to insert a J-tube when they removed the stent and we said thanks but no thanks to a third stent.

    If you go the stent route if you don't have a j-tube I would highly recommend getting one when the stent is inserted. If you have problems you can get nutrition and hydration and even medicine through the j-tube. And even if it doesn't fall into the stomach it may be that because of the radiation it will be too painful for Charlie to eat or drink. If you have any questions let me know.

    By the way my dad thought that if he had the j-tube it would limit him somehow or be admitting defeat but now he realizes that the importance of nutrition and hydration trumps vanity or fear of the feeding tube.


    Good luck with whatever you decide.

    Best,
    Cindy

    Thank you
    Cindy,
    Thank you for all the info. I am so surprised they would insert a stent, then do radiation. The radiation certainly shrinks the tumor....so wouldn't it be logical the stent would fall out?? The more I hear about the stents, I more I think we should just do the radiation. We will see what the GI dr says when we meet with him.
    Thanks again for all the info.
    Jane

Discussion Boards