Update on my status

My brother (jimsbrother) posted some information about me on 8/23. I was diagnosed with stage III adenocarcinoma. There is a 2 inch long tumor where my esophagus meets my stomach that is 2/3 obstruction my lumen (entrance to stomach). At Boston Medical Center I had a CT/PET scan and a Thoracic surgeon said that we need an ultrasound to accurately stage the cancer. Besides the tumor, 2 lymph nodes showed up; one very close to the tumor and the second a little farther away in the abdomen. This surgeon said that after staging he may recommend going straight to surgery, instead of radiation and chemo first, if the staging supported it. My internet research of radiation therapy and all the short range and long range impacts really threw me for a loop, so obviously going right to surgery appealed to me. Boston Medical Center is a good hospital, but it has a small cancer staff. For a second opinion I went to Massachusetts General which has a large and impressive cancer staff and cancer wing, with the latest technology, etc. There I met with a Medical Oncologist, Radiation physician and a Thoracic Surgeon. Their approach was to start right off with IMRT radiation and chemo, followed by surgery, etc. their belief is that the strongest chance at success is the aggressive approach and that the lymph node in the abdomen is far enough away that it is proof that my cancer is spreading. They are convinced that there is a 95% chance the lymph nodes are cancerous and that staging at this time would not change their approach. Both surgeons said they thought I was stage 3 without the ultrasound. Because little is known about adenocarcinoma (it was only 10% of the cases 20 years ago) treatments lean towards what they know about squamus cell; go with radiation/chemo first followed by surgery. I am still having the ultrasound and a byopsy of the 2 lymph nodes but at this point am siding with the Mass General approach and am starting IMRT radiation on 9/28 with chemo as my best chance going forward. As to what surgeon I chosse, I am still conflicted. I like the surgeon at Boston Medical better, but if I was hospitalized for surgery, Mass General is far better equiped for cancer. I am meeting with The mass General surgeon again when he is not seeing me when he is running from one surgery to another. From what I understand he is their strongest physician when it comes to laproscopic (minimally evasive surgery). The surgeon at Boston Medical Center has done more non evasive surgery than anyone else in Boston. When it's time for surgery, I hopefully will be able to make my best choice. Before embarking on this journey I am going away on vacation to Fort Myers Beach in Florida. At this time I have very little in symptoms and figure that this tumor has been growing in me probably a good year and was told that most likely a 2 week delay won't make a differance. The way I look at it is that right now my quality of life is good and who knows what the future will bring. I remain an optomist and probably a lousy speller. Thank's to everyone who responded to my brothers note. Best wishes to all of you.

Jim aka gatoraid