Q's about chemo

JimsBrother
JimsBrother Member Posts: 94
edited March 2014 in Esophageal Cancer #1
I've been reading about 2 chemo drugs, Cisplatin and 5-FU. I've also read about some of the many other chemo drugs and I have a question maybe someone can answer.

With all the drugs, I have noticed that they are using the above two drugs for many different cancers. My question is, how do they determine what drugs will work best against any one tumor? Do they do any advance tests, or determine in any way that this drug is best for adenomacarcinoma of the esophagus?
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  • cmn412
    cmn412 Member Posts: 69
    it worked for me.
    ROB
    I had the chemo treatment combination of Cisplatin and 5-FU along with Radiation treatments. I was stage IIA. The chemo/radiation treatment worked for me and the cancer was not found when they went in and did the surgery ( MIE on February 2010 at Duke, Durham, NC ).

    I was told by my Dr. that this was the standard treatment, as it has had showed the best results. Yes it is used in other cancers, I guess if it works it works on other tumors. He was aware of Clinical trial drugs and didn’t know of any he wanted to reuse (he did try them) at this point.

    The point is the Cisplatin and 5-FU worked for me and hopefully it will work for your brother too.

    My brother who lives in PA and is one year older than me also has/had EC StageIIA and he was given the same treatment at Hersery Medical center. He also had His MIE surgery there on April 2010.

    God bless
    callie
  • BMGky
    BMGky Member Posts: 621
    unknown said:

    This comment has been removed by the Moderator

    William, You are exactly
    William, You are exactly correct. Time is of the essence. If MIE is available, go for it. If it isn't, and you are a surgical candidate and have to have the more invasive form, go for it. There is no way our personal research can replace the knowledge and training of an oncologist who treats EC regularly. Research for information and understanding but once you've decided on an esophageal cancer team who knows what it's doing, you can't second guess treatment. The treatment and surgery, either form, is life altering but it is life and a good one. We thank God every day for the treatment and operation, brutal as they are, and for the kind medical staff who saw us through and are seeing us through this nightmare. One must understand, EC is not a basal cell carcinoma in situ. It spreads, and once out of the box, it is most efficient at attacking vital organs. I believe Rob and his family are still somewhat in shell shock at the diagnosis. This is understandable. They should keep reading, researching and learning as they may find something we don't know and can share. In the meantime, follow through with treatment ASAP. William, keep up the good work. You help so many including us.
  • Gatoraid
    Gatoraid Member Posts: 66
    cmn412 said:

    it worked for me.
    ROB
    I had the chemo treatment combination of Cisplatin and 5-FU along with Radiation treatments. I was stage IIA. The chemo/radiation treatment worked for me and the cancer was not found when they went in and did the surgery ( MIE on February 2010 at Duke, Durham, NC ).

    I was told by my Dr. that this was the standard treatment, as it has had showed the best results. Yes it is used in other cancers, I guess if it works it works on other tumors. He was aware of Clinical trial drugs and didn’t know of any he wanted to reuse (he did try them) at this point.

    The point is the Cisplatin and 5-FU worked for me and hopefully it will work for your brother too.

    My brother who lives in PA and is one year older than me also has/had EC StageIIA and he was given the same treatment at Hersery Medical center. He also had His MIE surgery there on April 2010.

    God bless
    callie

    Your Chemo Therapy
    Hi Callie,

    I am scheduled to start Cisplatin and 5-FU on September 28th and am curious about the side effects that you personally had and if now that you are no longer on them, if any of the side effects still bother you. I'm having and ultrasound and biopsy of the 2 suspect lymph nodes and that will tell my true staging. Without the ultrasound they assumed I was stage III but if I'm lucky it may be less. I've read on this site that people have long term symptoms of tingling/aching of their feet, fatigue and other symptoms. Of particular concern is the mouth/throat sores I read about. Eating and drinking is something I can do now and I'm hopeful that I can continue up until surgery.

    As for the radiation I am getting 28 days straight (not weekends) of IMRT radiation. Is that what you had? What was your experience with that?

    The chemo will be weekly and run concurrent with the radiation.

    Sorry for all the questions but you have alrewady gone through what lies ahead for me. Any information you could provide would be most appreciated.

    Thanks......Jim aka gatoraid
  • cmn412
    cmn412 Member Posts: 69
    Gatoraid said:

    Your Chemo Therapy
    Hi Callie,

    I am scheduled to start Cisplatin and 5-FU on September 28th and am curious about the side effects that you personally had and if now that you are no longer on them, if any of the side effects still bother you. I'm having and ultrasound and biopsy of the 2 suspect lymph nodes and that will tell my true staging. Without the ultrasound they assumed I was stage III but if I'm lucky it may be less. I've read on this site that people have long term symptoms of tingling/aching of their feet, fatigue and other symptoms. Of particular concern is the mouth/throat sores I read about. Eating and drinking is something I can do now and I'm hopeful that I can continue up until surgery.

    As for the radiation I am getting 28 days straight (not weekends) of IMRT radiation. Is that what you had? What was your experience with that?

    The chemo will be weekly and run concurrent with the radiation.

    Sorry for all the questions but you have alrewady gone through what lies ahead for me. Any information you could provide would be most appreciated.

    Thanks......Jim aka gatoraid

    Jim
    Jim aka gatoraid

    First I am at work so my answers are short and to the point.


    The Radiation (36 treatments) toward the end cause a burning sensation at the point of treatment and I had heartburn real bad and one hour after treatment I felt sick. I took my treatment at 2:30 so
    I could eat well in the mornings and I went home after treatment from work to lay down.

    I went to work every day except on the cisplatin day because they give that by IV and the day after on the second round, I was not feeling to good. The 5fu was worn as a pump for 5 days. I did have trouble with vomiting especially toward the end of treatments. The medicine makes you tired so I went home and layed down after work.

    But two weeks after treatment everything was much better and I do not suffer any side effects that I am aware of from the treatments now.

    To keep my weight up I drank instant breakfast milkshakes and If I vomited I just did it again. Most the time after I vomited I felt much better and could eat then.

    Good luck and God bless.

    You can do it. One day at time, sometimes one minute at a time, but step by step you will arrive.

    Callie
  • unclaw2002
    unclaw2002 Member Posts: 599
    Gatoraid said:

    Your Chemo Therapy
    Hi Callie,

    I am scheduled to start Cisplatin and 5-FU on September 28th and am curious about the side effects that you personally had and if now that you are no longer on them, if any of the side effects still bother you. I'm having and ultrasound and biopsy of the 2 suspect lymph nodes and that will tell my true staging. Without the ultrasound they assumed I was stage III but if I'm lucky it may be less. I've read on this site that people have long term symptoms of tingling/aching of their feet, fatigue and other symptoms. Of particular concern is the mouth/throat sores I read about. Eating and drinking is something I can do now and I'm hopeful that I can continue up until surgery.

    As for the radiation I am getting 28 days straight (not weekends) of IMRT radiation. Is that what you had? What was your experience with that?

    The chemo will be weekly and run concurrent with the radiation.

    Sorry for all the questions but you have alrewady gone through what lies ahead for me. Any information you could provide would be most appreciated.

    Thanks......Jim aka gatoraid

    Urgent plea to not delay your treatment for a month
    Jim,

    I wouldn't wait almost a month to start treatment --- I would be starting treatment next week if at all possible. Don't give this monster time to grow and get out of control. My dad went from being Stage III with good PET scan results at the end of April to Stage IVb in June with mets to the liver.

    Time is not your friend and I fear what a delay in beginning treatment could mean to your survival... I don't mean to sound mean but please fighting this cancer should be your number one focus and nothing should get in the way of you getting and starting the battle now. Don't let the cancer grow while you wait. This really is a matter of life and death.

    Best,
    Cindy
  • Tina Blondek
    Tina Blondek Member Posts: 1,500 Member
    Do Not Waste Your Precious Time
    Hello Rob
    Get this treatment started immediately. They are both great chemo drugs. This is what most drs. prescribe for EC. William of course has covered all basis. Time is of the essence. Do not give this cancer any more time to grow. Kill it in its footsteps. Thanks for your updates, keep them coming!
    Tina
  • llamp0922
    llamp0922 Member Posts: 40
    Gatoraid said:

    Your Chemo Therapy
    Hi Callie,

    I am scheduled to start Cisplatin and 5-FU on September 28th and am curious about the side effects that you personally had and if now that you are no longer on them, if any of the side effects still bother you. I'm having and ultrasound and biopsy of the 2 suspect lymph nodes and that will tell my true staging. Without the ultrasound they assumed I was stage III but if I'm lucky it may be less. I've read on this site that people have long term symptoms of tingling/aching of their feet, fatigue and other symptoms. Of particular concern is the mouth/throat sores I read about. Eating and drinking is something I can do now and I'm hopeful that I can continue up until surgery.

    As for the radiation I am getting 28 days straight (not weekends) of IMRT radiation. Is that what you had? What was your experience with that?

    The chemo will be weekly and run concurrent with the radiation.

    Sorry for all the questions but you have alrewady gone through what lies ahead for me. Any information you could provide would be most appreciated.

    Thanks......Jim aka gatoraid

    Hi Jim,
    I did the Cisplatin

    Hi Jim,

    I did the Cisplatin and 5FU @ MGH along with concurrent IMRT radiation in 2007. It wasn't pretty, but it worked.

    I was diagnosed 7/13/07, was at MGH for a second opinion 7/20, ended up inpatient after having to have the g tube and trach surgically place, yet didn't begin treatment until 8/20/07. It took a month for them to get everything in place, have the radiation simulation and have a treatment plan created for the radiation, along with the port and g-tube placed. It felt like I was waiting forever, but the radiation planning seems to take awhile. I felt like they were minimizing the damage to nearby important organs.

    As for treatment...if there was a side effect, I got it. Nausea, vomiting, nasty mouth sores from my lips throughout my digestive system, fatigue, low counts, dehydration, pneumonias, neuropathy, ear ringing and hearing loss (which continues today), thyroid damage, burns...well, you get the picture. It was not fun, but IT WAS SOOOO WORTH IT!!!! I had to stop Cisplatin after completing two cycles due to my hearing damage and toxicity. The chemo was really tough. I was unable to eat before treatment even began, and was g-tube fed for 4 months. I could hold that down, and had lots of gatorade thru the tube, plus home hydration and hydration at the infusion center. It really helps. They will offer you drugs...take them!!! Emend is the drug that helps the Cisplatin nausea, plus Zofran, Compazine, Ativan, Reglan (don't know if that is on the market any longer?). If they will help you, take them!!! Not everyone feels as rotten on the chemo/rad treatment. I either heard or read that those who get car sick or morning sickness tend to be sicker during treatment. The docs said it was the hardest treatment regiment to endure. I tried to remember if the treatment was kicking my butt, it was surely knocking my cancer out!

    Who is your oncologist, radiation onc and thoracic surgeon? Let me know if there is anything I answer for you. Hang in there!!!

    Positive thoughts, Jim!!!

    Lisa
  • Gatoraid
    Gatoraid Member Posts: 66
    llamp0922 said:

    Hi Jim,
    I did the Cisplatin

    Hi Jim,

    I did the Cisplatin and 5FU @ MGH along with concurrent IMRT radiation in 2007. It wasn't pretty, but it worked.

    I was diagnosed 7/13/07, was at MGH for a second opinion 7/20, ended up inpatient after having to have the g tube and trach surgically place, yet didn't begin treatment until 8/20/07. It took a month for them to get everything in place, have the radiation simulation and have a treatment plan created for the radiation, along with the port and g-tube placed. It felt like I was waiting forever, but the radiation planning seems to take awhile. I felt like they were minimizing the damage to nearby important organs.

    As for treatment...if there was a side effect, I got it. Nausea, vomiting, nasty mouth sores from my lips throughout my digestive system, fatigue, low counts, dehydration, pneumonias, neuropathy, ear ringing and hearing loss (which continues today), thyroid damage, burns...well, you get the picture. It was not fun, but IT WAS SOOOO WORTH IT!!!! I had to stop Cisplatin after completing two cycles due to my hearing damage and toxicity. The chemo was really tough. I was unable to eat before treatment even began, and was g-tube fed for 4 months. I could hold that down, and had lots of gatorade thru the tube, plus home hydration and hydration at the infusion center. It really helps. They will offer you drugs...take them!!! Emend is the drug that helps the Cisplatin nausea, plus Zofran, Compazine, Ativan, Reglan (don't know if that is on the market any longer?). If they will help you, take them!!! Not everyone feels as rotten on the chemo/rad treatment. I either heard or read that those who get car sick or morning sickness tend to be sicker during treatment. The docs said it was the hardest treatment regiment to endure. I tried to remember if the treatment was kicking my butt, it was surely knocking my cancer out!

    Who is your oncologist, radiation onc and thoracic surgeon? Let me know if there is anything I answer for you. Hang in there!!!

    Positive thoughts, Jim!!!

    Lisa

    HI Lisa,
    No sense in boring

    HI Lisa,

    No sense in boring you twice with the same message.
  • Gatoraid
    Gatoraid Member Posts: 66
    llamp0922 said:

    Hi Jim,
    I did the Cisplatin

    Hi Jim,

    I did the Cisplatin and 5FU @ MGH along with concurrent IMRT radiation in 2007. It wasn't pretty, but it worked.

    I was diagnosed 7/13/07, was at MGH for a second opinion 7/20, ended up inpatient after having to have the g tube and trach surgically place, yet didn't begin treatment until 8/20/07. It took a month for them to get everything in place, have the radiation simulation and have a treatment plan created for the radiation, along with the port and g-tube placed. It felt like I was waiting forever, but the radiation planning seems to take awhile. I felt like they were minimizing the damage to nearby important organs.

    As for treatment...if there was a side effect, I got it. Nausea, vomiting, nasty mouth sores from my lips throughout my digestive system, fatigue, low counts, dehydration, pneumonias, neuropathy, ear ringing and hearing loss (which continues today), thyroid damage, burns...well, you get the picture. It was not fun, but IT WAS SOOOO WORTH IT!!!! I had to stop Cisplatin after completing two cycles due to my hearing damage and toxicity. The chemo was really tough. I was unable to eat before treatment even began, and was g-tube fed for 4 months. I could hold that down, and had lots of gatorade thru the tube, plus home hydration and hydration at the infusion center. It really helps. They will offer you drugs...take them!!! Emend is the drug that helps the Cisplatin nausea, plus Zofran, Compazine, Ativan, Reglan (don't know if that is on the market any longer?). If they will help you, take them!!! Not everyone feels as rotten on the chemo/rad treatment. I either heard or read that those who get car sick or morning sickness tend to be sicker during treatment. The docs said it was the hardest treatment regiment to endure. I tried to remember if the treatment was kicking my butt, it was surely knocking my cancer out!

    Who is your oncologist, radiation onc and thoracic surgeon? Let me know if there is anything I answer for you. Hang in there!!!

    Positive thoughts, Jim!!!

    Lisa

    Cisplatin and 5-FU
    HI Lisa,

    My Oncologist is Panos Fidias and the surgeon is Christopher Morse at MGH. I've seen another sureon at Boston Medical Center and he is the one who wants to correctly stage me up front. While MGH wants me to go to chemo/radiation just like you had, the surgeon at Boston Medical Center wanted to know if the esophagus wall had been breached and wanted a biopsy on both lymph nodes before making his recommendadtion. He said if the wall wasn't breached, he may go right to surgery. Dr Fernando has the most experience with laposcopic surgery in Boston, which I was able to confirm. MGH takes the approach that regardless of staging, chemo and radiation are the safest bet. The differance of approaches confuses me and the side effects (possibly permanent) don't give me the warm and fuzzies either. How can I be sure that I don't get business as usual treatment that will negatively mess me up for the rest of my life. The surgeon that looked at my results and said the tumor was moderately differentiated slow growing)and told me that this thing has been in me probably a year and 2 weeks should make no differance one way or another is a very talented and caring physician. Alot of people on this site think I am crazy for putting off chemo and radiation 2 weeks. I just got married last September and I have minimal symptoms now. This may be the last time me and my wife can enjoy quality time together. If I end up a burdon, certainly it's not what ai wanted for my wife. Am, I taking a chance....possibly, but I am not going to look back with regrets and wish we would have taken our anniversary together. Life is luck. You can be as careful and healthy as you can be and get hit by a truck. If God is in a hurry to get my company, then it will happen regardless of my choices.

    I really appreciate your response and truly thatnk all of those who are concerned about me.

    Take care...Jim aka gatoraid
  • JimsBrother
    JimsBrother Member Posts: 94

    Do Not Waste Your Precious Time
    Hello Rob
    Get this treatment started immediately. They are both great chemo drugs. This is what most drs. prescribe for EC. William of course has covered all basis. Time is of the essence. Do not give this cancer any more time to grow. Kill it in its footsteps. Thanks for your updates, keep them coming!
    Tina

    Start of therapy
    I may be privy to some information that will ease our minds regarding the start of my brothers Chemo and radiation treatments. The earliest dates they were able to schedule the actual treatments, was during the end of the first week of his vacation which put him in Florida at that time. So he had to decide between cutting his vacation short, and come back about a week early or begin the treatments the day after he returns. So, what looks like a 1 month delay to begin his therapies, from now till then is actuality maybe be 7 - 10 days. The planning and tests he is set to have will all be done before he leaves so everything will be ready the minute he returns. I understand there is much to do with the actual planning of the IMRT radiation therapy that needs to take place prior to it starting. IMRT radiation therapy is not a simple process.

    We had thought also about speaking with the doctors at Dana Farber Cancer center in Boston because they are also one of the top centers in the country, The first possible appointment he could get was September 9th, so he set that up. Yesterday they called and said they needed to change this appointment to the 14th. If he would have listened to me and gone there first, the delay would have been much longer. Thank God he didn't listen to me and try to deal strictly with this center. He set his appointments for his initial appointment, and the appointments for the second opinion, long before he would have even been seen at Dana Farber.

    In a perfect world, he would have been set to have all of the test he was going to need when this diagnosis was first made. Better yet, if the doctors would have done a minimal amount of investigation back in October when he had the very first symptom, choking on food and visiting the ER, he might have been through all this by now and on the road to recovery.

    He still hasn't had the ultrasound that would give a more definite staging of his EC, something I now know is critical to this process and that in my opinion is the fault of the doctors and his Oncology Medical specialist that is supposed to be the one arranging all of these things for him. We didn't know or I am sure we would have asked for the ultrasound right at the start.

    That is exactly why we are here. We have to rely on you all to assist us so we can do what we can within the confines of everything else that factors in to something like this. You are his lifeline, his teachers for this cancer course he has been enrolled into by no desire of his own. We need you to be upfront, and yes even when someone disagrees with him or I.

    We have both spent hours and hours and hours in deep discussion since the day of his diagnosis. He is my big brother, back when I needed him to step up and make me do things I really didn't want to do, he did exactly that. Now it is my turn to step up and I am ready for the job. I told him on day one, he may not like what I have to say sometimes, but I will say it just the same. I first thought I would try and just give him the good not so disturbing information i found about this cancer stuff. I thought at first that would spare him the ugliness of this. But that would have been wrong and I knew it. He is faced with the biggest problem he has ever faced, and I will do my best to not let him face it alone.

    I think I said a lot more than I set out to say. So I will end now and sleep through the rest of this post. Like William said, we both stay up too late.

    Thank you all once again.

    Rob
  • BMGky
    BMGky Member Posts: 621

    Start of therapy
    I may be privy to some information that will ease our minds regarding the start of my brothers Chemo and radiation treatments. The earliest dates they were able to schedule the actual treatments, was during the end of the first week of his vacation which put him in Florida at that time. So he had to decide between cutting his vacation short, and come back about a week early or begin the treatments the day after he returns. So, what looks like a 1 month delay to begin his therapies, from now till then is actuality maybe be 7 - 10 days. The planning and tests he is set to have will all be done before he leaves so everything will be ready the minute he returns. I understand there is much to do with the actual planning of the IMRT radiation therapy that needs to take place prior to it starting. IMRT radiation therapy is not a simple process.

    We had thought also about speaking with the doctors at Dana Farber Cancer center in Boston because they are also one of the top centers in the country, The first possible appointment he could get was September 9th, so he set that up. Yesterday they called and said they needed to change this appointment to the 14th. If he would have listened to me and gone there first, the delay would have been much longer. Thank God he didn't listen to me and try to deal strictly with this center. He set his appointments for his initial appointment, and the appointments for the second opinion, long before he would have even been seen at Dana Farber.

    In a perfect world, he would have been set to have all of the test he was going to need when this diagnosis was first made. Better yet, if the doctors would have done a minimal amount of investigation back in October when he had the very first symptom, choking on food and visiting the ER, he might have been through all this by now and on the road to recovery.

    He still hasn't had the ultrasound that would give a more definite staging of his EC, something I now know is critical to this process and that in my opinion is the fault of the doctors and his Oncology Medical specialist that is supposed to be the one arranging all of these things for him. We didn't know or I am sure we would have asked for the ultrasound right at the start.

    That is exactly why we are here. We have to rely on you all to assist us so we can do what we can within the confines of everything else that factors in to something like this. You are his lifeline, his teachers for this cancer course he has been enrolled into by no desire of his own. We need you to be upfront, and yes even when someone disagrees with him or I.

    We have both spent hours and hours and hours in deep discussion since the day of his diagnosis. He is my big brother, back when I needed him to step up and make me do things I really didn't want to do, he did exactly that. Now it is my turn to step up and I am ready for the job. I told him on day one, he may not like what I have to say sometimes, but I will say it just the same. I first thought I would try and just give him the good not so disturbing information i found about this cancer stuff. I thought at first that would spare him the ugliness of this. But that would have been wrong and I knew it. He is faced with the biggest problem he has ever faced, and I will do my best to not let him face it alone.

    I think I said a lot more than I set out to say. So I will end now and sleep through the rest of this post. Like William said, we both stay up too late.

    Thank you all once again.

    Rob

    The staging is the key to
    The staging is the key to type of treatment. The IMRT does take a little planning. Husband diagnosed December 7, 2009. Got all tests in just before Christmas. In the two weeks after diagnosis, met with surgeon, got PET scan and got the staging scan whatever it is called as well as "measured" and tattooed for the radiation. Went to Disney World and visited with our 8 grandchildren. Great time even with the shadow of treatment in background. Doctor said that the two weeks involved wasn't a problem as IMRT couldn't start until January 11th. His team, not a board, all discussed plan of treatment and IMRT setup and walk through had to be completed. The team selected the surgeon. Our first one was great and placed the jtube; however, the team placed us with a thoracic oncology surgeon. The two surgeons work together. A third one assisted with his operation. I noticed you said gtube. Most everybody gets a jtube. I didn't know this difference was important but it is. A g tube can take bolus feeding and a much greater amount. A j tube uses a kangaroo joey pump and prepared supplement. The j tube goes into the jejunum which has a smaller capacity. If you have a j tube, don't let anybody do bolus feeding. Over filling the j tube results in back fill into the stomach and is most painful. You'd be surprised if you don't watch out, inattentive medical personnel will confuse the two. We learned the hard way. When we were experiencing problems, our son-in-law, a physician in another state, who we decided to ask--we were trying to handle things ourselves, said the capacity is so much smaller. He gave some great suggestions until we were given the pump. Also, my husband had extreme difficulty with swallowing, another issue, and could not take tablets. People recommend crushing them and putting with food. Son-in-law said there are many liquid equivalents to tablets and to ask for the liquid. All it took was asking our team, and immediately, all medications were changed to liquid, and lots of problems solved. I kept a log and monitored responses, BP, sugar, bathroom habits, food intake, medicine problems. It helped the doctors respond to adjustments. Also, it gave us a feeling of helping in our chance for cure. I could go on as there is so much we have learned in these 8 months. WE feel so blessed to have a fighting chance. Hopefully, your brother's treatment will go uneventfully. Just be there for him if you hit a few bumps on the road.
  • llamp0922
    llamp0922 Member Posts: 40
    Gatoraid said:

    Cisplatin and 5-FU
    HI Lisa,

    My Oncologist is Panos Fidias and the surgeon is Christopher Morse at MGH. I've seen another sureon at Boston Medical Center and he is the one who wants to correctly stage me up front. While MGH wants me to go to chemo/radiation just like you had, the surgeon at Boston Medical Center wanted to know if the esophagus wall had been breached and wanted a biopsy on both lymph nodes before making his recommendadtion. He said if the wall wasn't breached, he may go right to surgery. Dr Fernando has the most experience with laposcopic surgery in Boston, which I was able to confirm. MGH takes the approach that regardless of staging, chemo and radiation are the safest bet. The differance of approaches confuses me and the side effects (possibly permanent) don't give me the warm and fuzzies either. How can I be sure that I don't get business as usual treatment that will negatively mess me up for the rest of my life. The surgeon that looked at my results and said the tumor was moderately differentiated slow growing)and told me that this thing has been in me probably a year and 2 weeks should make no differance one way or another is a very talented and caring physician. Alot of people on this site think I am crazy for putting off chemo and radiation 2 weeks. I just got married last September and I have minimal symptoms now. This may be the last time me and my wife can enjoy quality time together. If I end up a burdon, certainly it's not what ai wanted for my wife. Am, I taking a chance....possibly, but I am not going to look back with regrets and wish we would have taken our anniversary together. Life is luck. You can be as careful and healthy as you can be and get hit by a truck. If God is in a hurry to get my company, then it will happen regardless of my choices.

    I really appreciate your response and truly thatnk all of those who are concerned about me.

    Take care...Jim aka gatoraid

    Cisplatin/5FU
    Good Morning Jim,

    It is very overwhelming to start the process of treatment. There are so many questions swimming around, with multiple answers too! Keep asking questions and the right decision will come to you. I'm sure you will have some consensus after your meeting at Dana Farber.

    I read your brother's post about the treatment only being delayed for a few days by your vacation. First, you are so lucky to have your brother as such an advocate. You will need the support of many people to go through this. Those people are your team, and help to make the process bearable. Second, speak to your treatment team about your vacation. If they are concerned about a delay, they will let you know.

    I am remembering back to my big appointment with the team where staging was discussed. They were thinking stage 2-3, but after the endoscopy/bronchoscopy it was staged at 3B, with lymph node involvement. That was when we knew the extent of the tracheal involvement and I became inoperable. I had been on the same 25 radiation with concurrent chemo plan that you are on prior to the staging.

    Have you been scheduled for a PET/CT? That is a great test for making sure the cancer hasn't gone anywhere else. MGH did one of those pretty quickly in the planning process.

    We are also going to Florida in mid September to celebrate our 20th anniversay. Enjoy!

    Have a great weekend!
    Lisa
  • JimsBrother
    JimsBrother Member Posts: 94
    llamp0922 said:

    Cisplatin/5FU
    Good Morning Jim,

    It is very overwhelming to start the process of treatment. There are so many questions swimming around, with multiple answers too! Keep asking questions and the right decision will come to you. I'm sure you will have some consensus after your meeting at Dana Farber.

    I read your brother's post about the treatment only being delayed for a few days by your vacation. First, you are so lucky to have your brother as such an advocate. You will need the support of many people to go through this. Those people are your team, and help to make the process bearable. Second, speak to your treatment team about your vacation. If they are concerned about a delay, they will let you know.

    I am remembering back to my big appointment with the team where staging was discussed. They were thinking stage 2-3, but after the endoscopy/bronchoscopy it was staged at 3B, with lymph node involvement. That was when we knew the extent of the tracheal involvement and I became inoperable. I had been on the same 25 radiation with concurrent chemo plan that you are on prior to the staging.

    Have you been scheduled for a PET/CT? That is a great test for making sure the cancer hasn't gone anywhere else. MGH did one of those pretty quickly in the planning process.

    We are also going to Florida in mid September to celebrate our 20th anniversay. Enjoy!

    Have a great weekend!
    Lisa

    Hi Lisa, and thank you.
    Yes, he has had his CT/PET scan, and I believe everything has been either done or is set to be done. The ultrasound being one that is set up along with the 2 lymph nodes to be biopsied.

    He also had a hearing test and the tech explained that the typical hearing loss after chemo is to the upper end of the scale, and because he lost much of his hearing in the upper end already when he was in the Army, she said he may not notice any change whatsoever. Good news.

    I know many times when faced with this diagnosis, the initial question we would ask ourselves is "Why me" and the attitude of "Woe is me" is not uncommon either. I must give my brother credit because from day 1 of his diagnoses and through today I have not heard either from him. I can't say that I would have responded in the same manner.

    I have no problem saying how proud I am of him for how he has handled this crisis. He is my hero in so many ways, this is just one more.

    Thank you Lisa for your replies. Jim told me you have exchanged emails and other information. I believe you can be instrumental in his decision making because you were also treated at Mass General. If you know of anything I can help either of you with, please don't hesitate to ask.

    Take care,

    Rob aka Jims favorite baby brother.
  • Gatoraid
    Gatoraid Member Posts: 66
    llamp0922 said:

    Cisplatin/5FU
    Good Morning Jim,

    It is very overwhelming to start the process of treatment. There are so many questions swimming around, with multiple answers too! Keep asking questions and the right decision will come to you. I'm sure you will have some consensus after your meeting at Dana Farber.

    I read your brother's post about the treatment only being delayed for a few days by your vacation. First, you are so lucky to have your brother as such an advocate. You will need the support of many people to go through this. Those people are your team, and help to make the process bearable. Second, speak to your treatment team about your vacation. If they are concerned about a delay, they will let you know.

    I am remembering back to my big appointment with the team where staging was discussed. They were thinking stage 2-3, but after the endoscopy/bronchoscopy it was staged at 3B, with lymph node involvement. That was when we knew the extent of the tracheal involvement and I became inoperable. I had been on the same 25 radiation with concurrent chemo plan that you are on prior to the staging.

    Have you been scheduled for a PET/CT? That is a great test for making sure the cancer hasn't gone anywhere else. MGH did one of those pretty quickly in the planning process.

    We are also going to Florida in mid September to celebrate our 20th anniversay. Enjoy!

    Have a great weekend!
    Lisa

    Cisplatin/5FU followup
    I've had the Pet/CT and it showed the tumor with 2 lymph nodes. There is a 95% chance the lymph nodes were passed the cancer cells from the tumor. I'm scheduled for an Ultrasound with a biopsy of the 2 lymph nodes on Sept. 7th. This will allow exact staging....how far the tumor is into the wall and whether the 2 lymph nodes are cancerous. Once that is known my decisions will either be easier or harder to make. I'll keep in touch one way or the other.

    Thanks, Jim ...aka gatoraid
  • Tina Blondek
    Tina Blondek Member Posts: 1,500 Member
    BMGky said:

    The staging is the key to
    The staging is the key to type of treatment. The IMRT does take a little planning. Husband diagnosed December 7, 2009. Got all tests in just before Christmas. In the two weeks after diagnosis, met with surgeon, got PET scan and got the staging scan whatever it is called as well as "measured" and tattooed for the radiation. Went to Disney World and visited with our 8 grandchildren. Great time even with the shadow of treatment in background. Doctor said that the two weeks involved wasn't a problem as IMRT couldn't start until January 11th. His team, not a board, all discussed plan of treatment and IMRT setup and walk through had to be completed. The team selected the surgeon. Our first one was great and placed the jtube; however, the team placed us with a thoracic oncology surgeon. The two surgeons work together. A third one assisted with his operation. I noticed you said gtube. Most everybody gets a jtube. I didn't know this difference was important but it is. A g tube can take bolus feeding and a much greater amount. A j tube uses a kangaroo joey pump and prepared supplement. The j tube goes into the jejunum which has a smaller capacity. If you have a j tube, don't let anybody do bolus feeding. Over filling the j tube results in back fill into the stomach and is most painful. You'd be surprised if you don't watch out, inattentive medical personnel will confuse the two. We learned the hard way. When we were experiencing problems, our son-in-law, a physician in another state, who we decided to ask--we were trying to handle things ourselves, said the capacity is so much smaller. He gave some great suggestions until we were given the pump. Also, my husband had extreme difficulty with swallowing, another issue, and could not take tablets. People recommend crushing them and putting with food. Son-in-law said there are many liquid equivalents to tablets and to ask for the liquid. All it took was asking our team, and immediately, all medications were changed to liquid, and lots of problems solved. I kept a log and monitored responses, BP, sugar, bathroom habits, food intake, medicine problems. It helped the doctors respond to adjustments. Also, it gave us a feeling of helping in our chance for cure. I could go on as there is so much we have learned in these 8 months. WE feel so blessed to have a fighting chance. Hopefully, your brother's treatment will go uneventfully. Just be there for him if you hit a few bumps on the road.

    Hi Rob
    I agree, the staging

    Hi Rob
    I agree, the staging is important and I was surprised to see that he has not had that done yet. How is an ultra sound going to show that? I would think they would do the staging with the scope, or the pet scan. They both show much more detail than an ultra sound. You are both doing an excellent job! Keep up the good work, and have him start his treatments a.s.a.p. We will be thinking of you and praying for you.
    Tina
  • BJeastOR
    BJeastOR Member Posts: 18
    Gatoraid said:

    Your Chemo Therapy
    Hi Callie,

    I am scheduled to start Cisplatin and 5-FU on September 28th and am curious about the side effects that you personally had and if now that you are no longer on them, if any of the side effects still bother you. I'm having and ultrasound and biopsy of the 2 suspect lymph nodes and that will tell my true staging. Without the ultrasound they assumed I was stage III but if I'm lucky it may be less. I've read on this site that people have long term symptoms of tingling/aching of their feet, fatigue and other symptoms. Of particular concern is the mouth/throat sores I read about. Eating and drinking is something I can do now and I'm hopeful that I can continue up until surgery.

    As for the radiation I am getting 28 days straight (not weekends) of IMRT radiation. Is that what you had? What was your experience with that?

    The chemo will be weekly and run concurrent with the radiation.

    Sorry for all the questions but you have alrewady gone through what lies ahead for me. Any information you could provide would be most appreciated.

    Thanks......Jim aka gatoraid

    Jim- Your chemo therapy and rado
    Just to add to the experiences. My hubby had the same regimen. Concurrent radiation/chemo pre-surgery. My research into the various treatment protocols showed me early on that there is no one perfect answer. I reviewed results of all types of trials etc and they showed me that this regimen probably had the best chance of the best survival rates, so we went for it. Others have said, it is not pretty. Hubby had most of the side effects as well. When he started to get mouth sores they just stopped the 5-FU pump for a week. The hearing loss (high tones) and neuropathy (feet numbness) continue (one year + later) and expect they will be permanent, however they really don't affect his lifestyle or quality of life.
    It is tough treatment. He was a sick puppy going through it and by the end used a wheelchair the last day to leave the treatment facility. I don't know how anyone can work during this time, actually. BUT-- it is only for this period of time and YOU CAN DO THIS!

    Jen
  • JimsBrother
    JimsBrother Member Posts: 94

    Hi Rob
    I agree, the staging

    Hi Rob
    I agree, the staging is important and I was surprised to see that he has not had that done yet. How is an ultra sound going to show that? I would think they would do the staging with the scope, or the pet scan. They both show much more detail than an ultra sound. You are both doing an excellent job! Keep up the good work, and have him start his treatments a.s.a.p. We will be thinking of you and praying for you.
    Tina

    Had the same question
    I had the same question about the ultrasound. But from what we have found, it is the only test that tells them if the tumor as gone through the outer layer of the esophagus. You can see actual ultrasounds being done at various web sites. I still can't make them out.

    Thanks Tina
  • unclaw2002
    unclaw2002 Member Posts: 599

    Had the same question
    I had the same question about the ultrasound. But from what we have found, it is the only test that tells them if the tumor as gone through the outer layer of the esophagus. You can see actual ultrasounds being done at various web sites. I still can't make them out.

    Thanks Tina

    Rob,
    You may want to see if

    Rob,

    You may want to see if you brother is a candidate for a clinical trial with Erbitux. Erbitux is an agent that attacks the tumor and the results have been remarkable --- it is already approved for colon and I believe neck cancer in the US and in Europe for esophageal cancer. The chemo agents in the trial are taxol and cisplatin. Just another bit of research for you to do in your spare time (LOL) --- this does become a focus of our lives trying to help our loved ones.

    Best,
    Cindy
  • JimsBrother
    JimsBrother Member Posts: 94

    Rob,
    You may want to see if

    Rob,

    You may want to see if you brother is a candidate for a clinical trial with Erbitux. Erbitux is an agent that attacks the tumor and the results have been remarkable --- it is already approved for colon and I believe neck cancer in the US and in Europe for esophageal cancer. The chemo agents in the trial are taxol and cisplatin. Just another bit of research for you to do in your spare time (LOL) --- this does become a focus of our lives trying to help our loved ones.

    Best,
    Cindy

    Excellent info
    Thanks Cindy, I was taking the day off, but now I have to read about this. I'll let you know what I find.

    Thanks again,
    Rob