Post Surgery Radiation?

Alaska_Kim
Alaska_Kim Member Posts: 34
in Esophageal Cancer #1
My husband started his 3rd of 4 rounds of post surgical chemo today and we met with his oncologist. She surprised us by telling us that after he was done with his 4th round of chemo, he would start radiation approximately 3 weeks after (she also mentioned Taxol and Carboplatin weekly during radiation). We were floored. Come to find out that she had left a message with my husband and mentioned radiation, but it was never brought up again until today. My husband thought at the time she was still finalizing the treatment plan and when it wasn't brought up again, it would just be the chemo treatment he is currently on.

My question to her was, if his esophagus and the entire tumor and local lymph nodes were removed, whats left to radiate? She explained that the radiation would target the original location of the tumor and the surrounding lymph nodes since he had 5 of 12 come back positive from pathology (he was initially staged T1b and did not receive any pre-op chemo or radiation). She said the radiation would clean up any other strays out there. I don't know how many treatments they want him to do yet; we won't meet with the radiology oncologist for a few weeks yet.

Has anyone else gone through post op radiation? I am still reeling; we thought July 19th would be the last of it, and I just feel so bad for my husband who was hoping to salvage the end of summer by doing a lot of fishing (we have short summers here in Alaska!).

I have a lot of reading to do; I didn't see this coming so I am not up on radiation treatment, side effects, etc., other than the few posts I have read here and there on this site. Any thoughts are more than welcome!

Thanks in advance, Kim

Comments

  • paul61
    paul61 Member Posts: 1,391 Member
    #2
    My story is a bit similar to your husband's
    Kim,

    Like your husband I was originally diagnosed as Stage 1 (T2,N0,M0) and therefore had no chemotherapy or radiation prior to surgery. The post surgery pathology showed one of the twenty lymph nodes removed was positive for cancer cells. I was re-staged to 2B.

    My oncologist told me I have two options for post surgery treatment. One was four rounds of chemotherapy with radiation, the other was six rounds of chemotherapy. He said, in his opinion, the radiation had more risks than the potential benefits over chemotherapy alone.

    I opted for the chemotherapy alone.

    It sounds like your husband had more node involvement but it may be worth getting a second opinion or at least a second conversation with your oncologist now that you have had a chance to get past the initial shock.

    Best Regards,

    Paul Adams
    McCormick, South Carolina

    DX 10/22/2009 T2N1M0 Stage IIB
    12/03/2009 Ivor Lewis
    2/8 through 6/14/2010 Adjuvant Chemo Cisplatin, Epirubicin, 5 FU
    6/21/2010 CT Scan NED
    3/14/2011 CT Scan NED

    Life may not be the party we hoped for, but while we are here we might as well dance!
  • Alaska_Kim
    Alaska_Kim Member Posts: 34
    #3
    paul61 said:

    My story is a bit similar to your husband's
    Kim,

    Like your husband I was originally diagnosed as Stage 1 (T2,N0,M0) and therefore had no chemotherapy or radiation prior to surgery. The post surgery pathology showed one of the twenty lymph nodes removed was positive for cancer cells. I was re-staged to 2B.

    My oncologist told me I have two options for post surgery treatment. One was four rounds of chemotherapy with radiation, the other was six rounds of chemotherapy. He said, in his opinion, the radiation had more risks than the potential benefits over chemotherapy alone.

    I opted for the chemotherapy alone.

    It sounds like your husband had more node involvement but it may be worth getting a second opinion or at least a second conversation with your oncologist now that you have had a chance to get past the initial shock.

    Best Regards,

    Paul Adams
    McCormick, South Carolina

    DX 10/22/2009 T2N1M0 Stage IIB
    12/03/2009 Ivor Lewis
    2/8 through 6/14/2010 Adjuvant Chemo Cisplatin, Epirubicin, 5 FU
    6/21/2010 CT Scan NED
    3/14/2011 CT Scan NED

    Life may not be the party we hoped for, but while we are here we might as well dance!

    Thanks for your suggestions
    Thanks for your suggestions Paul. I'm coming out of the shock and the questions are coming fast and furious. We definately need to talk to the team at MD Anderson concerning the treatment plan, what is the advantage of adding radiation versus no radiation. I also have concerns about the potential for incidental damage to other organs, specifically his heart. Locally, I need to look into the radiation technology available as well as the radiology oncologist's experience with EC(most likely not much). We still have time since they don't want to start radiation until after the chemo is finished (around 6 weeks from now).

    Other than ECCN guidelines, there sure isnt a lot of info out there on post operative that is current information. Although we want to do everything we can to minimize the chances of recurrencece, neither do we want him to go through more treatment "just because".
  • linda1120
    linda1120 Member Posts: 389
    #4
    Alaska_Kim said:

    Thanks for your suggestions
    Thanks for your suggestions Paul. I'm coming out of the shock and the questions are coming fast and furious. We definately need to talk to the team at MD Anderson concerning the treatment plan, what is the advantage of adding radiation versus no radiation. I also have concerns about the potential for incidental damage to other organs, specifically his heart. Locally, I need to look into the radiation technology available as well as the radiology oncologist's experience with EC(most likely not much). We still have time since they don't want to start radiation until after the chemo is finished (around 6 weeks from now).

    Other than ECCN guidelines, there sure isnt a lot of info out there on post operative that is current information. Although we want to do everything we can to minimize the chances of recurrencece, neither do we want him to go through more treatment "just because".

    Radiation
    Dear Kim,

    In my husband's case he had chemo and radiation concurrently. This seems to be the most common practice as I have observed here on this site. Jim had IMRT radiation which uses a special targeted radiation, thereby avoiding damage to the other organs. I would think that MD Anderson would have this available. To my knowledge radiation is never done after the surgery. Chemo is only if the cancer shows in the pathology reports. Radiation is used to shrink the tumor and the chemo is to kill the cancer cells.

    I hope this helps clear up some of your questions.

    Linda
  • Alaska_Kim
    Alaska_Kim Member Posts: 34
    #5
    linda1120 said:

    Radiation
    Dear Kim,

    In my husband's case he had chemo and radiation concurrently. This seems to be the most common practice as I have observed here on this site. Jim had IMRT radiation which uses a special targeted radiation, thereby avoiding damage to the other organs. I would think that MD Anderson would have this available. To my knowledge radiation is never done after the surgery. Chemo is only if the cancer shows in the pathology reports. Radiation is used to shrink the tumor and the chemo is to kill the cancer cells.

    I hope this helps clear up some of your questions.

    Linda

    Thanks Linda
    I had never heard of post surgery radiation or radiation after chemo either, and it was recommended by my husbands MD Anderson Oncologist without a good explanation from the local oncologist (I thought). That is one of the reasons why I was so surprised. I found out that one radiation clinic here does offer IMRT radiation, so we should be able to stay in-state if he does indeed go through with the radiation ( I keep worrying about his heart). We were planning on calling MD Anderson Thursday, but the third round of chemo side effects hit my husband hard. It took a combination of multiple nausea meds to finally get his nausea under control; was able to eat a bit today, but hasnt felt like talking to anyone. Hopefully we can talk to the Oncologist next week.

    Kim
  • annalan
    annalan Member Posts: 138
    #6
    Post op chemo/radiation
    Hi I'm new here but would just like to say that
    this time last year my husband was having post
    op chemo and radiation and yes it was really
    tough but at this moment he is just watering our
    garden and is feeling really well. Just hope to give
    you a few words of encouragement.
  • Unknown
    Unknown
    #7
    This comment has been removed by the Moderator
  • Alaska_Kim
    Alaska_Kim Member Posts: 34
    #8
    annalan said:

    Post op chemo/radiation
    Hi I'm new here but would just like to say that
    this time last year my husband was having post
    op chemo and radiation and yes it was really
    tough but at this moment he is just watering our
    garden and is feeling really well. Just hope to give
    you a few words of encouragement.

    Post Op
    Hi Annalan, thanks for the encouragement! It is helpful to know that there are others that have had similar treatments. What was your husbands cancer staged at? My husband was initially staged T1b, but moved to IIIa post surgery. He had no pre-op treatment, just surgery. Was your husbands post op chemo and radiation concurrent or one after the other? Did your husband have any eating issues?

    My husband has had a lot of problems keeping food down and since he had his 3rd dilation 2 weeks ago, we are pretty sure it is from the chemo. He is on 3 different nausea meds continually, but continues to get what he calls "the bubble" sometimes all day; the next time only at dinner; the next day it might come and go all day. I never know what food he will be able to keep down from one day to the next. It is never the same!

    Kim

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