after surgery/

chynadogs
chynadogs Member Posts: 1
in Esophageal Cancer #1

my husband has esophageal cancer stage 3, he had his chemo and then surgery, my doctor never went over the pathology report with me but i did get a copy of it from the nurse when he was in the hosp. (he was in the hosp. for 9 weeks). the report says 2 out of 16 lymph nodes are positive for Metastatic Adenocarcinoma... what does that mean and how do i know what stage his cancer is at or does he still have cancer... no one tells us anything and i did not know what questions to ask at the time.

he had complactions after surgery and became septic and i almost lost him, surgery was last may and he still has a good size hole in his back from the sepsis but we see the surgeon a lot and he goes to whomb care alot. i think with all the complactions they just were not worried about the cancer at the time.

he just had a CT done and they said it did not show anything but the blood work did show his CEA level went from 4.8-8.3 and his CA19-9 went from 17 to 57, i am worried about the blood work with these numbers but the doctor said she was not worried because the CT was good... i dont understand

 

Thank you,

Comments

  • Deathorglory
    Deathorglory Member Posts: 364 Member
    #2
    Hello Chynadogs,

    Hello,

    It sounds like you don't have a very communicative relationship with your doctors.  That's a shame and you should consider it completely unacceptable.  Don't leave the office until you have your questions answered to your satisfaction.  You do have a responsibility to educate yourself about your husband's condition and to have questions ready, but it is completely wrong of doctors to not provide you with information and answers that you need.  

    Spread to local lymph nodes is Stage III.  I don't know from what you've provided if the cancer was still there after chemo and surgery.  If it was, your doctors would likely have recommended some post-surgery chemo, unless your husband wasn't up to it.  The CT showing no cancer probably means that there was no residual cancer after the surgery.  The cancer markers in blood tests will likely go up and down over time.  It's when there's a pattern of it being elevated that will draw some concern.  If you didn't understand what the doctor was saying, you have to tell her that and ask for a more thorough explanation.  They make a ton of money off of us, they can take an extra few minutes to earn it by making sure you understand everything.  

    Hope everything goes well for your husband,

    Ed

     

  • paul61
    paul61 Member Posts: 1,391 Member
    #3
    Positive pathology for cancer often means post-surgery chemo

    I am so sorry to hear about the difficult time your husband had with surgery. Esophagectomy surgery is normally difficult but 9 weeks in the hospital is a very long time. I also had a pathology report positive for adenocarcinoma, and had an open wound when I left the hospital because I developed an infection in my incisions when I was in the hospital. My wound took over six months to finally heal but a large part of my issue was that the chemotherapy I had after surgery slowed the healing process.

    Normally a post-surgical pathology report would indicate follow up chemotherapy, but I think in the case of your husband, they may be waiting for his wound to heal before starting. I should add that although many surgeons recommend follow up chemotherapy after a positive pathology report there is no clearly demonstrated benefit in terms of preventing a recurrence.

    As for the elevated tumor markers in your husband’s blood work; elevated markers could indicate the need for scans to investigate for tumor activity. But if your husbands recent CT was clear, I am not sure what additional investigation your oncologist could do other than possibly ordering at PET scan to look for the elevated metabolic activity that may indicate a tumor too small to see with the CT scan.

    One positive thing to remember is that the lymph nodes that contained the cancer cells are no longer in your husband’s body. If they were adjacent to the tumor site, (as they normally are), then the cancer may not have traveled far outside your husband’s esophagus.

    Questions I would ask would include:

    1. Where were the positive lymph nodes located in relation to the primary tumor site?

    2. Would my husband benefit from post-surgical chemotherapy?

    3. If he would benefit from chemotherapy what might be the effect on wound care?

    4. What do you believe the explanation for the elevated tumor markers may be, given a clear CT?

    5. Would the application of a “Wound Vac” (a device that helps close the wound and draw out discharge) accelerate the healing process for my husband?

     

    Post-surgery is a difficult question because some oncologists believe there is no clearly demonstrated benefit, but I did it, and I am glad I did everything I could to promote a long term remission.

    Your poor guy has had a difficult journey so far, I hope things improve for him soon.

     

    Best Regards,

    Paul Adams

    McCormick, South Carolina

     

    DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
    Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
    Seven Year Survivor

     

     

     

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