Esophagectomy or Chemo?

Sasha69
Sasha69 Member Posts: 5
in Esophageal Cancer #1

My 74 year old dad was just diagnosed with Stage 1 esophageal cancer. He is having an esophagectomy on Tuesday the 8th. He is very healthy otherwise, works out regularly and eats well. We live near Pgh. so we will be having Dr. Luketich's team perform the surgery. Our surgeon said that this is the way to go. He does not need chemo or radiation prior to the surgery so he will not have a weakened immune system. I'm just worried that maybe we should've done chemo to see if it would've gotten rid of the cancer as opposed to the surgery. The surgeon feels that the chemo either won't work or if it does work, that the cancer will return within 6 months. Right now, you would never know there was anything wrong with my dad. I am concerned that after the surgery his life will be significantly diminished. Does anyone have any thoughts on this?

Comments

  • paul61
    paul61 Member Posts: 1,391 Member
    #2
    My diagnosis was very similar to your Dad's

    Hi Sasha,

    My initial diagnosis was very similar to your Dad’s. All the original tests and scans indicated that I was Stage 1 with no spread to surrounding lymph nodes and the tumor encapsulated in the upper layers of my esophagus. They told me I did not need chemotherapy and I went straight to surgery.

    The pathology tests on the tissue removed in surgery including lymph nodes adjacent to the tumor indicated that there we active cancer cells in one of the lymph nodes. I was restaged as Stage 2B and had five months of chemotherapy after my surgery.

    Chemotherapy is typically difficult, but chemotherapy while recovering from major surgery is very difficult.

    I am glad I had surgery. And now, 10 years later, I am happy to still be here. I have some life style changes necessitated by the surgery. I sleep in an elevated position, I eat 7 small meals a day, I have to reduce my activity for 30 minutes or so after eating, and I have to be careful how much sugar I eat, but I would still say the quality of my life is good. I was 61 when I had my surgery and am now 71.

    I would encourage you to get a second opinion about the need for chemotherapy prior to surgery. But if you have to be treated for esophageal cancer, you can’t be in a better place than UPMC and Dr. Luketich's team. He wrote the book on minimally invasive esophagectomies.

    One other question comes to mind. If your Dad is indeed Stage 1, have they considered endoscopic mucosal resection (EMR)? I would include that option in your second opinion discussions if you choose to have them.

    Wishing you best of luck

    Regards

    Paul

  • Sasha69
    Sasha69 Member Posts: 5
    #3
    paul61 said:

    My diagnosis was very similar to your Dad's

    Hi Sasha,

    My initial diagnosis was very similar to your Dad’s. All the original tests and scans indicated that I was Stage 1 with no spread to surrounding lymph nodes and the tumor encapsulated in the upper layers of my esophagus. They told me I did not need chemotherapy and I went straight to surgery.

    The pathology tests on the tissue removed in surgery including lymph nodes adjacent to the tumor indicated that there we active cancer cells in one of the lymph nodes. I was restaged as Stage 2B and had five months of chemotherapy after my surgery.

    Chemotherapy is typically difficult, but chemotherapy while recovering from major surgery is very difficult.

    I am glad I had surgery. And now, 10 years later, I am happy to still be here. I have some life style changes necessitated by the surgery. I sleep in an elevated position, I eat 7 small meals a day, I have to reduce my activity for 30 minutes or so after eating, and I have to be careful how much sugar I eat, but I would still say the quality of my life is good. I was 61 when I had my surgery and am now 71.

    I would encourage you to get a second opinion about the need for chemotherapy prior to surgery. But if you have to be treated for esophageal cancer, you can’t be in a better place than UPMC and Dr. Luketich's team. He wrote the book on minimally invasive esophagectomies.

    One other question comes to mind. If your Dad is indeed Stage 1, have they considered endoscopic mucosal resection (EMR)? I would include that option in your second opinion discussions if you choose to have them.

    Wishing you best of luck

    Regards

    Paul

    Thank you Paul,

    Dr. McGrath, who is a top notch gastrologist here at UPMC did perform the EMR. He got all he could but said there was some cancer cells left in the next layer which he could not remove during the EMR. I appreciate your quick response and encouragement. Because we felt that we had the best team there was, we chose not to get a second opinion. I think our main concern was that if the chemo did not work, then my dad would still need the surgery and he would probably not be near as healthy after chemo. 

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