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Stage 2 Esophageal Cancer surgery success. Would you do post surgery treatment Chemo and radia...

Stage 2 Esophageal Cancer surgery success. Would you do post surgery treatment Chemo and radiation?

Posted by SVG on Jun 30, 2020 10:28 pm

Hi My wife just had successful stage 2 Esophageal Cancer surgery. Clean margins. Thinking positively the stats are 70% chance no  reoccurance of cancer. Now must decide whether to take  post surgery treatment of  Chemo and radiation for a potential extra 5%. Would you do it for an extra 5%?  Pros and Cons  of anyone who has faced this decision would be appreciated. I will support my wife no matter her choice.

Re: Stage 2 Esophageal Cancer surgery success. Would you do post surgery treatment Chemo and radiation?

Posted by Rayline on Jun 30, 2020 10:42 pm

SVG‍ I  was diagnosed with breast and lung and at stage one and  chemo is not an option. I would have gone for it at 5% extra.Chemo sounds extremely difficult but it is only temporary. Just my two cents and I have not experienced chemo. 

Re: Stage 2 Esophageal Cancer surgery success. Would you do post surgery treatment Chemo and radiation?

Posted by cancertakesflight on Jul 1, 2020 7:06 am

SVG‍ 

It can be daunting to make some of these treatment decisions and each of those decisons are very personal ones. What is right for one person may not be right for another. 

If you dont mind answering, can you tell me why chemo is being recomended? I had breast cancer and it was recommended that I have chemo after my surgery because some cancer was found in two lymphnodes, which meant that the cancer could be in other parts if my body. What I had to learn was that surgery and radiation are for specific areas of the body and chemo is a whole body experience. They are technically serving slightly different purposes.

I had my cancer treatments in 2011 and my oncologist didn't give me a lot of percentages; however, my mentality at the time was to do everything I could to kill the cancer so if it came back there would be no regrets. I didnt want to wonder whether, if I had chemo, the cancer would still have come back.

Having said that you have to consider the potential side effects from the chemo. I dont know if you have had tjat conversation. I actually worked during chemo but it is not the same for everyone. 

So, in answer to your question. I chose to have chemo because I needed to do it for piece of mind and because I knew that the cancer had reached one level of lymphnodes so i wanted to make sure it didn't go any farther.

Your wife may feel totally differently and the reason it is being recomended may impact whether or not that 5% is important. No one on this site can make that decision for you.

If you are willing ti share your decision please tag me in your response by using the @ symbol followed by my user name cancertakesflight and then select my name when it appears in a pop up. You can do this for anyone on the site.

cancertakesflight
Laughter is a lifestyle choice. www.laughterandcancer.com/blog

Re: Stage 2 Esophageal Cancer surgery success. Would you do post surgery treatment Chemo and radiation?

Posted by Cynthia Mac on Jul 1, 2020 8:03 am

SVG‍ , I tend to agree with what cancertakesflight‍ said - it’s a very personal decision, and there are numerous factors to consider: the type of cancer, whether it has spread to the lymph system, how strong the patient is, and even, to a degree the patient’s mental attitude. Different strains of a type of cancer may even need to be factored in.

For example, my Dad’s chance of recurrence with or without chemo differed by only 5 percent, but Dad’s was lung cancer, and, we were told, a particularly volatile strain. Dad chose the chemo, and, looking back, it probably bought him another good year before it spread. The second round of chemo (with immunotherapy) gave him an additional 8 months of life with a modicum of quality.

Again, it depends on her cancer, and her physical and mental condition, and her wishes. Already it’s clear that you’re a supportive husband, and she’s lucky to have you!
“When the root is deep, there is no reason to fear the wind.” - Japanese saying

Re: Stage 2 Esophageal Cancer surgery success. Would you do post surgery treatment Chemo and radiation?

Posted by Survivor5 on Jul 1, 2020 9:10 am

SVG‍ 
I had surgery for lung cancer and was told the same thing.  Chemotherapy would increase my chances by 5%. I decided to do the chemo as any percentage of non reoccurrence is a bonus.  As the old saying goes.....short term pain for long term gain.  So 14 years later I am still in the clear.
Good luck with the rest of your journey
Survivor5

Re: Stage 2 Esophageal Cancer surgery success. Would you do post surgery treatment Chemo and radiation?

Posted by SVG on Jul 1, 2020 11:02 am

Thank you for all the quick replies. I know I did not share much detail and we do realize it is a personal decision. so do not fret about sharing. What works for 1 does not work for others.

Current status Details: 1> Because of age, 71, living in a nursing home due to other health issues, and of course Covid-19 factors. The standard chemo radiation treatment of 6 months before surgery was not done  2> Other health issues that have to be factored in in her case is a heart valve issue that just passed the biggest stress test possible by having surgery. 3> 8 weeks post surgery doing well down to 8 hours on the feeding tube and able to eat soft foods and creamed soups. Healing well. Physio in the nursing home due to Covid-19  restrictions not as intensive as at the hospital or home. 

We were lucky that the surgery was a treatment option and that she came through so much better than expected. I was lucky enough to be her transport from home to hospital so we could see and touch each other before her surgery. We can now have "outside" visits with a fence between us. Video conferences up to now.

The treatment offered is chemo " lite" and radiation 25 treatments. Why offered? 5 of 37 lymph nodes removed had cancer. Cancerous nodes were concentrated where the cancer was. At the junction of esophagus and stomach.  Everything taken had clear margins.  Which means we do have a worry.  

I had a brother who had leukemia and is 10+ survivor so we have seen chemo heavy. My wife's brother (2+ yr) and my cousin(5+ yr) had prostrate cancer followed by radiation and both are survivors. So we know the benefits for some cancers but esophageal cancer is/was different.  But cancerous cells can still exist even after treatment. We had a dear friend who died with multiple different cancers at the time of death and a sister in law who died due to melanoma's. 

We want some quality of life. Covid has robbed us of part of that. Treatment could make her so much more susceptible to any other infections which are so easy to pick up anywhere. No need to elaborate to you all. We chose surgery so she could have a chance we were looking at 50:50 chance of 5 years. We see it as 70:30 now.  It is a hard decision to make to go for 75:25.  I want to see her get stronger not weaker due to treatment. Oh and my wife from experience seems to get every negative side effect any medication offered especially nausea and diahrea. Vomiting and hair loss is likely too . Plus added strain on the heart.

We are coming up with our own pros and cons.Some Pros I get to see her every day during treatment because I would be her transport. She will have nursing care with people she knows care about her and want her better. Some Cons she will feel worse every day. I will be aware of this. It will take many months for her to recover and get some strength back. She will be very vulnerable to everything and anything.

Like I said before it will be a hard choice. Is 5% worth it?  Younger healthier people it might be 10% which is big! As the Doctor said there is no wrong decision here. She is doing great right now and has a 70% chance. A lot better than 3 months ago! 








 

Re: Stage 2 Esophageal Cancer surgery success. Would you do post surgery treatment Chemo and radiation?

Posted by Ken Anderson on Jul 1, 2020 1:17 pm

 
SVG‍, I asked a similar question of the members of this forum when I was diagnosed with Stage 2 HPV+ base-of-tongue cancer and was given the option or chemo-radiation (35 radiation doses over 7 weeks + 3 Cisplatin sessions) or just radiation (6 per week for 6 weeks).  Most responses were to the effect of "I'd do anything to extend my life".

My medical oncologist made it clear that the chemo option was definitely optional.  I learned that the chemo isn't intended (in my case) to seek and destroy cancerous cells trying to set up shop away from the primary site, but rather to improve the effectiveness of the radiation treatments.  I also learned from discussions with my medical and radiation oncologists, and through a lot of reading, that there's a lot of debate as to whether or not Cisplatin treatment in my situation significantly improved chances of long-term survival or recurrence.

I was 63 at the time, and otherwise very healthy.  I'd had a good life, and wanted more, but I was also very aware that we all have to die sometime; the questions are: when and how.

I decided that quality (QOL), not quantity of life, was more important to me.  I felt that the many side-effects of Cisplatin treatment posed, to me, a greater loss of QOL than the gain in QOL resulting from the possiblity that chemo would extend my life.

I declined chemo.  I am, 8 months post treatment, apparently fine in all respects (save for a little xerostomia, and some slight loss of taste resulting from the radiation).  I do not regret my decision.

As always, and as you already know from your other experiences with cancer, your wife's results will differ from mine.

You have my sympathy for what you're going through.

Best wishes,
-Ken
http://dealingwithbaseoftonguecancer.home.blog/