What is Esophageal Cancer

Esophageal cancer is malignancy of the esophagus. There are various subtypes. Esophageal tumors usually lead to dysphagia (difficulty swallowing), pain and other symptoms, and is d...

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chemo after surgery
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My brother was diagnosed with Stage III esophagus cancer 2 1/2 months ago. We live in Orange County, CA He had the Ivor Lewis surgery 2 months ago at the VA Hospital in Long Beach and they removed 2/3 of his stomach and 1/2 of his esophagus. The margins were clear around the tumor and only 2 of the 11 lymph nodes had cancer cells so as far as they could tell they got it all. He is supposed to start Chemotherapy (5-FU & Cisplatin and possibly Epirubicin) but is still vomiting and having headaches that he never had. He doesn't want to start Chemo until he gets stronger. The are going in to stretch his esophagus today hoping that will solve his problem of vomiting but the upper GI showed only a little constriction. He is staying with me and I am his caregiver. I don't seem to find many people that had the surgery 1st then the Chemo. The cancer board decided he only needed Chemo and not radiation. Many things I've looked up said Chemo after surgery doesn't increase the % of cure that much. Does anyone have a similar story or has anyone taken that type of Chemo? Thanks so much.

Judy
Posted on 10/27/09, 12:10 pm
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Reply #1 - 10/29/09  12:40am
" I think there are a lot of ways they try to treat and cure esophageal cancer. Different studies, different chemo drugs, different schedules for how often and how long to have them. They're always searching to get the best survivor rate possible. I didn't know what the Ivor Lewis surgery was when you mentioned it, but after looking it up online it doesn't sound much different than mine.

My Drs. wanted me to have chemo and radiation before surgery. Then they removed most of the esophagus and a little bit of my stomach and attached the two remaining ends together.

I have heard of people who have had surgery first and then chemo. It makes sense to me that if you have surgery first, you might not need radiation, because I think the radiation is more to shrink or kill the tumor. Chemo I've heard is like a mop and is used to mop up the cancer cells. I have NO medical experience, so I'm just repeating things I've heard and read along the way.

I did not have chemo (again) after my surgery even though 2 of 12 lymph nodes had a micropscopic cancer cell. A panel discussing my case felt that I'd already received the best drugs I could for it and my Oncologist said with a little more time (because chemo/radiation works after it is finished being given) those would probably have been killed off with a little more time. Course those 2 were removed during my surgery.

I never had any headaches, but I have found that volume is a key to my feeling better. If I eat too much (which is not a large volume) then I feel weak and sick to my stomach. When your brother is vomiting is it pretty soon after he eats and pretty much like it went in? For me, that's how it was. Ask him to eat a small amount and see if he feels ok. When he vomits is he eating more than the small amount that was ok? If so, I'd have him try to watch volume and see if that's the key. It is for me.

I hope he feels better soon. I'm sure, if he should have chemo after his surgery, they'll advise him when he should have it. I imagine there's a certain amount of time that he should have it, if he's going to have it.

I had the 5-FU, but not the other two types you mentioned for him. But I had several others. Course, they are probably all pretty similiar.

In the end we don't know if our cancer will come back, just like no one else knows if they'll receive news that they have cancer tomorrow. So....we go on hopeful :-) But I am a firm believer in listening to the Drs. and our own bodies and having our follow-up scans and scopes. And prayer... Prayer always helped me.

Good luck to your brother. I hope he starts feeling better real soon. How nice of you to stand by his side and help him through this. My sisters were an immense help through this for me. Thank God for sisters :-) I'm sure your brother would agree :-) God bless. "
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Reply #2 - 10/30/09  11:54pm
" Brenda, Thanks for your reply. The doctor called today and said that when he went in to stretch the esophagus he saw food still in there so he thinks his stomach is not emptying so that could be cause of the vomiting. It doesn't explain the dry heaves but he is going to try the medicine he gave him to take 3 times daily to help his stomach empty. He still does not want to start chemo until he feels better and gets stronger and I can't blame him. It day by day and the hardest thing is to keep his spirits up. Thanks for the words of encouragement. "
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Reply #3 - 10/31/09  12:42am
" I'm glad they found out why he is vomiting. You know, I'd forgotten, but in the beginning after surgery and during my recovery there were times that I didn't feel good and I would feel like I had to have something come up. It wouldn't at times, but that heaving seemed to help give me some relief for some reason. It was kinda odd, but I'd sit in the chair with a garbage can in hand and do that. Luckily most of the time nothing would come back up but I had that heaving feeling. Odd. I don't have that anymore though. I know they told me my stomach now is in my chest in the form of a tube. Although it can expand some - it can't expand much because there's not that much space in the chest for it to. That's why they say we will always need to eat smaller meals and more often, so we can get the nutrition we need. I can tell you though, in the beginning I was a little nervous about eating. I was a little nervous about eating out with people, but now I have a better idea how much I can eat and that makes a world of difference.

Tell your brother I said thanks for serving our country :-) I appreciate him helping keep our freedom :-) I hope his spirits get better. It's great that he has survived the surgery. I wondered if I would really be able to do the surgery after the chemo and radiation, but I was. I hope he finds happiness. It's hard when going through something so life altering, but each day should get better and if he needs the chemo, I just recommend counting down each treatment to the point that they'll be done and he'll start getting his strength back.

Where I got mine there were others getting theirs and we all had recliners and warm blankets, if we wanted them and pillows, tv, snacks, drinks and very nice and attentive nurses. Before I had my treatment I didn't even like to take aspirin, but I knew I had to have the chemo/radiation and surgery to try and beat this cancer, so I took it a day at a time and got through it. I was thinking the chemo was easier for me than the radiation and surgery, but it is probably different for everyone. Hopefully, his won't be too bad. I know they watch you closely and can stop it a while, if they need to. Ok, hang in there! God bless. Brenda "

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