Medical jargon

[racy]

Two years post op and the cancer has returned. It's on the stump of the oesophagus where the remains of my stomach is joined. Tests have confirmed a couple of nodes above the anastomosis which are adenocarcinoma (what does the word mean ) plus mediastinal lymph nodes (again, translation please ). This information is from my copy of the consultants letter to my GP. Any information will be appreciated.

[Hidden]

I am sorry to hear about that.

Mediastinal lymph nodes are glands that act as filters between your breast bone and your spine, in other words near your oesophagus. Nodes are the junctions through which cancer tends to spread. The surgery often involves removing nodes to try and combat this, but it is not always successful.

The anastomosis is the surgical joint where they joined your stomach to the stump below your throat. They try and leave a good margin to be on the safe side, but cannot always do this for technical reasons.

Adenocarcinoma is the type of oesophageal cancer that 70% of people get in the UK. The other type is squamous cell carcinoma. Adenocarcinoma is quite often related to the long term effects of stomach acid splashing up into the oesophagus. Squamous cell carcinoma tends to be higher up towards the throat, traditionally has been more associated with alcohol and smoking (but by no means for everybody), and can sometimes be successfully treated by chemotherapy and radiotherapy.

Having had an oesophagectomy already, I think that further major surgery will probably not be an option for you. So the discussion with your doctors will be about whether or not further chemotherapy will be helpful or not. If it had been squamous cell carcinoma there might have been a better prospect for this.

It is a big challenge for you, and news that you certainly did not want to hear. But you should find that there are a good number of services available through your local hospital system. And do not forget OPA Charlie's Circle on HealthUnlocked that has been set up for people in your situation.

It takes time to come to terms with it all, and we give you our very best wishes.

Alan

[racy in reply to Hidden]

Hi Alan,

Thank you for the detailed response to my questions. It is much appreciated. My surgeon has confirmed that further surgery is not an option. They are going to try Endoscopic Mucosal Resection with possibily chemo/RT. I,ll report again when i know more.

[golfking in reply to Hidden]

Alan I have read a lot of your replys to various problems and find your knowledge amazing and very comforting,you have more understanding and explanation to most of our problems its a pity our consultants and doctors dont focus more on post op issues as these are are future problems after going through cancer and very serious surgery,I had full oesophagectomy and still have some dietry issues bile mainly,but none as bad as some of our friends on this site so I wont or cant complain but people like you are a godsend keep up the good work and advice please as we are all learning from your understanding of our problems,thanks again Alan.

Dave.

[racy in reply to golfking]

Hi Golfking,

I totally agree with yourr comments regarding Alan and his wonderful knowledge. He's a star !

[Hidden in reply to racy]

I am pleased to help! If you need a really bright star, ring Dawn on the helpline! (0121 704 9860).

[patchworker in reply to golfking]

Yes, Alan IS wonderful. He tells it straight. but manages to be comforting at the same time! We are so lucky to have him, this site wouldn't be the same without him.

[cherrybailey in reply to patchworker]

I think the same about Alan Wonderful!! Been through what he has but on here for everyone!

[Lynleahy]

Hi there - my husband also has has recurrence about two years on. Treatment options very much depended on whether it had spread any further than what could be seen in the CT - same place as you incidentally. We were told straight away that further surgery was not an option. A PET scan confirmed it was localised spread only and had not gone outside of the one area and our oncologist decided to throw everything at it - chemo and five weeks of radiotherapy - if it had have spread then it would have been chemo only. Alan has given you a very thorough explanation of the medical terminology , I would just add regarding the lymph nodes that there are distant and local nodes - yours are local which is more encouraging. We finished the treatment two weeks ago and I have to be honest it was very very tough , unable to have the third session of chemo as too unwell but got through the RT, the effects are still ongoing and it is going to take a while to get over this and hopefully put back some of the stone he lost but can ill afford to. The other thing I would mention is how hard it has been emotionally dealing with recurrence. For us harder than the original diagnosis to be honest, all those fears of "will it come back" have been realised and we now have a very anxious wait until August when he will be scanned again to see what his response to treatment is. Incidentally anyone reading this who has also had concurrent chemo/RT for recurrence what was your response to treatment and how long did it take you to get over it ?

Hang in in there , still battles to be fought.

All the best

Lyn

[racy in reply to Lynleahy]

Hi Lyn,

Thank you very much for the information and words of encouragement. They are going to try Endoscopic Musocal Resection with possible chemo/RT afterwards. I,ll let you know how i get on. You and Alan have been really helpful.

[Lynleahy]

I know we felt much better when we had a treatment plan in place - something to focus on and move forwards from. Keep smiling and do keep in touch.

Lyn

[SteveJ]

To Racy and Lynleahy

I'm sorry to hear you are going through such a tough time. May I wish you both the best and hope things work out well for you both.

Kind Regards

Steve

[racy in reply to SteveJ]

Hi Steve,

Thanks for your kind words and good wishes.

[Lynleahy]

Thank you from us also Steve - tough times at the moment - may I too add my thanks to Alan for all he does and all he offers - Dawn too you both help more than you can possibly know and I thank you sincerely.

Lyn x

[racy]

Further to my questions under Medical Jargon the hospital had me in last week to carry out an Endoscopal Musocol Resection on my tumours. When they got there they realised the tumour roots have grown through the lining of the oesophagal stump and into the muscle. They decided that if they tried to do the EMR they risked perforating the stump causing further problems. They are going to try chemo to hopefully shrink the tumours so they can safely do an EMR at a later date.Please can anyone advise as to the bad side affects i'm likely to suffer. I believe one is nausea but other than that i don't know.

Any information will be appreciated.

[gutlesswonder]

I had Chemo only after my Ivor Lewis -- 4 rounds of Cisplatin,about one month apart..

On each occasion I was supposed to receive this over-night as an in-patient but after 2 hours of slow drip infusion I felt fine ,discharged myself and drove home.

In retrospect pretty stupid , however I was young and gungho !

Minor nausea was controlled by taking a drug called Ondansitron.

By the end of the course most of my body hair had gone (later it grew back even more lush )

and my head hair had thinned but not fallen out.

My appetite was impaired but I developed a very sweet tooth ,which counteracted weight loss. I went right off alcohol but continued to fancy my wife .

Everything was back to normal within a year except that there is some lasting damage to skin quality - dryness,sensitivity etc and also to the veins of the legs with minor circulatory problems similar to varicose veins.

I think I was lucky.

I hope you are too.

[racy in reply to gutlesswonder]

Hi gutlesswonder,

Many thanks for the info re the side effects of chemo. It all sounds good except going off alcohol. I'll let you know how i get on.