Anyone out there has experienced to have a tumor TIII and after the coadjuvant chemo plus radio treatment the biopsy shows no cells afected.

[trinta]

I have a tumor TIIIN2M0 and I am now through different test ( ecoendoscopy, gastrorndoscopy and TAC) to re evaluate the effect of chemo and radio on the tumor and I just questioning what happens if there is, no cancer cells. Thanks in advance.

[Hidden]

It might depend upon whether you have had squamous cell carcinoma or adenocarcinoma. For squamous cell carcinoma, chemotherapy and radiotherapy are sometimes the treatment that provides a cure without surgery, but that is normally at an earlier stage I believe.

I think they would perhaps consider a PET or CAT scan to further check on whether there are any detectable cancer cells.

Then the decision is whether you have done so well that you may not need surgery; or whether surgery is the safest option. It is a decision that the medical people would advise you on, taking your individual details into account. One factor might be whether you have Barrett's Oesophagus, for instance.

So I think you will have to wait for the next appointment and a discussion of the Multi Disciplinary Team before knowing how things will go forward. One is always cautious about raising expectations, but this sounds like good news for you, whether or not you need the surgery.

[RayM in reply to Hidden]

Alan

How would the prescence of Barrett's impact on the decision on whether or not surgery was the best option?

[Hidden in reply to RayM]

The Barrett's would mean that the cells were different. If there were dysplasia in the Barrett's segments, they might be able to be treated with, say, radio frequency ablation, and this would avoid the need for an oesophagectomy. If there was high grade dysplasia in the Barrett's segments then that would certainly be a risk factor. If it was Barrett's without any dysplasia in a part of the oesophagus that was some distance away from where your cancer was, they might consider that it would be a low enough risk not to treat, because the risk of Barrett's without dysplasia is low. There is more information about Barrett's on actionagainstheartburn.org.uk

[RayM in reply to Hidden]

Thanks Alan. Although my tumour was on the site of my Barrett's it would seem that the type of cells were unrelated to Barrett's. Very strange. Very rare apparently. The endoscopy, biopsy and CT scan seem to to indicate that the chemo/radiotherapy has done a good job. But I'm due for a PET scan in a couple of weeks which should give a clearer picture. Through you Alan can I pass on my grateful thanks to some great people in OPA who have been a real source of support to me over the past few months. I first made contact just a few days after my diagnosis when I was in a very stressed and emotional state. You guys gave me hope and helped me to move forward with a positive and optimistic attitude. I'm convinced that the attitude that I adopted with your encouragement helped support the treatment. A positive mental attitude is so important. The mind can really impact on the body and its ability to heal and respond to treatment. So keep up the good work. I hope that I can support the work of the association in a practical way in the future, when I've recovered from my treatment.

Thanks again

Ray

[Hidden in reply to RayM]

A pleasure! Hope the good news continues!

[trinta]

Thank you for answer me. I will let you know after I finished all the tests, including a CAT.

[RayM]

Just joined the forum, and your story jumped out at me.

I am in much the same situation as you. I was diagnosed in late November 2013 with a tumour at the lower end of the oesophagus on the site of my Barett's. It was staged as T2, N1. The main problem was the type of cancer cells. One pathologist described it as nuero endocrine, whilst another throught it was a small cell lung cancer type of cell - both of which are rare and fairly aggressive. They decided to asume that it was the later for treatment purposes. I started treatment with coadjuvant chemo/ radio therapy treatment with the first of 4 cycles of chemo starting on 16th December and the radiotherapy running alongside the 2nd chemo cycle for 3 weeks from 6th January. The results of the endescopic examination and biopsy on 1 April seemed to suggest no obvious evidence of the tumor. The CT scan suggested significant reduction in tumour size from the original 5cms with ' minimal residual thickening' of the oesophagus. I saw a surgeon yesterday who is going to arrange for a PET scan in the next couple of weeks to see if there are any hotspots present. The decicision will then be made regarding whether or not surgery will be necessary. I am of course hoping that it won't be! Great treatment so far from Christie's in Manchester I have to say.

Does anyone out there have any experience of the type of cancer cell/cells that I seem to have? And is there anyone else with experience or knowledge of coadjuvant chemo/ radiotherapy tretatment. It does seem to be an alternative to surgery that is growing in popularity. Is there clinical evidence to support this, or is it driven by economics? I can't seem to get a clear answer to this.

Feedback would be much appreciated

[Hidden]

Once you are in the hands of the experts like you are, they will give you the best treatment according to your situation.

Some people do respond to the chemotherapy differently from others, but if the best scans show no cancer cells, then that is excellent news.