inoperable cancer because glands are outside the surgical field in the bronchus

[strangetimes]

Hi everyone ,I'd be grateful for views/comments on a dx which says

" PET scan shows glands away from the tumour " sic ,presume they mean affected glands ?

cont ."we cannot remove the cancer as the glands are outside the surgical field in the bronchus "

presume the lymph glands are somewhere inaccessible and because they cannot be safely operated on it is felt that the op to remove the tumour at the junction of the stomach and oesophagus is not worth it .

Even though the chemo is shrinking the lymph node enlargement ?

[Mauser1905]

Suggest getting second opinion from qualified specialist in this case.

Everything else will be pure speculation, in my honest views.

Good luck.

[strangetimes in reply to Mauser1905]

Thank you Mauser .So tricky doing things on behalf of someone else who is distracted by and caring for v sick wife with lung cancer and bone mets .

[Mauser1905 in reply to strangetimes]

So sorry to know that. Hope all goes well for everybody

[Mauser1905 in reply to Mauser1905]

Reading in between the lines.

Assuming adenocarcinoma at the lower GE junction for the patient. Lymph nodes affected as per the PET scan and chemo ongoing for controlling the cancer cells.

Typically a oesophagectomy is considered to be best outcome providing normal lifespan if all the cancer contained within the surgical removal area or less.

Surgery is a radical one and survival in surgery is not great without collateral damage.

Bronchus is the tube work from trachea to lungs and any glands on this network is very difficult to remove successfully. Also not all speed is visible on the PET scans inthe glands. This is why surgeons take out as much as glands they can get hands on while operating for better success of the surgery.

This is also assuming that these are not separate cancer cells as to the GE junction tumor noted. Sometimes the cells observed within the base of the lungs are shrunk with chemo as these can't be operated and this ql be continual ongoing chemo for survival.

If the MDT believes that (based on the tests,reports discussed) the surgery not worth it means they have seen things which are not giving them surgical success confidence. GI team will not speculate nor will they put things in records which they see but cant quantify, nature of the job.

hence I mentioned a qualified second opinion.

A patient exposed to radical oesophagectomy and extensive gland removal surgery on lungs same time may have much reduced chances of recovery from the surgery itself. This is blunt speculation. Regular oesophagectomy have the lungs collapsed and chances of recovery are subjective, hence my understanding this way, without further elaborating the cancer cells which could not be taken out.

Please take this as a pure speculation only.

Thank you and good luck

[strangetimes in reply to Mauser1905]

Mauser your post is really helpful,thank you .Grateful to you for taking the time to put what I think is a v reasonable assessment into words .

[asifchaudry]

Sorry to hear about your situation. Removal of lymph nodes at the level of the right and left main bronchus is generally a standard step in an Oesophagectomy for cancers. Were you given any other information?

[strangetimes in reply to asifchaudry]

I don't have much information .It's my twin brother (non identical) who now has the cancer I had 7 years ago .Though mine was operable and of course each case is different .

My twins dx has coincided with his wife developing lung cancer which has now spread to her bones . So...the focus has been v much on her . And the inabilty to visit in person has not helped communication .

On the telephone my brother has said that he thinks the affected lymph gland/s are behind the bronchus and inaccessible .