Surgery or not!

[P5132]

Hi, I’m 77 years of age and I’ve just joined the Macmillan Cancer Club. My story is that following some difficulties swallowing, in April 2021, I had a gastroscopy and was diagnosed with T3N2M0 oesophageal cancer. I had radical chemoradiotherapy treatment for 6 weeks in July / August that year. After initially being told the tumour had been greatly reduced in size, I was given the ‘all clear’. However, in June this year, an endoscopy indicated histological evidence of local recurrence of cancer cells! I currently have almost no symptoms and lead a fairly normal, active life. My oncologist and surgeon have now suggested that I have a choice to make between major surgery to remove the oesophagus, with the trauma of the surgery and the subsequent adverse effects on overall quality of life or, because of my age, ‘watchful waiting’ and to move on to palliative care / treatment when the need arises. Does anyone have any experience of my, or a similar, situation and advice on this difficult choice

[phil]

i cannot understand after your tumour had been greatly reduced in size you were not offered the operation. If you are fit enough for the operation it's a no brainer and if it was me I would take that option. Its a serious operation and recovery is slow but you can still have an active life and enjoyable life after. The alternative of waiting and watching for palitive care would not be my choice. There has been a number of patients in our support group who would have loved to have been offered the operation but for various reasons it was not an option. I was lucky that I was able to have the operation 16 years ago and although it has been frustrating and challenging sometimes it's been a good life and long may it continue

Best wishes

[Cavalier3]

I agree with Phil… if they have offered you surgery they must believe you are fit enough to make a good recovery. I’m about 1 1/2 years post surgery and yes there are some adjustments you need to make but my life is great. It’s a tough surgery and the first few weeks are hard but it’s worth it. I’m surprised you weren’t offered it after your treatment last year. My PET scan showed complete response but I was strongly advised to go ahead with surgery. I didn’t think not to for a second. My histology showed residual cancer cells so it would have come back.

[Deeedals]

I’m very surprised too, that they didn’t go straight to surgery post radio/chemotherapy but if it’s been offered now, go for it.

Yes it’s tough at first, let’s not kid ourselves, there are changes to be made but it’s worth it compared to your other option.

I’m 18 months post op 66 years of age and lead a happy, active life with a few dietary changes.

Good luck in whatever you decide ❤️

[Rsw1fe]

My husband was 77 when he went through the tough chemo regime and the big operation from which he made an excellent recovery. We had 11 more years of fun and love and before he died of a different cancer.

Go fo the op if it is offered. Good luck!

[Kentishred]

I'm 2 and a half years post surgery and so very glad that I had the surgery I'm well and reasonably fit at 75 in fact the only thing that slows me gown is arthritis.

Yes ot is tough and takes a while to recover there are adjustments to make but over all its worth it.

Good luck for the future.

[petercaron]

I am 5 years post chemo/ radiation ( now 73) and then a 10 hour esophagectomy and I would do it all over again. If the doctors feel you are physically fit and a good candidate for the surgery, I would take them up on the offer.

I am also surprised that they didn’t recommend the surgery after your first chemo and radiation regimen, but that ship has sailed. Only about 10% of us lucky individuals that get this cancer, even get an opportunity for surgery to cure and survive this cancer.

I now just about eat and drink everything I did before the surgery I do not experience any dumping that you read about, so life is good

Best of luck on your decision!

[purplekey]

what a difficult decision you have. Both choices are very difficult. It is a huge op but they are offering it you and maybe you have to put your trust in the doctors. You are unsymptomatic now but you have to consider the palliative option. I would talk to your family and then the dr again and get more information about both. I had the op 18 months ago after chemo/ radiation at 66. I’m glad I had the op although it was very difficult post op. X

[grandylynda]

you wouldn't be offered surgery if they didn't think it was worth it and you are fit enough. Like Peter, I am now 73 and 5 years ago had chemoradiotherapy followed by surgery. Its a tough slow journey but was worth

[Spikey]

Sorry for the late reply, but I agree with the others. A friend of mine who is in his mid 70's recently had the surgery and, after a few complications (he had an anastomotic leak), is making a good recovery and getting on with his life. The simple fact is that survival rates among those who have the operation are very good, whereas among those who don't are very bad. However, rather than simply dismiss the choice offered by the oncologist and surgeon out of hand, perhaps you should ask them what they would do in your situation and why they think the "watch and wait" option is a viable alternative. For instance, do you have any underlying medical conditions which would make the surgery more risky.

[docLocke]

On the surface it may seem obvious to elect surgery but we don’t know what surgery. Most comments seem to assume the Ivor Lewis procedure—but that depends on the tumor location. If it’s at or near junction, IL would be likely. Higher up the esophagus—maybe different, more complex (like colonic interposition). Plus we don’t know if or how chemo or rad might be included.

If IL, I’d tend to agree with other comments. In my case I was fortunate: my junction tumor discovered early on was treatable with chemo, chemo radiation, followed by IL surgery. Agree that recovery is a challenge. I lost 25 lbs, but a month after surgery I was on skis (x-c). Now coming on 5 years post-op. 82 yo—thankful for each day, looking forward to a fine winter of deep snow.

[Bien-aimee]

Don't dally. have the op, get as fit as you can before hand. Eat well, exercise and sleep well and do the same afterwards. I HAD A BRILLIANT SURGEON AND EVEN WITH TEN MONTH GAP BETWEEN CHEM AND RADIO THERAPY TO THE OPERATION IT WAS SUCCESSFUL

[P5132 in reply to Bien-aimee]

Sorry for the slow response, Bien-aimee, but my grateful thanks to you and to all the others that responded, previously, to my original post. After taking in to consideration all your helpful and positive replies, plus long discussions with my wife, my oncologist and surgeon and a small group of friends who have also undergone the IL Op, I have decided to go for it and will be going into Southampton General next week!! With my fingers crossed!!

[Bien-aimee in reply to P5132]

God bless you . Many people prayed for me and I will pray for you. God loves us and our days are in His wise hands. Trusting in Him gave me enormous peace - essential for life's trials. "Cast all your cares on Him because He cares for you." 1 Peter 5 verse 5-7 in Bible.

Jean