Adenocarcinoma of the lower oesophagus

[Redlodge111]

Can this be treated with targeted therapy such as Herceptin ( I am not aware of the presence of HER 2 ) but have been told that the surgical option would kill my husband who is 75 yrs old even though CT scan shows no spread . He has not had a PET scan.

[Stewh]

I had the Ivor Lewis surgery in November last year aged 70, and it didn't kill me. The surgery took 10 1/2 hours, and was pretty brutal, but I recovered well.

Unfortunately the Surgeons didn't manage to remove all the cancer cells, and another tumour has since grown. I'm undergoing 5 weeks of radiotherapy and chemo.

If you husband is strong then surgery is probably the best option. I wish you both well.

[Redlodge111 in reply to Stewh]

Thanks for that and we wish you well, but they have said that surgery is not for him

[phil in reply to Redlodge111]

This is a very serious evasive operation on the body and the reasons the Surgeons are not offering surgery could be your Husbands health issues. It could be respiratory or cardiovascular problems that is causing them concern.Herceptin is well researched and is currently being used successfully in many areas.

But if it was me I would request a second opinion because age should be no barrier for surgery

My best wishes to you both

Phil

[Redlodge111 in reply to phil]

Thank you Phil

[petercaron]

I had an Adenocarcinoma in the lower part of the Esophagus which was diagnosed in July 2017 when I was 67 years old. I had 28 radiation treatments and 5 chemo treatments in Aug 2017. The oncologist didn’t want me to initially have the esophagectomy due to my weight loss. But the two surgeons who did the surgery told the oncologist they were good to move forward with the surgery in Oct 2017.

When I got out of the operating room after 11 hours of surgery, which back then was partially performed roboticaly, and required a larger shark bite incision on my back,, the doctors felt pretty confident they got it all. No further chemo or radiation was deemed necessary after the surgery

Now, except for sleeping in a recliner, I live a pretty normal life on three meals a day. And I can eat just about anything I want

In the two- to three years after the surgery I did require I think three stretches of my esophagus, but that is all These were performed painlessly under anesthesia with no side effects

I have had Catscans every year for the last 7 years and all is good.

It’s a tough surgery initially, but I have had a good, almost normal life after the first 1-2 years after the surgery I had two amazing surgeons and oncologist here in Atlanta.at an an Emory Hospital

I agree, you should probably get a pet scan and then a second opinion

I wish you the best on this journey!

[Redlodge111 in reply to petercaron]

Thank you and all the best to you

[grandylynda]

Age isn't a barrier to surgery, I was nearly 69, but I did have to pass a tough fitness test. Maybe there are other medical conditions which rule it out for your husband. It never hurts to get a 2nd opinion though

[sddsdsaa]

speak with your cancer team who can discuss all the treatment options available.

Your cancer nurse specialist will be able to help

[FKM100]

Yes, Trastuzumab is indeed an option if the tumour is HER2+. In 2020/21 I had a year's worth of post-op Ogivry (a biosimilar to Herceptin) because my tumour was HER2+. I don't know that Ogivry would have been enough of a treatment on its own, as that was not discussed, since I was fortunate enough to be able to have surgery (after chemo). In fact, it was only the histology done during surgery that picked up that the tumour was HER2+, not the initial biopsy. I'm not sure why not, but suspect that perhaps the initial tissue sample was too small. As my oncologist explained, it is unlikely that the entire tumour would have been HER2+, probably only the parts that had mutated. But then those would also be the most aggressive parts, so targeting them was of definite therapeutic benefit.

I would say that it is definitely worth asking about targeted therapy - and asking can never hurt.

All the best, Shelley.

[Redlodge111 in reply to FKM100]

Thank you we will do