Hi my husband was diagnosed oesophageal cancer T3NiMo had chemo then surgery,
Pathology shows 1positive node and close circumferel margins.Seeing radio oncologist next Tuesday to work out plan for radiation.Does anyone know if this path report will affect his prognoses also how side effects will be. Many thanks.
Hi Zilpha,
I have no idea about the first part of your question but can add just a little about radiotherapy and side affects. I am just into my third week of rt. So far its been quite cope-able with but I gather weeks 3-4 can be more difficult and several weeks after the end of rt as it goes on working for a time. I am now feeling very tired though and as the tumour is in my throat, it's beginning to make itself felt which means I am tending to eat softer foods amongst other things. If you message me individually on the site I can give you a bit more info. on the rt side of things. How long ago did your husband have his surgery? Best of luck to you both.
Charlie
The T in TNM stands for the stage at which the tumour has grown, so in this case it will have grown into the wall of the oesophagus, but I think not through it. N stands for Node involvement, the nodes being the junctions through which the cancer spreads to other parts of the body, so the fewer nodes involved the better. M stands for metastatic spread of cancer so that is good. Your medical team can explain further. It sounds as if there is a fairly specific area where there is a problem.
The margins are to do with how much the surgeon can take away, leaving a good distance from the tumour so that they cut away healthy flesh rather than the distant edges of the tumour. This is not as easy as its sounds, and there are often all sorts of difficulties in achieving this. The patient's oesophagus is analysed after the operation to check for signs of cancer that are invisible to the naked eye. In this case it sounds as if there are signs of potential cancer round the margins, but you will need to talk this through with your medical team.
Given a choice, it is better not to have these signs of cancer, but they do occur in this way every so often. Some patients are treated with radiotherapy and/or chemotherapy after the surgery for this very reason. It can be quite successful, but the prognosis is something only your medical team can help with. I think that you should hang on to the positive aspects of how things have gone and the analysis to date.
Radiotherapy is very specifically targetted these days, and patients do vary considerably in how their bodies react (but probably not not so much as the variation with chemotherapy).
I think it is another aspect of the treatment that will require you both to dig a bit deeper into your stamina, but you can reasonably hope that your husband will be making significant progress after the surgery. There are no guarantees in all this, but your medical team will have offered the surgery in the first place because there is a reasonable chance of a cure for your husband. The findings will indeed affect the chances of a complete recovery in statistical terms because there are some patients for whom the analysis will not have shown these issues. But statistics are meaningless for you. There will be patients who have had comparable results and will have gone on to make a complete recovery after treatment; and it is equally true that some will not have been so fortunate. If you can try and adopt a positive state of mind (which does not mean projecting cheerfulness all the time) I am sure that it will help. You and your husband are also in this together. Your conversations may be some of the more difficult you have had, but people tend to find that the more that they can share their anxieties and troubles, the better the overall outcome. It is easier said than done though. It certainly puts life in perspective.
Hi Alan thankyou for your comments .I posted stage cancer was at as i thought it would help people to relate to.I am aware what they mean.My first concern is radiotherapy,as my husband is not able to with stand severe reaction like he had in chemo. I was asking if anyone had experienced radiotherapy,also had anyone had close margins and survived long term. Thanks again. Zilpha
