Oesophageal Patients Association
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Is there anyone who took the decision not to go for surgical solution after chemo and radio and follow a surveillance of the tumor?

I had adjuvant chemo and radio and my tumor close to stomach was T3N2M0 and now is T2N0M0 and after an endoscopy the biopsia shows no cancer activity. I will have a visit to my oncologist doctor and I am considering to ask him to postpone op. and to be under a surveillance program and just in case the tumor be active again then go for the operation.

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I am sure your health professionals will give you sound advice. I only wanted to mention what my surgeon said to me after the op, albeit 5 years ago so things may have changed...

I was T3N1M0 and I had nine weeks of chemo and then the op. After the op I was told that the tumour had shrunk so much that he could barely feel what was left between his fingers. So I asked why I'd had such drastic surgery then. His reply was that as far as he was concerned the only chance of a cure was to cut the whole area out, regardless.


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Thank you John-Grantham. Most likely is that the answer they gave you is the true, but what about to give a chance to check if that is really true or not ?. I am not saying not to the surgery I am just trying to postpone it as much as possible in a reasonable and safely way.


You are still T2.

And you were N2....indicating that cells had circulated in the lymphatic system.

If it was me I would not gamble on those odds.

The surgery is tough and for most people the after-effects are very trying but I have now enjoyed 725,328,000 extra seconds that I probably wouldn't have had but for the Ivor Lewis procedure.

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Thank you for your answer. I really appreciate your opinion. Probably I am not able to express myself adecuately because of my limitation with language. I will try my best: your comment about the cells circulating in the lymp. system also apply if you go through op. Please do not misunderstand my position, specially for all those of you who decided to go to surgery, probably all of you have made the right chose and the evidence is that you are alive! I just want to share my case with you with the possibility to delay, and if it´s posible to avoid the surgery. I am still pending of a test to check if the tumor is still a T2 or on the contrary if it is inactive.


I think these decisions all depend on your outlook and how you regard the risk of getting it 'wrong' by deciding against surgery and the cancer spreading.

There may be a difference according to whether you have squamous cell carcinoma or adenocarcinoma. It is sometimes possible to treat squamous cell oesophageal carcinoma in its early stages by chemo-radiotherapy but it is the exception rather than the rule.

There may be some non-oesophageal cancer types where the tumour can be left in an inactive state, but this is not one of them. So whenever we have had similar conversations with people in your situation we can generally say that if you decide not to have the surgery, then the cancer will take hold in the not-too-distant future and that means that you will end up dying from it. Some people are comfortable with that thought; others believe that going for a cure, which is not guaranteed by surgery, is the way to go because life is worth living and extending. It is a bit of a blunt choice, and you will not know the answer for certain until it is too late to change your mind.

If you do have the surgery but the cancer returns you might feel that it was not worth the hassle of the treatment for the extra years that you were granted; if you do not have the surgery you might regret not having given yourself a chance.

There are plenty of people who do enjoy a reasonably good quality of life, sometimes many years after surgery, and their opinion is worth listening to.

Regardless of anything else, you are doing the right thing in thinking the situation through, not least because there is always a mental / emotional path to travel along as well as the medical one, and you won;t be able to avoid the mental dilemmas and the grief at the loss of your previous good health. Being diagnosed with cancer is a traumatic event for you and those around you, and there will be counsellors and advisors available to help you come to terms with what you will be going though whatever route you take. If there is a Maggie's Centre, or equivalent, near you, they will help; or you could ask the specialist nurses or your GP for a place to which you could be referred. They are used to dealing with the questions you ask, because it is quite normal to ask them.

We do wish you well.


Thank you so much AlanM for your good sense and wise comments. Finally and after an open heart discussion with my GP I have decided to go for surgical solution. I can assure you was not an easy decision but after considering pros and cons seems to be the most reasonable. I also want to thank all the people that share their experiences in this forum telling how they feel and how they cope with the op. this was and will be also very useful info for me I hope very soon to tell also my experiences after op. and try to help others in this difficult but hopeful situation.


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