Oesophageal Patients Association
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Abnormal cells

Hi I was told I have abnormal cells in my oesphagus and recommended for radio ablation therapy however I,ve now been told this is not suitable for me . I should be getting an appointment soon to have it explained to me . Does anyone know what other options there are the nurse did mention an oesphagetomy but because the cells aren't actually cancer this worries me does anyone know of other options or if the cells are likely to turn cancerous and how long this would be .

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Hello Molly,

How the diagnosis was done for the finding you quote? Is this near GE junction or higher up?

Have you been through scans including PET scan?

Who recommended radio ablation therapy? Who is then saying not suitable?

Only your MDT will come with recommendation in regards to your diagnosis and your GI surgeon will discuss this with you and provide details and options etc.

Typically high grade dysplasia is pre cancerous tissue which eventually becomes cancer. However only your MDT will have recommendation for most preferred treatment depending upon many variables.

Good luck.

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Hi thanks for your reply I,ve had 3 endoscopes and a ct scan I was told the cells showed moderate Dysplasia . This is all new to me and I,m trying to get my head round it. I,m waiting for an appointment to get things explained to me . I,m hoping for some kind of treatment that isn,t so invasive do you know of the other options available . Thanks

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Ok so you haven't had PET scan and possibly any ultrasound scans from the PET results. Until that is done Drs won't know if it has metastasis issue at this stage.

There are various options depending upon the location, cell development and growth elsewhere primarily cancer staging and other factors such as type of cancer, age, health history and many other factors which MDT will take into account to give prognosis.

Radio ablation, chemotherapy, oesophagectomy involving two or three stages. And combination of these all where required.

Did the endoscopy report state the location of the biopsy sample?

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Hi I.m very naive about all this medical jargon I don't even know what a pet scan is ( i,ve just looked it up ) do abnormal cells always progress to cancer without treatment I had biopsies done when I had an endoscope which were clear . What do you mean by two or three stages I,m sorry but I don't understand a lot of this

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Do not worry, I also learnt on the way about all this. Most important thing is your cancer has been caught up at very early stage. This is very good news.

Try and see if you have CLAN Macmillan or Maggie's centre nearby and pop in to talk to professionals and read information etc. This has helped me a great deal to settle my emotions.

I was of the same view you had about very local (biopsy area only) treatment. However the MDT preferred radical If or Lewis Oesophagectomy to give me normal life expectancy post treatment. This meant removing the tissues not only in the surrounding area but taking out most of the oesophaegus and stomach.

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Hi ,I had abnormal cells on my oesophagus saw a specialist in the Royal, Liverpool who said it would take about two years to complete ablative surgery, never got there , shortly after I contracted cancer,ended up with an oesophagectomy. It is now well over 2 years since and I'm doing well.

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Hi glad your doing well it's reassuring to hear . I was told I have moderate Dysplasia so I thought it would mean I would just be kept an eye on so all this has come as a shock to me I thought they would only treat the cells when they actually became cancerous did you have any symptoms of cancer or was it found during check ups

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Hi Molly, it was found during six monthly endoscopies, I was told I had moderate dysplasia but it still turned into a small cancer tumour which was removed by keyhole surgery which is much less invasive but still a major op.Its almost like having a gastric band because your food consumption decreases quite a lot and you don't put on weight as a rule.

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Thanks for your reply I have got an appointment at Preston royal on Friday so will find out more then . Was your oesphagus removed or just the tumour?

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Hi Molly

I had very similar circumstances to Creoncol, i'm a little over 4 years post op and life is fine. Having the operation is life changing but better than not having it, it's just a case of adapting to a new way of life.

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Hi thanks for your reply glad your doing well in what ways is the operation life changing what way have things changed for you

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Hi Molly

It's life changing in that it leaves a few "after effects" shall we say. Getting used to a new plumbing system is certainly one of the biggest things, i used to be a fairly big eater but now i have little or no appetite, sleeping can also be problematic until you find a way of staying comfortable. There are numerous other things but if you asked me if i would do it all again (or risk the cancer spreading), yes i would, in a heartbeat. I'll finish up by saying that my general fitness level is greater now than it was pre op. I also believe that Preston Royal has recently carried out the 1st robotic Oesophagectomy outside of London, I'm a little further north from there (Carlisle) so i went over to Newcastle.

Ade

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HI thanks for replying the nurse phoned me yesterday and it's looking very much like I will be having the op . I know they,ll talk me through everything but I prefer to talk to people who have actually had it done . How long ago did you have the op and how long does the recovery take. What kind of foods can you eat and drink .sorry to keep asking questions but there's all different things going round my head at the moment I keep waking up in the night and everytime I think about it I get panicky feelings did you get them and how did you cope with them ?

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Radio frequency ablation is a treatment that can be used in a variety of settings, including removing the top layer of cells in the lining of the oesophagus when somebody has Barrett's Oesophagus that has developed dysplasia, a precursor to cancer. It all depends on whether it is low grade or high grade dysplasia, as the risks are different. Low grade dysplasia carries a risk of 5% in the following eight years, high grade dysplasia 50%. So it might mean that the risk of cancer is too low for this treatment to be justified; or that the procedure would be counterproductive for you in some way, or that you need a different sort of treatment, perhaps an oesophagectomy, but perhaps an endoscopic treatment that would remove a small cancerous tumour without the need for the larger operation.

It is sometimes difficult to assess a patient's condition because the biopsies are taken in small localised sample locations.

So there are a whole range of possibilities, and you really need to wait for the appointment to see what the details are. I suggest that you take somebody with you as these things are sometimes quite complicated to understand, and you sometimes wish you had asked another question when you are on the way home from the clinic.

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Hi Alan yes the nurse phoned me to tell me the cells were moderate to high grade and so unsuitable for rfa so looking like the op is necessary . My husband is coming to the appointment with me because as you say it's complicated to understand a lot of what they say . I,ll let you know how things go n Friday after my appointment .

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