Last Test Before Treatment?

Friday my 83 year old father under went an Endoscopic Ultrasound. His doctor told us this test would definitely let us know if surgery should take place.

The doctor who performed the ultrasound told us the tumor is very large and that it had entered the walls of the esophagus and the lymph nodes near the tumor.  He did not give us a stage, only that he is not an expert but would recommend radiation to shrink the tumor followed by surgery.

We do not meet with dad's doctor until Tuesday.  Is the radiation treatment necessary, why not just surgery?  I worry that dad could not physically handle radiation treatments then the surgery. 

Dad was diagnosed with EC December 15 and we still do not have a treatment plan as of January 26th.  Everything has been dictated by someone elses schedule.  It is frustrating. 

I have read the book 100 Questions & Answers About EC, but what plan of treatment should be followed?  Any suggestions would be appreciated.

I need a plan for my dad.

It does seem like a long time between diagnosis and a meeting with a specialist.  I wouldn't have been as patient only because my husband had lost so much weight and couldn't swallow anything when he was diagnosed. The oncologist should be able to explain the stage of the disease, possible treatments and what treatments work together and they shoud take into consideration your Dad's overall health. 

My husband was diagnosed with stage IV EC October 2005 at the age of 48.  I have been his advocate and caregiver since then.  Someone who knows your father well needs to be an advocate for him.  I am not a medical expert but I have followed up every suggested treatment with my own research, looked for clinical trials and said no to things that I knew my husband couldn't physically tolerate.

The importance of someone advocating for your Dad who knows him well and how he is really feeling is that when he tells the doctor he is doing fine and at home you know he is really feeling sick or uncomfortable you can give the doctor your observations about pain, food intake and overall comfort. 

Your Dad may be different and be upfront about how he feels but he still needs someone to take down the information and review it with him again so he knows what his treatment plan is.  I go to every appointment and procedure. If I didn't there would have been things missed and some mistakes made by medical staff who were not familiar with his case. 

I am sorry your Dad has to go through this, he is lucky to have family to help him.  I hope things go ok on Tuesday.

KatyB

I understand your concern over your Dad's treatment, particularly at his age.  My husband's EC growth was very large at diagnosis pretty much filling the space at the base of his esophagus so swallowing food was beyond him.  The radiation quickly began to shrink the growth so he was able to begin eating again (although he had a PEG the chemo made it next to impossible to hold anything down).  We have done radiation and chemo together pre surgically and chemo alone after, and if I had to choose I would clearly pick radiation as the lesser evil.  That was a very long wait for EUS.  I think mine was 2 weeks and the gastro who diagnosed was pushing me to call Lahey appointment head regularly to get cancellation because he didn't want it to wait that long. 

Thank you for responding.  I am writing down the questions that I have for dad's Thoracic surgeon on Tuesday.  If we are told that surgery is not an option, then I will have to contact dad's oncologist and see if I can move up his appointment.  It seems strange that at this point dad is not in any pain.  His esophagus has not closed.  His only sign of the EC is that when he eats he seems to get full sooner.  His food portions are smaller.  He never complains, he just says he doesn't seem to have the appetite he used to have.  I appreciate you taking time to share your thoughts.  Thank you.