Stage 4

a close relative (47) recently diagnosed with stage 4 EC. Any advice on where to seek most aggressive treatment possible is appreciated. He has 4 children and youngest is 5. Please help!   

Where is your friend located? That might determine where he seeks treatment since there are some really good places in various parts of the country. It might also be partly determined by if there is metastasis and where it has metastasized since treatments vary depending on where it is, etc. If you can give us a little more info, the folks in this group will come up with some appropriate suggestions for sure. Many varied experiences.

My brother-in-law lives in Charlotte, NC but is willing to travel anywhere for treatment. The cancer is in the G-E juncture in his esophagus, top part of his stomach and nearby lymph nodes. It has also spread to a spot on his bone in his pelvis. He has been offered a clinical trial in Charlotte, is visiting the Cleveland Center this week and Duke next week. We have also heard mention of Mayo Clinic and Johns Hopkins but could use the names of the specialists at Mayo and Hopkins. Also, if anyone is aware of a treatment plan for stage 4 which is still localized in one region of the body. Thanks again.    

MD Anderson is ranked #1 in the country for esophageal. Have heard mixed reviews on John Hopkins but they rank near the top. We used a local oncologist (outside Boston) with a protocol developed at Dana Farber. Sloan Kettering is another top rank. I looked at current protocols for EC treatment this morning and noticed the chemo regimen we used had a success rate over 60% and well ahead of any of the others, which was why our oncologist said she chose it way back when. UPMC in Pittsburgh is excellent also. They are currently using some laporoscopics and there are also some facilites beginning to use DaVinci robotics for surgery, but you usually have to be free of metastasis to be a surgical candidate. We were blessed to have a doctor who was willing to try to beat it down before ruling out the surgical option, and it worked for us so the esophageal growth shrank and the lung mets cleared up making surgery possible. I believe Beth Israel in Boston does DaVinci now and their care is in conjunction with Dana Farber. The chemo is brutal, which makes close to home good. If you have good care near home, you might be able to consult with Dr.'s elsewhere but treat at home. Good luck with it.

I am absolutely sold on Duke in Durham, NC.  I had EC in 2004, they did surgery then chemo and Rad and I am still getting clear CT's and hopefully the next one in May will be clear also.  When you pull up to the Cancer Center, you will see license plates from all over the US.  I know that when I went on the internet to see the most successes with EC that Duke was tied with Sloan Kettering for the most successes and Dr. Thomas D'Amico at Duke was tied with a doctor at Sloan, I have forgotten his name,  You are right to talk to more than one facility.  Just go where you are comfortable, but make sure the facility you choose does a large number of these and find out what your surgeons success rate is. 

These are scary times and I know it, I will pray for you.

Gerri

I am so sorry to hear about your brother-in-law but you have come to the right place for help. My dad just recently had a surgery consult with Dr. Luketich at University of Pittsburg (UPMC). We also consulted with a medical oncologist named Dr. Michael Gibson who seemed very knowledgeable and offered us several options if Daddy is not a candidate for surgery. We've only had consults with these drs but were very impressed.

Another website you might try is  Cathy's EC Cafe and www.acor.org.

I will be praying for your brother-in-law.

Please keep us updated!

 

Thank you for your information and your encouragement. I will pass on this information to my sister and brother-in-law. Currently, he is being offered a clinical trial with 3 groups each receiving different meds. Group A receives Epiurubicin, Cisplatin, Fluorouracil and Cetuximab. Group B receives Cisplatin, Irinotecan and Cetuximab and Group C receives Oxaliplatin, Fluorouracil, Leucovorin and Cetuximab. Has anyone out there participated in this clinical study or had experience with these drugs? We are hopeful that when he meets with specialists at Cleveland Center and Duke that they may offer a treatment plan. It is encouraging to hear that some centers will treat stage 4 and consider surgery later. Is there a reason why the clinical trial would not include chemo and radiation? We are still so new to all of this and have so many questions. God Bless all of you for assisting others in need.   

What are DaVinci robotics? Who are your doctors and where are they located. Not sure if Dana Farber and Beth Israel are different facilities. Thanks for your help.   

What stage were you when you had surgery?

Who were your doctors and where are they located?