confused about why some are surgery candidates and other not

My husband was diagnosed stage IV 2b June 4, 2009.  5 cm tumor pressing against lower esophagus.  1 rib involved and many nodes.  He cannot swallow and is jtube fed 24 hrs, 7 days a week.  Other then the swallowing, he is quite healthy.  Ran 6 days a week. At first they said only chemo but then found it didn't spread lower so now he is on Taxol/carboplatin for 6 months.  He is three weeks on 1 week off while simultaneously receives tomotherapy everyday for atleast 28 days.  He just turned 49.  They said they didn't want to do surgery on him and said that it wouldn't be the best course of treatment. Too dangerous to open him up.  I am very confused as to why they can't go in and atleast help him so that he can swallow?  Why are some candidates for surgery and some not?  He is very strong, goes to work everyday while taking his cocktail and radiation.  His weight is now stabilied by adding fishoil to nutren feeds.  He is able to swallow minimal liquids and they are hoping the treatments will give him back his swallowing.

Hopefully, the radiation will allow him to swallow, and the chemo will downgrade the number of areas where he is showing cancer now because it works systemically. All doctors are different. Our surgeon made no promises because my husband was stage 4 at dx, so we knew it was possible she could start the surgery and not go through with it if she went in and found cancer somewhere else. We were fortunate to clean up the lung mets in chemo before the surgery, so when she opened him all she came up with was 3 of 6 nodes with EC but the lung and esophagus were cancer free at surgery. He had 25 radiation with 6 infusions of cisplatin, docetaxel and irinotecan prior to the surgery (and was 49 years old). Some of the surgeons won't talk about possibility of surgery till they see patient is a true candidate when they downstage with scans after treatment.  So don't lose hope...things can change with treatment. There are always second surgical opinions too, so find someone good who does a lot of esophageal work.  Husband has had several recurrences of lung mets, but we have managed them with treatment and he is currently enjoying a chemo break, and we'll hope they don't return again. His dx was 12/2005, so he's definitely beat the odds for a stage 4.

 

On 7/10/2009 bailey1459 wrote:

My husband was diagnosed stage IV 2b June 4, 2009.  5 cm tumor pressing against lower esophagus.  1 rib involved and many nodes.  He cannot swallow and is jtube fed 24 hrs, 7 days a week.  Other then the swallowing, he is quite healthy.  Ran 6 days a week. At first they said only chemo but then found it didn't spread lower so now he is on Taxol/carboplatin for 6 months.  He is three weeks on 1 week off while simultaneously receives tomotherapy everyday for atleast 28 days.  He just turned 49.  They said they didn't want to do surgery on him and said that it wouldn't be the best course of treatment. Too dangerous to open him up.  I am very confused as to why they can't go in and atleast help him so that he can swallow?  Why are some candidates for surgery and some not?  He is very strong, goes to work everyday while taking his cocktail and radiation.  His weight is now stabilied by adding fishoil to nutren feeds.  He is able to swallow minimal liquids and they are hoping the treatments will give him back his swallowing.

I was dx last July stage 3 but no spread anywhere. My Boston dr, didn't hesitae for one second. He said surgery or you would only have 6 months.

I was tube fed and had rad and chemo. At this moment I am cancer free and happy I had the surgery. I say get a secind opinon. God bless and good luck. If you need info on my surgery you can contacy me at

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 or this message board.

 

On 7/11/2009 luvliving wrote:

 

On 7/10/2009 bailey1459 wrote:

My husband was diagnosed stage IV 2b June 4, 2009.  5 cm tumor pressing against lower esophagus.  1 rib involved and many nodes.  He cannot swallow and is jtube fed 24 hrs, 7 days a week.  Other then the swallowing, he is quite healthy.  Ran 6 days a week. At first they said only chemo but then found it didn't spread lower so now he is on Taxol/carboplatin for 6 months.  He is three weeks on 1 week off while simultaneously receives tomotherapy everyday for atleast 28 days.  He just turned 49.  They said they didn't want to do surgery on him and said that it wouldn't be the best course of treatment. Too dangerous to open him up.  I am very confused as to why they can't go in and atleast help him so that he can swallow?  Why are some candidates for surgery and some not?  He is very strong, goes to work everyday while taking his cocktail and radiation.  His weight is now stabilied by adding fishoil to nutren feeds.  He is able to swallow minimal liquids and they are hoping the treatments will give him back his swallowing.

I was dx last July stage 3 but no spread anywhere. My Boston dr, didn't hesitae for one second. He said surgery or you would only have 6 months.

I was tube fed and had rad and chemo. At this moment I am cancer free and happy I had the surgery. I say get a secind opinon. God bless and good luck. If you need info on my surgery you can contacy me at

--Message edited by CancerCompass staff. For personal protection, email address removed. Consider private reply. Please review CancerCompass Member Guidelines at http://www.cancercompass.com/common/guidelines.html--

 or this message board.

My husband was diagnosed with Stage 3 EC in March, 2008.  He had an endoscopy on March 11 that confirmed a tumor and IL surgery on March 17.  His tumor was located where the stomach and esophagus meet and he was given 3 months without surgery. 

Pl. send me the 15 page report that yu mentioned,I know a lot many people asked so it's just one more