CancerCompass message board discussion started by AttorneyAnn on 4/11/2008 http://www.cancercompass.com/message-board/message/all,22960,0.htm Thu, 24 Jul 2008 00:00:00 GMT Thu, 24 Jul 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ 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!    AttorneyAnn Fri, 11 Apr 2008 00:00:00 GMT 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. tongrenhealer Fri, 11 Apr 2008 00:00:00 GMT 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.     AttorneyAnn Mon, 14 Apr 2008 00:00:00 GMT 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. tongrenhealer Mon, 14 Apr 2008 00:00:00 GMT 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 Gerri Mon, 14 Apr 2008 00:00:00 GMT 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!  GeorgesGirl Mon, 14 Apr 2008 00:00:00 GMT 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.    AttorneyAnn Wed, 16 Apr 2008 00:00:00 GMT 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.    AttorneyAnn Sat, 19 Apr 2008 00:00:00 GMT What stage were you when you had surgery? AttorneyAnn Sat, 19 Apr 2008 00:00:00 GMT Who were your doctors and where are they located?    AttorneyAnn Sat, 19 Apr 2008 00:00:00 GMT Dana Farber and Beth Israel are affiliated with one another and located next to each other, so the oncologist may be at Dana Farber while the surgeon could be at Beth Israel. I think doctors often have teams they work with for particular types of treatments.Da Vinci robotics are a method of robotic surgery they use, so it a is very precise and less invasive method of surgery. Believe it was originally used with prostate surgery but it's uses are being expanded and include esophageal surgery now.  I would guess only certain people are candidates for this method. You can locate info online on davinci procedures since I know I have seen websites listed for them in some of my medical language and coding classes. Think several people have mentioned having davinci surgery done in California. tongrenhealer Mon, 21 Apr 2008 00:00:00 GMT My spouse was recently diagnosed with Stage 4 EC. I proposed the question regarding radiation with chemo and the answer was that when receiving radiation, you must stop the chemo during that period of time as it will interfere with the chemo. Hope this helps. My husband is receiving EOX treatment and we have been to Dana Farber in Boston.  rncaregiver Sun, 04 May 2008 00:00:00 GMT That's odd. We started this journey in December of 2005 with EC and lung mets. Initial treatment was 25 radiation treatments with 6 simultaneous weeks of chemo (1 chemo cocktail infusion/week).  We used cisplatin, irinotecan and docitaxel because of radiosensitivity, which means they actually enhance the radiations effects while working systemically on the cancer. At the end of this, he took a brief break (not too long or surgery is no longer an option due to tissue toughening as side effect of radiation). We rescanned and lung mets were gone, EC primary tumor shrunk and we went on to Ivor-Lewis and lung resection.  I'm surprised to say the least. The chemo protocol we used was developed at Dana Farber. tongrenhealer Sun, 04 May 2008 00:00:00 GMT