Upper Oesophageal Cancer Treatment Options

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[Cross-posting to the Head and neck cancer forum] 

Hello all, 

In June 2022 I was diagnosed with upper oesophageal squamous cell carcinoma in the post-cricoid region, with bilateral lung secondaries (T3 N1/N2 M1). So far, I’ve had two cycles of chemo (carboplatin + 5FU), eight of immuno (pembrolizumab) and one course of radio (20Gy/5fr). 

The tumour in my throat has reduced in size by about 50%, but at the end of March I developed an auto-immune response to the immuno, so the plan now is to pause that for at least a month and return to chemo. 

I can’t swallow at all at the moment and take all water and food via a RIG tube. That isn’t a problem, but I would really love just to be able to drink a glass of water again. The most debilitating symptom though is the incredibly sticky saliva which I have no option but to spit out at regular intervals. 

I’ve been told that surgery is not an option because of the proximity of the tumour to my larynx and other structures, and that further radiotherapy could be detrimental to swallowing and/or breathing. However, my feeling is still that surgery would be the most effective if it could be achieved without too much risk.  One also reads so many stories of breakthroughs with personalised treatments / vaccines etc. - perhaps there are trials of these sorts of therapies which I should be considering. 

I'd be keen to hear from anyone who has had different / more successful treatment for similar cancer – and especially anyone who has found a way of dealing with the terrible saliva! 

Thank you so much for taking the time to read this post! 

  • Hi I can’t really advise on your current difficult situation as my husband’s presentation  was totally different ..but at the height of his illness (pre treatment ) he had to carry a jar around with him to collect his saliva as he also couldn’t swallow anything ..He found this very embarrassing and debilitating..He had to stop working as it became impossible for him to go into clients houses carrying a jar and regurgitating ..as well as making it difficult to carry out his work  .. ..It wasn’t nice to see and for him it became a disability ..However for him after his first FLOT chemo cycle it did reduce in severity and by the third cycle it had disappeared altogether and he could eat and drink again ..Sorry  I can’t help in suggesting a solution but I do sympathise as it’s an awful symptom to experience….Wishing you all the best in your future treatment and recovery 

  • Hi santander

    I also have the same cancer as you. I am T3/N0/M0.  I have had cisplatin and 5FU along with 25 radiotherapy sessions and I am currently waiting for the results of my CT scan for how I've progressed. I was told that surgery wasn't an option  as it was too high in my throat. 

    I too haven't been able to swallow for months, since last September. I have a RIG where I take all my liquid food and water. I carry a 'spit pot' everywhere and yes, it's embarrassing.  I have been off work for 8 months and won't be going back all the time I have to spit out saliva and use my feeding tube.

    I spit out the most foul tasting saliva/regurgitation and find that mentos mints helps as they totally dissolve and your able to just spit it out. Tictacs also made my mouth a little less claggy too. 

    I can't advise on a successful treatment as I am still awaiting my results,  but I too would just love a cup of tea or even a bottle of ice cold water let alone something to actually eat.  Sounds like we are in very similar positions but you're a little further down the line than me.

    Good luck 

    Mel

  • I forgot to say I used Difflum mouthwash which was quite good (on prescription).  I also used soluble aspirin both for gargling and spitting out which seems to help the sticky mucusitis in the mouth.  Hope this helps