Why more surgery?

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Hi all,

Firstly, I've been reading a lot on this forum and I'm sorry that so many people are going through such hardship, much like myself.

In Apr a routine OGD & biopsies found a small tumour as base of oesophagus. In June, I had a successful ESD to remove everything, as I was only believed to be T1a. Surgeon hoped that was the end of everything, much like me.

Pathology results showed tumour was fully removed, but... by 0.5mm, had just reached the sub mucosal layer, so now T1b. Surgeon said, 75% chance that everything would be fine, but there was "an unacceptable risk" of 25% for it getting to lymph nodes, as I'm only mid-40's.

I was referred to a specialist surgeon and met with him. He said, "my only option" was an oesophagectomy. Removing 90% of oesophagus and 25% of stomach. This seems dramatically radical to me, when there's a 75% chance that all is ok. Why do it? It's a life altering & risky surgery, with lots of possible complications, no question about it.... but for just 25% risk, it seems very, very excessive. I have no idea what to do. The ESD was rough going for a few days, but this is rough going for months & years by all accounts.

If anyone has been through an oesophagectomy, or been in a similar situation, I would love to get your thoughts. Thanks and God bless.

  • Hi perplexed I really don’t feel qualified to give you any advice. My husband has just finished his chemo and while not pleasant was not too bad until the 4th which hit him like a ton of bricks. We are unaware of the staging etc of his tumour as they have not told us but did mention one or two nodules appear to have been affected. He had pet scan today and now we await the results which I pray will be ok for the surgery. I wanted to ask where I can find the information relating to OAP guide etc as I can not find the website and would be interested to read it. Let me know what we are in for !! 

    I do however feel you really should have more information from the experts involved in your cancer care as it’s a very big decision to make.  I understand the decision is ultimately yours but to make that decision you need to be fully informed of all pros and cons and I think I would be inclined to ask the question “what would you do in this situation”. Also will you be having regular screening, what would the symptoms be if it did become cancerous. 25% is quite a high risk in my opinion, between 1 and 10 for me would be low risk. Also how long could they give you to make that decision, as you have not long had one and in a years time you may feel different. Wishing you all the best for whatever you decide.

  • Hi 

    The website is https://opa.org.uk/. It was highly recommend to me by my surgical team and I understand they sometimes give talks etc. to members. 

    I hope that helps 

  • Great thank you Jacpop

  • I totally understand where you’re coming from ..I’ve not been able to stop thinking about your predicament..I have two adult children in their early forties ..both with younger children and your situation really hit home for me ..Going through all this was hard enough with my husband but the thought of it happening to a person around the same age as two of my children is terrible and so unfair .

    I know we are ‘strangers ‘ but ‘strangers are just friends you haven’t met yet’ (Jane McDonald lol ) but we all have an unfortunate link ..we are all behind you …stay in touch 

    regards J 

  • Hi Perplexed 

    My husband had his oesophagectomy 14 years ago and it was engorged lymph nodes that initially made surgery too risky.  He had 8 cycles of ECX chemo - the tumour all but disappeared and the lymph nodes returned to normal, the medical team couldn’t believe what had happened, some described him as a walking miracle.

    His recovery was relatively straightforward, overnight in critical care and then 2 weeks in a room near the nurses station.  I was so worried about him coming home after such major surgery but he coped really well and knowing that the cancer (and many lymph nodes) had been removed was such a relief.  Yes, we’ve had the odd hiccup but, given the alternative, we’re so grateful that he’s still here and enjoying life.

    I don’t know if this is any help to you, you have a lot to think about being younger (he was 56 when he had the op) but there are positive outcomes and I wanted to share ours.

    All the very best to you. J x