Gullet (oesophagus) cancer

A support group for anyone affected by gullet cancer (also known as oesophageal cancer) to come together, share experiences and ask questions.

Chemotherapy Alone for GOJ

oyita
Posted by

I was wondering whether anybody can share thoughts or experience about chemotherapy alone (FLOT) for treatment of GOJ adenocarcinoma.

PingG25
Posted by

Dear Oyita

FLOT appears to work well with the various people posting on the site - you should ask your Oncologist and Surgeon the “why” question at least 6 times to get to the bottom of why chemo and surgery and then more chemo - ask about current findings in the last 12 months - I am currently having this debate with my surgeon and tomorrow will ask my Oncologist and also get a second opinion. I believe nutrition and exercise will play a role in prevention going forward. 

regards

John

oyita
Posted by

Thank you very much John!!

My husbands results came back all clear today after the checks post 4 initial doses of FLOT. Tomorrow and Saturday we have appointment with surgeon and oncologist. I will surely ask them; yet sometimes doctors just speak so little.

We do have a list of questions. I hope we can go through it.

oyita
Posted by

Dear John,

I would love to hear the feedback you recieve from your Oncologist about this, I hope your appointment goes well.

There are some clinical trials out there that are ongoing and I am sure the medical community have access to preliminary results better then we would ever have just by reading off the web..

Regards,

Oyita

PingG25
Posted by

Hi Oyita

that is good news and very interesting - have they given you the specific results from the PET scan the SUV change which will be in the report. 

You could ask the question how the results compare to others  under their care with FLOT since they started using FLOT or how it compares to other centres globally in the last 12 months.

My Oncologist referred me to the report published in the Lancet May 2019 393:1948 which is the protocol being used. 

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32557-1/fulltext

Let me know how you get on

Regards

John

oyita
Posted by

Dear John,

We did not have PET scan at this stage, but  a contrast IV CT was done and a gastroscopy following that. 

They did not see the tumor and the lymph nodes have significant regression back to normal dimensions. That is basically what it says in the report. We are being treated outside the UK so the report is not English.

We are waiting for the pathology result from the gastroscopy as well. 

I have read the Lancet article and also reading about the lastest findings on pre and post operative FLOT considerations. You may also fınd this one interesting:  https://www.mdpi.com/2072-6694/11/3/399/htm

We will know more after the appointment tomorrow, but we are very happy that the treatment gave postive results thus far.

Regards,

oyita

oyita
Posted by

Just to share our update, we have had the appointment with our oncologist the other day. My husband has had almost complete response to the FLOT protocol after the first 4 doses, and the interdiscipliner comite decided that he should continue with 4 more doses to complete 8 doses to achieve full protocol pre-op. After that they will give him the surgery and that would be it. 

The oncologist did not give us much technical information during this appointment despite our full list of questions. What he was able to explain in plain words is that with the current available technology they do not have chance of knowing whether the malignancy is fully gone without resecting the stomach and the lymph nodes. So he says that not having any surgery would be like playing Russian Roulet... So, they strongly advise to do the surgery given my husbands young age. 

He told us that there were better advances in colorectal cancer to avoid surgery and continue with close follow ups when there is full response, but today he says that this is way too risky for GEJ adenocarcinomas.

We will recieve pathology results this afternoon, so still waiting on that.

Do you know about genetic testing of the tumor or similar, to know whether the root cause genectic (I presume under this case surgery would be an absolute yes...) or due to environmental factors?

In any case we are very very happy with the results we have achieved so far, and hope that the next doses do not give too much trouble. Just cannot wait to go back to our normal routine.. but still we have to be patient as this will take a few more months between the chemo and the surgery.

PingG25
Posted by

Fantastic Oyita - good luck with the rest of the protocol and thank you for the information 

Best wishes

John