Dad diagnosed with Esophegus Cancer

[sleepless44]

Hi I just found out that my father has been diagnosed with cancer of the esophegus.  My father is 87 years old. I live in a different country, so the caretake that regularly takes him for his doctor appointments accompanied him to the doctor for the diagnosis.

As it was explained to me, the doctor said that  the cancer is in about 3 inches of the esophagus, the nearby lymph nodes and lungs are clear.  There are currently no issues with swallowing food.

Three options were presented.

# 1 Extensive surgery to remove the cancerous portion of the esophagus, all nearby lymph nodes and the upper half of the stomach.  The remaining stomach would then need to be moved higher within the chest cavity and reconnected with the shortened esophagus.  Prior to the surgery radiation and chemotherapy would be used to shrink the tumor as much as possible.

The doctor said that finding a thoracic surgeon who would be willing to do such an extensive surgery on an 87 year old patient would not be easy.  The oncologist did not feel that this would be a viable option.

# 2 Radiation to the esophagus followed by chemotherapy.  The radiation would cause the esophagus to close about halfway through the therapy which would mean that nutrition would need to be via a feeding tube inserted into the abdomen. Particular type of chemo used in this treatment is usually pretty well tolerated.  As the esophagus heals from the radiation it would reopen again.  This is a tough protocol to endure for someone of your Father's age. It is all done on an outpatient basis.  When pressed the oncologist said that the median survival with only this type of treatment is 1 year.  Each patient is different, some live less some live longer.

# 3 Palliative Care.  The focus here would be to treat each symptom as it arises and to keep your Father as comfortable as possible.  It is very difficult to give a survival timespan but doctor mentioned at least 3 months.

I was told that my Dad was almost completely silent during the entire appointment.   The doctor asked him what did he want to do based on the information given.  He answered a little tentatively, Palliative Care.  The doctor said that based on this he would remain available to him should there be any further questions but that he would arrange a referral to Palliative Care.

My source of information about this is from the third party caregiver. My father generally keeps to himself and doesn't share, so he doesn't bring this up at all in our regular phone calls. 

Not sure what to tell him, and whether to influence his decision one way or another.

[Budgie]

Hi sleepless44,

Most older folk do tend to keep this type of info to themselves because they don’t want to be a burden on anyone.   While a death from cancer can be cruel at times, treatment with chemo & radiation, on anyone let alone one of 87 years, can be just as cruel.  

Do talk to him about it though as it would probably provide him with some relief, as well as yourself.  But at the end of the day, if your father is of sound mind, it’s his decision one way or another.   Although it’s hard on all concerned, 87 years is a good innings. 

Take care

Budgie

[sleepless44]

Hi Budgie 

Thanks for your response. You expressed very clearly what I was thinking but found it too difficult to articulate. Yes my father has lived a full life, and until now, not suffered health-wise. My mother passed away last year, so dealing with with looming death is still fresh for me.

Thanks for the support.

Sleepless

[chandilli]

Hi, my dad got diagnosed with esophagus cancer back in january. He has 2 tumours near the bottom of the esophagus. My dad is 72 and currently going through chemotherapy. He is so weak and has done nothing but sleep for the last 2 days. He wont eat and hardly drinks anything. He has 1 more chemo dose left, then more scans and then the dr wants to operate. My dad also has copd. He is looking so frail and is loosing weight. My dad chose to have the chemo and wants the surgery. It is so hard seeing him this way. I dont even know if he will survive the surgery to be honest. I hate this. I dont think dad should have the surgery but its his choice. The dr said if he survives the surgery he could have another 1 -5 yrs at most but recovery could take 6 -12 months. I dont want to lose my dad but i hate seeing him like this. Its hard on his granddaughters too.

[Budgie]

I understand how difficult this is for you & your family, chandilli.  Chemo can really take it's toll on the body & mind.   

I don't have a lot of faith in the prognoses that doctors tell people - it's amazing what you'll put up with if you want to live, & their estimates can be way off.

There are dietary suppliments your father can have to increase his calorie intake, eg; Ensure.  He will need his strength if he is to have the surgery.  Are you in touch with a palliative care team?  They can provide a lot of help and suggestions with how to cope.  Your father will be able to get a referal through either his GP or his oncologist.  

I hope his surgery goes well.  

Budgie