Seeking Advice for Advanced Esophageal Cancer

[micki8899]

Hello everyone,

I’m looking for advice and insights about a case of advanced esophageal cancer. We’re trying to understand what can be done at this stage and what the likely outcomes might look like.

Patient Details:

• Diagnosis: Moderately differentiated squamous cell carcinoma (SCC) of the esophagus, HER2-positive (confirmed via FISH report), diagnosed in early 2024.
• Treatment History:
  • First-line therapy: 10 cycles of FOLFOX5 + Pembrolizumab (stopped due to progression).
  • Second-line therapy: 10 cycles of Taxol + Pembrolizumab (initially showed mixed results).
• Current Status: The latest PET/CT scan (January 2025) shows significant progression of the esophageal tumor, mediastinal lymph nodes, and metastases to the liver and lungs.
• Planned Next Step: The doctors are considering Irinotecan as the next line of treatment.

The patient has a history of cardiac issues (two heart attacks, open-heart surgery, and a stent)

Questions:

1. What are the realistic treatment options at this stage, especially given the recent progression and the patient’s cardiac history?
2. How bad does the current situation look in terms of prognosis and quality of life?
3. Are there additional steps we can take to manage symptoms, slow progression, or improve comfort?

I can share the latest PET/CT scan report if it helps provide more clarity.

[Susana_CCNSW]

Hello Micki8899,

Thanks for joining Cancer Council online community and for reaching out.

Our community provides a safe space for those affected by cancer, get together to provide and receive support from each other.

You are seeking some specific medical information, and unfortunately we do not have a medical team that could help give you the information you are after.

Hopefully one of our members has gone through a similar experience that  would like to share  with you.

Below is a link that provides some information about Oesophageal cancer, symptoms, diagnosis and treatment. I hope you find it helpful.

https://www.cancer.org.au/cancer-information/types-of-cancer/oesophageal-cancer

Best wishes

Susana

Cancer Council

Online Community

[edwardsmith]

Hello Micki8899

I have known TIG. and I would suggest you to contact them. 

Patients can request free initial consultation to understand available options and receive direction tailored to their specific health condition. here you can request a free consultation with TIG (Treatment in Germany) to receive individualized guidance and coordinated access to specialized oncology centers.

[Internal_Ice_64]

Hi @micki8899, I’m really sorry you and the patient are facing this. Seeing progression after two treatment lines must feel frightening and exhausting, especially with spread to the liver and lungs and the added concern of past heart problems. At this stage, it may help to ask the oncology team very directly what the goal of irinotecan would be: slowing the cancer, easing symptoms, or giving more time with acceptable quality of life.
Because of the cardiac history, tolerance matters just as much as response. You could also ask about support for swallowing, nutrition, pain, breathing trouble, fatigue, and emotional comfort alongside treatment. I hope you get clearer answers soon and that the next step brings some relief.