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.
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