Category: Esophageal Cancer

As expected, this installment won’t be any more cheerful than the last. I’m writing this account for two reasons, first so that I have a way to deal with my emotions as I have to deal with what’s going on with my wife, my role as the supportive spouse, and the role as parent of a teenager facing the real prospect that he will lose his mother in the next several months. The second reason is in case somebody else finds this account and may be going thru the same cancer in their family.

I would have written sooner but the doctors found ways of delaying the PET scan and coming up with a treatment plan—a plan that while formulated still lacks a start date.

It’s now been about three weeks since the initial diagnosis. In that time, my wife has developed much more difficulty in chewing food since it keeps getting caught on the tumor. Clearly the tumor continues to grow.

The PET scan results were emailed to us and the doctor simultaneously just a few hours after the procedure. The tumor is in my wife’s esophagus just above the stomach. It is 40 v 27 mm in the axial plane (left and right) and 60 mm in craniocaudal extent (up and down). This translates to 1.57 by 1 by 2.36 inches. The cancer was found in only one location and thus excludes a stage 4 diagnosis.

Per several medical studies that I’ve read on the Internet, the over/under on tumor size for esophageal cancer is 3 cm (or 30 mm) in height. Under 3 cm, the odds are much better for survival. Over 3 cm, the odds are markedly worse. Per one study that did three divisions, under 3 cm, 3 to 6 cm, and over 6 cm; the numbers are even worse over 6 cm. This is regardless of stage of the cancer.

The difference between stage 2 and 3 for cancer in this situation is a matter of how many layers of esophageal tissue that the cancer has penetrated. More superficial is stage 2 and more layers containing cancer is stage 3. Given the size of the tumor, I think it’s stage 3, but the doctor won’t commit to saying that. The doctor said that the treatment is the same so why does it matter? As an aside, the doctor capable of making the determination is on vacation so waiting for the endoscopy ultrasound would cause even more delays in treatment.

Oh, the treatment is six weeks of daily radiation and weekly chemotherapy. This will be followed by surgery to remove the cancerous area. Per Doctor Google, as my wife calls the Internet, the surgery portion for this type of cancer is pure butchery. When I think about this treatment plan, I have a mental picture of Star Trek’s Dr. McCoy (Deforest Kelly) mumbling about the damn primitive 20^th Century butchers.

Besides waiting to get a start date for treatment, we are waiting to be contacted by a “nurse navigator”. Apparently, this nurse will be our go-to person and point of contact to guide us thru the maze of cancer treatment. My sister says there is also a similar person whose job is to guide you thru the financial and insurance obstacles necessary to get treatment.

After writing this draft we did get more info on the treatment plan from a “clinical nurse navigator”. Also, and I don’t know if its just because its August or it’s a Covid thing, but the radiologist assigned my wife’s treatment is on vacation and thus we are experiencing another delay as we wait for him to return. Ditto for the surgeon. Additionally, due to Labor Day being during the first full week of September, we may be pushed back another week because they want chemo on Mondays (of course they have Monday holidays off). Thus, we are probably looking at another three-week delay before any treatment will begin. Hurry up and wait may be monotonous for military life but for this type of cancer, its just more time for it to grow and spread, two things that make it even more life threatening. I think the doctors should be allowed vacation but the fact that their workload seems to freeze when that happens is concerning. Sometimes it feels like our emergency is not their problem. I’ll post more as things develop further.

“And as it is appointed for men to die once, but after this the judgment” Hebrews 9:27

Yep, we merrily go along living our lives and suddenly, everything comes crashing down. That is the place that my family is in now. I always knew that our plan to exit California would be contingent on certain things happening or not happening—making allowances for elderly parents was what I had in mind—but the unexpected and unanticipated happened from another vector altogether. You see my wife has esophageal cancer.

Unlike my experience with skin cancer, cutting it out and stitching up the hole won’t work on this one.

Nope, by the time you have symptoms, you’re probably hosed.

Here’s some quotes from research that I did.

Unfortunately, most esophageal cancers do not cause symptoms until they have reached an advanced stage, when they are harder to treat.

Trouble swallowing
The most common symptom of esophageal cancer is a problem swallowing (called dysphagia). It can feel like the food is stuck in the throat or chest, and can even cause someone to choke on their food. This is often mild when it starts, and then gets worse over time as the cancer grows and the opening inside the esophagus gets smaller.

When swallowing becomes harder, people often change their diet and eating habits without realizing it. They take smaller bites and chew their food more carefully and slowly. As the cancer grows larger, the problem can get worse. People then might start eating softer foods that can pass through the esophagus more easily. They might avoid bread and meat, since these foods typically get stuck.

Signs and Symptoms of Esophageal Cancer

The 5-year survival rate for esophageal cancer is alarmingly low.

It’s essentially a death sentence. Just HOW does esophageal cancer cause death?

The 10-year survival rate of this cruel disease is virtually zero, says Alex Little, MD, a thoracic surgeon with a special interest in esophageal and lung cancer, and clinical professor at the University of Arizona.

That’s because almost always, it’s discovered after it’s already spread.

Furthermore, esophageal cancer grows and spreads quickly.

How does esophageal cancer eventually kill a person?

There are two types of esophageal cancer, each with different risk factors:

Adenocarcinoma
Cancers that start in gland cells at the bottom of the esophagus are called adenocarcinomas. This type of cancer is the most common esophageal cancer. It usually occurs closer to the stomach. Chronic acid reflux, gastroesophageal reflux disease (GERD), Barrett’s esophagus and chronic heartburn can increase your risk of developing adenocarcinoma esophageal cancer.

Esophageal Cancer

Per Dr. Fauci’s agency are these Esophageal Cancer Facts

5-year survival rate 19.9 %
1 % of all new cancer cases
2.6 % of all cancer deaths

In 2021, it is estimated that there will be 19,260 new cases of esophageal cancer and an estimated 15,530 people will die of this disease.

Cancer Stat Facts: Esophageal Cancer

Oh, sorry you woke people but race and gender matter with this cancer.

Among 2025 patients, 87.9% were White and 12.1% were Nonwhite. Median survival was 18.7 months for Whites vs 13.8 months for Nonwhites (p = 0.01).

Survival Disparities by Race and Ethnicity in Early Esophageal Cancer

According to the American Cancer Society, the percentages of people who live for at least five years after being diagnosed with esophageal cancer (taking into account that some people with esophageal cancer will have other causes of death) is 43% for localized cancer to the esophagus, 23% for cancer that has spread regionally, and 5% with distant cancer spread.

Esophageal Cancer

The male to female ratio of the esophageal cancer incidence is 3:1.

Esophageal Cancer: Should Gender Be Considered as an Influential Factor for Patient Safety in Drug Treatment?

I grant that I tend to be the cup half empty kind of guy, but can you blame me after reading the above?

Meanwhile my wife leans to the unicorns and rainbows end of the spectrum, but she too is making preliminary plans to make radical changes in her life. In fact after I wrote a draft of this post, she got the biopsy results and 20 minutes later quit her job.

We had plans to do other things but right now they are on hold. Folks we could use some prayers for a whole host of decisions that we are expected to make in a very short amount of time. Whether God heals my wife or not, is up to Him. My biggest concern is for our teenaged son.

For more information, here are two videos for your consideration. In the first video, Christine talks about her diagnosis of esophageal cancer. The second video is an announcement of her death five months after her original diagnosis. Oh, Christine was 34 years old. Sobering stuff.