Personal Details : F*** ,75 Male, Delhi
Last Seen : 29 Mins Ago
Views : 09
Disease: Cancer Stomach
Past Activitie: The patient has been diagnosed with Esophagus Cancer, has spread to the liver as well, please advise what treatment can be given , he is undergoing radiation currently, he will be given 10 sittings of radiation, but has pain and difficulty in swallowing, he is diabetic and has high Blood Pressure as well. The doctors have rules out surgery, what is best treatment that can be given and what are the chances of cure. The doctors have prescribed him Crocin, Pregabel and other pai n killer with LimCee 500.
Reply:
Reply:

Dear patient,

I am really sorry to hear about your ill health.

I have reviewed your medical documents (Endoscopy /Biopsy / Liver FNAC / PET CT scan). The cancer of the lower esophagus that you are suffering from is in an advanced stage. It has already spread to the liver as your FNAC report confirms. This is a stage 4 cancer. 

I agree with your treating doctors who have decided not to do surgery. Surgery does not have any advantage in this situation.

The next best option is to consider radiation concurrently with chemotherapy. But I notice that you are receiving radiation therapy alone (already planned for 10 days). I believe this could be because you are 75 years of age and may not be in the best of health to receive a combined chemotherapy and radiation treatment. It depends on your treating doctors assessment of your health and ability to bear aggressive treatment.

Your difficulty in swallowing and the pain is because of the cancerous growth obstructing the lumen of the esophagus. If the radiation dose is effective you should have a relief from these symptoms in about 4-6 weeks.

Meanwhile you have to realize that the treatment of stage 4 esophageal cancer is only palliative. You cannot cure this disease at this stage.

If you are physically fit then you can have chemotherapy after you complete the radiation treatment. This will help in reducing the tumor both in the esophagus and also the liver leading to a better quality of life. However if you are not fit enough to take injectable chemotherapy then you can opt for oral tablets of chemotherapy once your are able to swallow. This also can provide you some comfort.

If you however decide not to take any chemotherapy medicine, it will be a good idea to get in touch with a palliative care physician who will be able to help you stay symptom free.

Please feel free to write back, if something is not clear.

Wishing you the very best.

Wesley M Jose

Medical Oncologist

Replied by: WESLEY M JOSE MBBS,MD,DNB,MNAMS, FIACM, PGDIM,MD,DNB,MNAMS
Reply: <p>Dear patient,</p><p>I am really sorry to hear about your ill health.</p><p>I have reviewed your medical documents (Endoscopy /Biopsy / Liver FNAC / PET CT scan). The cancer of the lower esophagus that you are suffering from is in an advanced stage. It has already spread to the liver as your FNAC report confirms. This is a stage 4 cancer.&nbsp; </p><p>I agree with your treating doctors who have decided not to do surgery. Surgery does not have any advantage in this situation. </p><p>The next best option is to consider radiation concurrently with chemotherapy. But I notice that you are receiving radiation therapy alone (already planned for 10 days). I believe this could be because you are 75 years of age and may not be in the best of health to receive a combined chemotherapy and radiation treatment. It depends on your treating doctors assessment of your health and ability to bear aggressive treatment.</p><p>Your difficulty in swallowing and the pain is because of the cancerous growth obstructing the lumen of the esophagus. If the radiation dose is effective you should have a relief from these symptoms in about 4-6 weeks.</p><p>Meanwhile you have to realize that the treatment of stage 4 esophageal cancer is only palliative. You cannot cure this disease at this stage. </p><p>If you are physically fit then you can have chemotherapy after you complete the radiation treatment. This will help in reducing the tumor both in the esophagus and also the liver leading to a better quality of life. However if you are not fit enough to take injectable chemotherapy then you can opt for oral tablets of chemotherapy once your are able to swallow. This also can provide you some comfort.</p><p>If you however decide not to take any chemotherapy medicine, it will be a good idea to get in touch with a palliative care physician who will be able to help you stay symptom free.</p><p>Please feel free to write back, if something is not clear.</p><p>Wishing you the very best.</p><p></p><p><strong>Wesley M Jose</strong></p><p><strong>Medical Oncologist</strong></p>

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