Facing Esophageal Cancer
- The wall of the esophagus is made of up several layers of tissue; cancer begins on the inside lining and spreads to the outer layers of the esophagus as it grows.
- Once diagnosed, t's important you have a direct talk with your doctor and to get your questions answered.
- This cancer can be very difficult to treat because in many cases, the disease is diagnosed at a later stage
Understanding Your Esophageal Cancer Diagnosis
When it comes to facing the challenging diagnosis of esophageal cancer, learning more about your specific case can help you feel in control. That’s why it’s important to ask your doctor or doctors for more information about your specific type of esophageal cancer, the journey you face and your treatment options.For starters, there are a few basic things you can do to help manage the process when you first learn of your esophageal cancer diagnosis:
- Have someone come with you to the doctor: it is important to bring a close friend or family member not only to support you, but also to help you understand and digest all the information.
- Take notes: writing down what you hear can help you focus and create a record of the information so you can refer to it later on.
- Don't be afraid to get a second opinion: your doctor won't be offended if you get a second opinion. It is extremely important to go through the process with a doctor you trust.
- What specific type of cancer do I have? Is it an adenocarcinoma or an esophageal squamous-cell carcinoma?
- What does my prognosis looks like?
- Will I have a better chance of success if I travel to a cancer treatment center instead of seeing a local provider?
- Should I consider getting a second opinion?
Understanding Your Treatment Options
You will also want to ask about your treatment options. Knowing what to expect during treatment will help you plan ahead for any additional care or support you may need during this time. Consider asking:- What are my treatment options? Will I have surgery performed, or chemo, or radiotherapy?
- How soon should I begin treatment?
- How will you determine which treatment is best for me?
- What are the potential side effects of each treatment?
- What are the potential risks of treatment?
- How will we know if treatment is working?
- What's the goal of this treatment? Will it cure me of cancer, control the disease or stop it from coming back?
- What is the expected recovery time with each treatment option?
- How long will treatment last?
- Will I be able to work while receiving treatment?
Clinical Trials
Clinical trials are incredibly important both from an individual and a societal standpoint. These studies give patients, who have diseases that are not responding to typical treatments, access to a bevy of new drugs that are currently being developed by pharmaceutical companies. Testing these treatments on people in experimental trials is really the best way for research to progress.
A lot of the therapies being tested in clinical trials will fail. However, participants in clinical trials are statistically more likely to have better outcomes, according to the Director of NYU Perlmutter Cancer Center, Dr. Ben Neel. Among the large group of clinical trials that are currently underway, there will be some dramatic successes.
SuvivorNet has put up a clinical trial search tool specially designed for you. You may see new results over the course of several days as new clinical trials are added daily. You can also use clinicaltrials.gov, which is the national registry of trials, but it's vast and a bit hard to navigate.
Consider asking:
- Is there any clinical trial on advanced esophageal cancer?
- Am I eligible to a clinical trial?
Immunotherapy
If you're diagnosed with advanced esophageal cancer, it's worth discussing immunotherapy with your doctor. Immunotherapy works by helping a patient's immune system to recognize and attack cancer, but it's not for everyone.
"It's important for a patient to be aware of immunotherapy as a treatment option. I highly encourage patients to ask their physicians about immunotherapy," Dr. Rutika Mehta, a medical oncologist at Moffitt Cancer Center in Tampa, FL, tells SurvivorNet.
Patients with advanced esophageal squamous-cell carcinoma (ESCC) who receive first line chemotherapy, which means they were treated with chemo first, have poor overall survival with the median survival of less than 1 year. Incorporating immune checkpoint inhibitors, such as Nivolumab or Ipilimumab, into that initial treatment might help extend survival. Physicians usually refer the initial treatment as first-line treatment or first-line therapy. This treatment is usually what worked best in clinical trials for people with the same type and stage of cancer. How well your treatment works often varies. Your first-line treatment may not work, may start but then stop working, or may cause serious side effects. Your doctor may then suggest a second-line treatment, also called second-line therapy.
"Immunotherapy is here to stay. And it's really changed the face of cancer," says Dr. Brendon Stiles, a thoracic surgeon at Montefiore Medical Center.
Consider asking:
- Am I eligible to receive immunotherapy? Am I more, or less, likely to respond to this treatment?
- What is my tumor's PDL-1 level?
- If I my tumor's PDL-1 level is ≥ 1%, will it change the course of my treatment?
- What are the most common side effects of immunotherapy?
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