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Cancer: Esophageal Message Board
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Old 11-28-2011, 08:21 AM   #1
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Chemo May Not be Working. What can be done?

Hello,

My mother is 86 years old and has esophageal cancer. I have asked questions about her health on this website before on several occasions, and I have received valuable feedback and helpful advice from people here. I wanted to ask if you folks could kindly help me once again.

My motherís cancer has spread outside of her esophagus to her chest area and near her lungs.

She started chemotherapy in March and has been receiving the Folfox 6 treatment. Due to the side effects of her chemo treatments, she was doing chemo once every 3 weeks instead of once every 2 weeks.

Unfortunately, she also took a 2 month break from chemo, so she did not complete her six chemo treatments until August.

At the end of the six chemo cycles, her symptoms had disappeared, and she was not having any pain or any problems swallowing.

A PET Scan was done in August and showed that her cancer had not spread and had shrunk slightly in the chest wall area.

After August, she took a 1 month break from chemo.

Since September, she has undergone 4 chemo cycles. Again, she is having chemo done once every 3 weeks instead of once every 2 weeks. Also, since the chemoís side effects were bothering her, we asked that the dosage of the Folfox drugs be reduced.

About a month ago, she once again started to have symptoms.

Initially, she started to have pain when swallowing and after swallowing at the juncture of her esophagus and stomach. Then she started to experience pain in the back between her shoulders. Now, she is also having pain in her chest area under her breasts.

She used to experience all these problems in the past but they had all disappeared for about 3 months. Now, they have all come back with greater intensity than before. (The pain is quite unbearable).

Iím very worried since I think this means that the cancer is getting worse.

In view of the above, what do you think can be done?

1. Iím thinking she should continue with chemo.

However, even though the dosage of the chemo has been reduced, the side effects my mother experiences are even more difficult than before. Also, even though the dosage has been reduced, it now takes more than 3 weeks for her white cells to return to normal. So the doctor had to withhold one of the drugs for the last three chemo sessions.

2. Should her drugs be changed? It seems to me that may be her Folfox treatment isnít as effective as before.

3. Should she get radiation?

Iím really worried and donít know what can be done.

I know this is a very complex situation and itís hard to come up with any solutions. But if anyone can think of any ideas or suggestions, or provide any advice, I would deeply appreciate that.

Iíd like to thank everyone for their kind attention, time and assistance.

Thank you!

Tom

 
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Old 11-28-2011, 12:46 PM   #2
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Re: Chemo May Not be Working. What can be done?

Tom,

Your mother is a very strong and courageous woman. She has fought this disease with all her might and I'm sure much encouragement and support from you. There comes a time when we have to accept the fact that no one is getting out of here alive. Something will do all of us in at some time. The final decision on treatment must be hers with the advice of her doctor. Chemo severely impairs the immune system and at her advanced age and debility from the cancer and chemo, it's hard for her body to recover. She could try the radiation, if the doctor thinks that would be of help. Have they done PET scans or other imaging? Those will show the extent of metastasis.

I hope I haven't been upsetting or unduly direct, but we must be mindful of the suffering and quantity is not necessarily better than quality of life. Take care

Last edited by rudiraven; 11-28-2011 at 12:48 PM.

 
Old 11-29-2011, 06:04 AM   #3
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Re: Chemo May Not be Working. What can be done?

I think she should have another PET scan to clarify the situation. This way any change can be seen since the last scan & also the degree of any spread.

What does your Mother want to do at this point- treatment wise? She is obviously a great fighter but it's so hard to make these big decisions when one is in so much pain. Perhaps you could see if there is anything to help control her pain more?

Perhaps you should all meet together- your mother, her oncologist & yourself. The Oncologist could discuss the possible options with you both & you could take it from there.

I wish your mother & you all the best Please let us know what you decide!
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