My Dad's Cancer Diagnosis: What to Expect

[arildno]

Recently, my father was diagnosed with having a malignant tumour in his oesophagus.

The prospect doesn't look too good; only 10 percent are expected to survive the 5 first years after diagnosis.

Does anyone at PF have any good knowledge about this disease?

Thanks in advance.

 

[El Hombre Invisible]

I have no information; I just wanted to offer my sympathies and hopes for the best. I'm very sorry to hear this.

 

[Astronuc]

arildno, I am very sorry to hear of your father's illness. I wish him a much longer life.

Perhaps this will help with respect to more information - http://www.nlm.nih.gov/medlineplus/esophagealcancer.html

http://www.cancer.gov/cancerinfo/pdq/treatment/esophageal/patient/

http://www.oncologychannel.com/esophagealcancer/

http://www.mskcc.org/mskcc/html/331.cfm

There are many more sites, but NIH and NCI are prominent sources.

 

[arildno]

Thank you for your concern, both of you. That is warming!

I guess it is one particular issue that at this moment worrying me:

My Dad noticed this spring that he had some difficulties swallowing when eating, but he didn't regard it as more than a nuisance he wouldn't bother the doctor about.
This condition lasted and didn't worsen (at least, that is his perception of it) until October, when he figured he ought to see a doctor after all.

That he had a tumour was fairly rapidly established, and he was scheduled for radiation therapy over two weeks ultimo November/primo December.
The result has been rather alarming:
His condition has over these two weeks rapidly worsened!
It is, of course, to be expected that the radiation therapy kills off quite a few healthy cells, and thus that it should be expected that his throat should become more sore than it was prior to the therapy.
However, he feels that the tumour seems to have grown, rather than shrunk, and here's basically what I would like to ask:

a) Since it is well known that radiation (may) induce mutations in cells, can it be the case that his tumour cells have mutated into a rather more nasty, aggressive type than previously as a direct result of his radiation "therapy"?

b) One of the distinguishing marks between a "benign" and "malign" tumour is that the benign tumour encapsulates itself in a coat, preventing metastasis, for example.
But:
Is it not possible that the body as a response to the growth of a tumour tries to section it off (however inadequate that response is in case of malign tumours)?
Could therefore the destuction of healthy cells around the tumour (as will happen in radiation therapy) disrupt the weak, natural protection we have, and hence, accelerate the tumour growth?

 

[Astronuc]

It is difficult to develop an informed opinion on the efficacy of the treatment. For one, we do not know the details, and unfortunately each case is different.

I think radation and perhaps chemotherapy are standard, and usually the radiation is directed to the proximity of the tumor, and the cancer cells are much more susceptible to radiation than healty cells. Surgery is also another treatment.

I have a friend whose father developed throat or esophageal cancer. He had been a cigar smoker. He received treatment, but I believe the cancer had metasticized to lung cancer, and while treatment prolonged his life, the cancer had already spread too far.

Hope for the best - and we'll be here for you!

 

[DocToxyn]

Sorry to hear about the diagnosis. I’m sure you and your family are struggling with many questions, biological and not, so please enlist us wherever you think we can help. It is difficult for any of us who are not physicians/oncologists to give you any sound advice on these issues. Typically I would bow to their knowledge as far as course of treatment and progress and I would hesitate to strongly question their actions unless I knew a lot about the particular disease. This is not to say that you shouldn’t discuss your thoughts with the doctors and if they are not receptive to this perhaps find some that are, even just to talk to. I’m not encouraging you to dump the current doctors and find others.
Having said that, here are my thoughts on your questions, based on my biology experience and what I can find in reputable books and websites. The radiation protocols used for cancer treatment are going to be at doses which are designed to be deadly to the targeted cells and (hopefully) cause minimal, repairable damage to the surrounding healthy cells. Since your father was initially diagnosed with malignant cancer, it was already in a rather aggressive form and the small chance that treatment would exacerbate the already existing cellular mutation (that what cancer is) is probably far outweighed by the benefits of radiation-based removal of the cancer cells.
The encapsulation issue may not be quite as you perceive it, although the issue is still under investigation and the exact mechanism is not entirely known. One theory suggests that benign tumors become encapsulated because they push against the surrounding tissues and form a fibrous tissue coat around themselves. It may not be that the tumor actively creates this coat to hold itself together, it may simply be a result of that particular tumor type and its behavior. The metastatic tumor is more invasive and moves into surrounding tissues rather than just pushing them away, thus there is no encapsulation. The characteristics that differentiate a benign tumor from a metastatic one may result in the presence or absence of a coat, but this encapsulation may not define or mediate the tumor’s behavior. Researching this topic is made even more difficult by the plethora of papers that use encapsulation of drug/agent delivery systems for the treatment of caner, it’s difficult to sift through all the paper to find what one is interested in. Again implementation of destructive therapies like radiation and whether such treatment disrupts some natural defenses the body had set up is a judgment call made by the physicians/radiation therapists and is weighed against the benefits experienced by use of these therapies in the past. There will obviously be some collateral damage and the body will hopefully recover following the treatments, it’s really a cost-benefit type of issue.
While your questions are logical and reasonable, one might also say they are obvious (not to suggest that therefore they are also any less meaningful). This leads me to believe that they have already been addressed by physicians who deal with these matters and they are of minimal concern. Again, these are my thoughts and I do not claim to be an expert in these realms. Please if you continue to be troubled by them, seek to discuss them with those who are immediately concerned with your fathers care . Best of luck to you, your family and your father.

 

[Moonbear]

Arildno, I just want to chime in with the others to offer your father the best of wishes for recovery, and you and your family the best of wishes in coping with his illness.

One thing to keep in mind is that by the time tumors are diagnosed, they are often already growing rapidly, which is how they became sufficiently symptomatic to seek consultation with a physician. For this reason, sometimes it's perceived that the tumor is growing more aggressively after treatment, but really, it was already reaching a rapid growth phase prior to treatment.

Does your father's oncologist think the tumor has grown, or is this your father's opinion? He may just feel all the effects of the tissue damage and swelling surrounding the area treated with radiation and it hurts more to swallow than when it was all tumor.

The way radiation and chemotherapy work is they are toxic to dividing cells. The tumor cells divide more rapidly than the normal, healthy cells surrounding the tumor, so are more susceptible to the treatments. Some healthy cells are killed too, and can leave the patient feeling pretty sick. It's far from an exact science yet.

 

[Monique]

Does your father's oncologist think the tumor has grown, or is this your father's opinion? He may just feel all the effects of the tissue damage and swelling surrounding the area treated with radiation and it hurts more to swallow than when it was all tumor.

Also, the production of saliva will halt after radiation therapy to the neck, making swallowing uncomfortable. Hang in there and support him the best you can.

As for your question whether radiation wouldn't induce new tumors, that is not something that you need to worry about now. Normal cells who divide that are damaged by radiation die, cells that are not dividing are not affected by radiation damage. It is known that secondary tumors arise due to radiation therapy, those show up after several years in a small percentage of people.

 

[Math Is Hard]

I was very sad to hear your news, Arildno. I am hoping for the best.

 

[Evo]

My thoughts are with you and your family arildno, I'm very sad to hear about your father.

 

[arildno]

As for your question whether radiation wouldn't induce new tumors, that is not something that you need to worry about now. Normal cells who divide that are damaged by radiation die, cells that are not dividing are not affected by radiation damage. It is known that secondary tumors arise due to radiation therapy, those show up after several years in a small percentage of people.

I am relieved to hear that.

He is at the very beginning of the treatment, and will continue the radiation therapy after Christmas. Hopefully, his condition will improve somewhat, but I guess we have a long battle in front of us.

 

[Wishbone]

I also want to offer my sympathies, please have a very nice Christmas, and I wish your father all the best.

 

[honestrosewater]

I'm so sorry, arildno. It's encouraging that he has someone like you by his side. Give him a hug for me? (Or whatever is most appropriate?)

 

[Sensible]

A good source of information can be found at
Have you given any thought to the cause of his cancer?
Best Wishes

 

[arildno]

Hi, Sensible!
Thank you for your concern and best wishes.
It is, however, rather late, since my Dad died in June 2006, i.e, within a year after his cancer was diagnosed (which is typical for patients diagnosed with oesophagal cancer)

Since my father was a heavy smoker, and that group is rather over-represented, that may have been part of the cause.

Fortunately, his end was fairly rapid and without much pain.

 

[Sensible]

So sorry
Just joined and didn't see the date
Best Wishes