2nd opinions

We met with 2 different oncologists today. One within the St. Francis hospital network and one within the St. Vincent's hospital network. We started this journey within the IU/Clarian hospital network several weeks ago. So - that's three hospitals, 5 doctors (3 oncologists and 2 surgeons)... I'd love to say that we absolutely know the direction to take...but we don't.

Here are the basics: all of the doctors seem to suggest a combination of chemo/radiation and surgery. The approaches to chemo/radiation all appear to be the same. The biggest difference we learned today was that one of the oncologists (St. V's) recommends Roger having a food tube surgically inserted into his stomach BEFORE chemo starts. He said he does this with 90% of his patients - especially those with esophageal cancer - so that they can get the nutrients, vitamins, and calories they need. Apparently with radiation, the esophagus will become irritated and swollen and will swell so much that he won't be able to eat/drink. Um, not news we wanted or expected to hear.

The doctors all seem to agree that surgery is necessary. The surgery is to remove 2/3 to all of the esophagus. Very very aggressive - but the preferred treatment because of:

1. they say then need to remove the cancerous sites and at least 6-8 cm above/below the last site of cancer - the "cancer free field" - thus 2/3 or all of the esophagus is removed
2. removal of the lymph nodes and esophagus are believed to lead to a greater cure rate
3. the 2 or 3 incision surgery is preferred over the laproscopic surgery as it allows the surgeon to complete the procedure - reattach the organs - with the greatest success rate....fewest incidences of complications or leakage.
4. Roger is believed to have a cancer gene which means his likelihood of cancer returning is even greater
5. finally, Roger is young - the doctors would rather do this procedure (be as aggressive toward cure as possible) now while he's young and able to sustain the trauma

All of the doctors want to get started with the treatment process as soon as possible. We need to make a decision. All of the doctors seem to be good...some have more experience, some have better people skills, some hospital networks have better touch-feely-feel-good stuff, and some make you feel like a number. A diverse set of options.

The reality of the situation is all to raw. The weight of the decision is practically suffocating.

We truly appreciate the thoughts and feedback that many of you have provided. Will let you know our decision within a couple days at most.

breathe in...breathe out.