Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.

Question Title: Gastric cancer of the GE Junction

Forum: The Gastroenterology and Liver Diseases Forum
Topic: Esophageal Cancer


Can you tell me why a Doctor wouldn't do surgery on a cancer patient? Acording to the doctors, the tumor is too big! How can that be? I always thought with cancer time is of the essense. The doctors said they couldn't get all of the cancer if they were to do surgery first.

So what happens if the chemo doesn't work? Do they then do surgery after wasting so much time? Also what determines the size of a tumor as to " it's to big" Especially if there is no metastasis. Please excuse all of my spelling!

thank you, Lynn

Dear Lynn,

Cancer treatment depends upon the type of cancer and the type of therapy that has been proven in clinical trials to improve
survival. It may include surgery, chemotherapy or radiotherapy or a combination of the above. For unclear reasons,
gastroesophageal junction cancer incidence has been increasing in the United States. There has been recent literature to suggest
that shrinking esophageal tumors (with chemotherapy and radiotherapy) prior to performing surgery (called neoadjuvant
therapy) will improve the results of the surgery. Furthermore, the delay of surgery with this treatment does not influence survival.
Many esophageal cancers are sensitive to the chemotherapy and radiation therapy combination and can actually shrink to the
point where the tumor is no longer visible on standard scans. This makes the surgery much easier to perform and therefore it
will have a better chance of being more successful. I hope you find this information helpful.

This response is being provided for general informational purposes only and should not be considered medical advice or
consultation. Always check with your personal physician when you have a question pertaining to your health.

If you wish to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment
to see Dr. Muszkat, one of our experts in Gastroenterology.

HFHSM.D.-ym
*Keywords: esophageal cancer, treatment


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