Is the information I have accurate?

[jennifer]

My 84 year old mother - who was in excellent health - was recently diagnosed with adenocarcinoma of the distal esophagus.  While the doctor hasn't come right out and told us what stage the cancer is in, I have been able to determine that it is minimally stage III and most likely stage IV since the CT scan showed that, and I quote, "multiple necrotic masses are demonstrated in the liver consistent with metastatic disease."  Surgery is not an option for her.  She is currently receiving chemotherapy.  I have done extensive research on the internet - which is how I found this website - and so far I have found many different sources of information all essentially saying the same things but in slightly different ways.  I have a few questions and would really appreciate it if someone could give me some straight forward answers.  First of all, I have found that the 5 year survival rates even with surgery are very poor.  I am not disillusioning myself with thoughts of my mother being being alive 5 years from now.  But what I am unclear of is it seems that, from what I've read, we'll be lucky to see her live just ONE year. I realize that for each individual the survival rates vary according to the individual's age, health, etc.  My first question is, given the current statistics, do you think she could live a full year?  I've read that the median survival time is 5-8 months, is that accurate?  I've also read that chemotherapy can prolong someone's life 2-3 months - at best.  Is that accurate as well?  Additionally, I have not been able to find any information regarding the effectiveness of the two drugs she is receiving.  The two drugs are Taxol and Camptosar.  I HAVE found information about these drugs but what I haven't been able to find are any statistics regarding the effectiveness of them on esophageal cancer.  Also I have not found any mention of the word "remission" used in conjunction with esophageal cancer.  Is this because remission NEVER happens for someone with such an advanced case as my mother?  It's just hard to believe that she might not be around (and from what I've read, more than likely won't be) a year from now.  She looks good.  She's eating (she had a stent put in) and the only side effect she's had from the chemo is hair loss.  Which brings me to my next question.  The doctor is giving her the chemo at a low dosage once a week.  He said that there really hasn't been shown to be a significant difference in effectiveness between a large dose and a small one.  Does this sound accurate to you?  And lastly, I have read that "esophageal cancer is recognized as the most difficult to treat and is second only to pancreatic cancer as the most lethal of all gastrointestinal malignacies."  Is that an accurate statement?  And, if so, the way my mother is today, is this the best she will be?  Should I expect that it is all going to be down hill from this point on?  Thank you in advance for your responses.  I greatly appreciate it.  -- Jennifer

[HFHSM.D.-rf]

Dear Jennifer,
Survival statistics and responses to therapy indicate thew effect in a large population.  For example if you study a sample of 100 people and find that the average survival is 6 months, some people may live only 1 month whereas others may live 24-36 months.  At present, we can not predict the survival of any specific individual.  THere are s9ome clues, however, that can indicate how long someone may live.  Performance status is one factor.  Weight loss, inability to eat, bone marrow supression from chemotherapy can adversely impact survival.

Esophageal cancer is poorly responsive to chemotherapy.  With regard to your questions about remission- yes remissions can occur but they are not common.

This ionformation is presented for educational purposes.  Ask specific questions to your personal physician.