Spindle Cell Carcinoma: Prognosis?

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lisabucc@hotmail.com - 23 Dec 2004 17:04 GMT

(Sorry this is a cross-post from sci.med.disease.cancer. Not only have
I been away from groups for a long time, I'm accessing them in a new
way. I had meant to put it here in the first place, but goofed.)

Hi. I used to post to this group on a regular basis, as I had
breastcancer. Everyone (except the ganodema spores and agaricus
mushroom guy) was very helpful and supportive. Due to a new job with a
software start-up that requires mega hours, and family obligations,
Ihaven't been around for a couple of years.

My mothers older brother (89) has just been diagnosed with spindle cell
carcinoma. He's had prostate cancer for years and a year ago was
diagnosed with bladder cancer. He's also got Parkinsons. I know,that's
quite a mix.

Here's what she wrote me about the diagnosis:

"To make a long story short, they found a tumor, known as a spindle
cell carcinoma, on the back side of the esophogus, resting on the
spine. They didn't, at that point have much hope for a good outcome and
decided to emplace a feeding tube, and not try radiation or
chemotherapy. However, just today, at a meeting of the radiation,
chemotherapy and surgical staff, they decided that the tumor had not
invaded the spine, which they had thought had happened. It has invaded
some of the lymph nodes and deep muscles. He still has mobility. They
further decided that he should not get a feeding tube and should start
treatment with radiation and chemotherapy."

Does anyone have experience with this type of cancer? If so, how long
do you think that he might have? Six months? A year? More? I'm his
excutrix and when he passes, it going to be a major job to get
everything settled and if I can plan at all for that time, it would be
great.

Thanks for any help.
...lisa

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J - 23 Dec 2004 22:27 GMT

Hello Lisa, I've been wondering how you're doing..
I'm sorry to read about your mother's older brother.

> My mothers older brother (89) has just been diagnosed with spindle cell
> carcinoma. He's had prostate cancer for years and a year ago was
[quoted text clipped - 13 lines]
> further decided that he should not get a feeding tube and should start
> treatment with radiation and chemotherapy."

I know you didn't ask, but I would skip the chemo and ask for _judicious_
radiation therapy to try and hold the cancer away from his spine to keep
him as mobile as possible for as long as possible ....and see if they can
target it near the esophagus to prevent it from breaking through without
,too much damage to the esophagus (which would prevent him from eating).

However, you haven't told us how advanced his prostate cancer is, whether
it's in any of his bones (spine) which can potentially affect his mobility
(and life) and/or chronic bleeding and/or low blood counts. (which would be
worsened by chemo). Frankly, I think it's a crime that they would suggest
chemo for someone who has so many problems and is so elderly. IMO. And
only one type of prostate cancer responds to chemo anyway. Is he on
hormonal treatments?

It says here (and I don't know if this is a good source) that
http://www.ecr.org/T/ECR01/sciprg/abs/pa0109.htm
"Neoplastic and non-neoplastic tumors of the esophagus
The most common primary malignancy remains squamous cell carcinoma. SCC
appear as fungating polypoid masses, ulcerating masses, areas of stricture,
varicoid tumors or, rarely, as superficial spreading carcinoma. Spindle
cell carcinoma, in most cases a variant of SCC, usually presents as a large
polypoid sessile mass, especially in the mid-esophagus."

If there was damage and he could no longer eat, but still mobile, maybe
feeding tube. If not mobile, palliative care. (hospice)

And bladder cancer can be SCC squamous too.
http://www.cancerbacup.org.uk/Cancertype/Bladder/General/Typesofcancerofthebladder

so I'd be wondering if it's his bladder cancer that has spread and when I
look at the names of the chemos there, no way would I do that to my father
or uncle, at that age. I realize it's a loved one...

> Does anyone have experience with this type of cancer? If so, how long
> do you think that he might have? Six months? A year? More? I'm his
> excutrix and when he passes, it going to be a major job to get
> everything settled and if I can plan at all for that time, it would be
> great.

I'd be guessing without knowing a lot more details. My FIL died of bladder
cancer. The last 6 months or so, he was bleeding quite severely. (perhaps
on/off, it's was 35 years ago and I forget some of the details).
Untreated, he died about two and and a half years after we became aware of
some of his bleeding. His heart and kidneys were good. His liver,
questionable.

So not knowing a whole bunch of details about your uncle, I'll take a stab
and say:

With radiation therapy (if it doesn't affect his esophagus too badly),
possibly 6 - 12 +/- months.
Without radiation therapy > 6 months
With chemo > 4 months.

I could be all washed up on this, so watch for reply from Steph (the
expert).
Keep in touch and let us know how you and he are doing.
J

Reply to this Message

J - 23 Dec 2004 22:44 GMT

Hi Lisa, I truly hope it's more that I posted, however only to prevent a
"disaster" such as losing his mobility and not to the detriment of his
current quality of life.
I forgot this.
Perhaps Steph's "Questions to Ask" would be helpful to his family in making
decisions.
http://groups-beta.google.com/group/alt.support.cancer/msg/1b25021ba108fca1?hl=e
n&lr=&ie=UTF-8

HTH
J

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Steph - 24 Dec 2004 02:42 GMT

> (Sorry this is a cross-post from sci.med.disease.cancer. Not only have
> I been away from groups for a long time, I'm accessing them in a new
[quoted text clipped - 32 lines]
> Thanks for any help.
> ...lisa

It's just a variant of common or garden oesophageal cancer.

However in an 89 year old with lymph nodes involved, I have to wonder what
the expected benefit of radiation plus chemo would be. It is certainly
unpleasant treatment and the likelihood of cure is approximately 0%

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J - 24 Dec 2004 09:04 GMT

> However in an 89 year old with lymph nodes involved, I have to wonder what
> the expected benefit of radiation plus chemo would be.

Neither?

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Steph - 24 Dec 2004 16:39 GMT

>> However in an 89 year old with lymph nodes involved, I have to wonder
>> what
>> the expected benefit of radiation plus chemo would be.
>
> Neither?

Some simple radiation would likely help with swallowing difficulties or
pain.

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lisabucc@hotmail.com - 28 Dec 2004 13:37 GMT

Thanks, guys, it's about what I thought. I'm not sure why the folks at
Mt. Sinai are talking chemo and I didn't have a ggod feel for it to
begin with.

My mom and dad are headed down to NYC (where he lives) to be with him
for a few days while they shuffle the cards and decide what to do.
This guy was (and still is - the mind's not changed, which is probably
what makes this so hard for him) a brilliant man and my dad's a
certified genious. The two of them together have always been scary.
Between them, with my mother's homespun sanity check, they'll cook up a
plan. If they ask my advice, I now have more ammo against the chemo.

Reply to this Message

J - 29 Dec 2004 00:30 GMT

> Thanks, guys, it's about what I thought. I'm not sure why the folks at
> Mt. Sinai are talking chemo and I didn't have a ggod feel for it to
[quoted text clipped - 7 lines]
> Between them, with my mother's homespun sanity check, they'll cook up a
> plan. If they ask my advice, I now have more ammo against the chemo.

My thoughts will be with you and the family, Lisa.
We're here for you whenever you need to talk or vent.
Hugs,
J

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