Father's Ailment

 In mid-April, father’s voice was changing, and he was finding it difficult to swallow food. From then on, the following series of tests, events, and decisions unfolded:

1. Endoscopy was ordered and a biopsy was taken. The biopsy came back as adenocarcinoma — cancer in the food pipe (esophagus), close to the GE junction.

2. A PET-CT scan was ordered, and the results showed that the cancer had metastasized to other locations. It had spread through lymph nodes and also to the lungs.

3. Pulmonary tests indicated that lung function was reduced.

4. Further molecular testing showed that the cancer was HER2 positive, making targeted therapy a possible treatment option.

5. After much deliberation, we decided to continue treatment at MVR Cancer Centre, Kozhikode. However, before starting cancer treatment, we were advised to first improve his nutrition by placing a feeding tube (PEG) directly into the stomach.

6. For this procedure, he was admitted at Aster MIMS Kottakkal. Since placing a stent in the food pipe was considered complicated due to the tumor location, we proceeded with PEG tube placement in the stomach. For the procedure, his blood thinner medicines had to be stopped for 9 days.

7. Around the time of PEG placement, the cancer started bleeding. Because of this, we had to admit him to MVR earlier than planned, and radiation therapy was started targeting the bleeding tumor area to control blood loss.

8. Blood thinners were once again stopped for 13 days. After completing 10 sessions of radiation therapy, the bleeding came under control.

9. Initially, the planned chemotherapy regimen was FOLFOX along with Trastuzumab (HER2-targeted antibody therapy). However, before starting treatment, an ECHO test showed that his heart pumping function (LVEF) had reduced to 45%. Because of this, Trastuzumab was considered risky and was not administered initially. Instead of FOLFOX, he received Paclitaxel chemotherapy for the first session.

10. The heart attack in March 2025 and the resulting reduction in heart function became very important factors in deciding his cancer treatment approach.