Q: My father is 65 years old. From the past few months, he was suffering from cough and phlegm and frequently used to vomit whatever he ate. This vomiting has become alarmingly frequent recently. We stopped our visits to the ENT specialist and consulted a gastroenterologist. He took an endoscopy and found that there is a 3 cm long ulcerative growth in the food pipe, and immediately sent the samples for biopsy. The biopsy report states that there is moderately differentiated squamous cell carcinoma. This report came yesterday and the oncologist suggested immediate treatment. He told us that at this stage, it is treatable. It seems, some local radiation and chemotherapy will be used. What things do we need to take care of? My father is a longtime diabetic and has undergone diabetic retinopathy operation a month ago.

A:The optimal treatment for localized squamous cell cancer of the oesophagus is controversial. For stages IIB, III and IVa, the general consensus currently is for trimodal therapy (i.e., three different treatments). This consists of preoperative chemo and radiotherapy followed by surgical resection, if that is possible. For early stage cancer (Stage 1, IIA), surgery is the best option and the benefit of preoperative chemoradiotherapy is less clearcut. You should feel free to discuss all these options with your oncologist and thoracic surgeon.