Mr. Venkatesh is a case of Squamous cell Carcinoma Esophagus. He was initially diagnosed two years back. He had a locally advanced cancer and started on chemotherapy at another hospital. He responded well to the treatment but defaulted after 3 cycles of treatmnet once his symptoms resolved. This happens very frequently in those patients who are not properly counselled about the nature and prognosis of the disease. He began symptomatic again this year and was reevaluated at our centre. The disease had come back but fortunately it was still localised. Chemo was re-started and mid cycle a course correction was done as the response was less than expected. It is important that patient is monitored very closely to pick up the grades of response early and timely action can be initiated. We also did stenting to his esophagus to facilitate smooth swaloowing of eaten food. Presently he is much better and we are planning his response evaluation PET Scan. His PDL1 was postive and he was an ideal candidate for immunotherapy but it was not financially viable option for him, so we tailored the best poosible chemo option for him and it worked.