Best EC Oncologist & Surgeon


I am a newbie to the site and my husband was diagnosed with stage 3 adenocarcinoma October 2017.  Possibly stage 4 as they found a liver met, but couldn't biopsy it, as it was too far back and the spot is the size of a of a salt grain, but are saying highly suspicious of cancer.  He had 27 radiations and 5 chemos, PET Scan this Thursday.  They say hope the spot in liver hasn’t changed and to hope for the surgery, but I’m not sure.  I had to ask the oncologist to test him for HER2.  Ugh, shouldn’t they have know to do that in EC?  Or do they typically wait until after treatment?  We are in Chicago, looking to get more opinions locally at Rush, UIC, Loyola in Chicago then go to MD Anderson in Houston.  Any help, guidance or suggestions are greatly appreciated!





  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
    Tina~Have given U web links 2 help guide U 2 make best choices

    Hello Tina,

    Since I just answered another person who was asking about a good oncologist and hospital to go to, I will give you the same references I gave her plus many more.  You have to do your own homework most often Tina.  My husband and I knew next to nothing in the beginning.  I didn’t even know how to spell “Esophageal”!  Since then we’ve learned oh so much more.

    You might not know that the USNews Health Report ranks hospitals according to their specialties.  Esophageal Cancer falls in the category of Gastroenterology and GI Surgeries, since it is a gastric cancer.  And as such, MDAnderson in Houston doesn’t rank among the best for treating Esophageal Cancers.  That probably comes as a surprise.  Just because a hospital has “cancer” in the name of their hospital does not mean that they are proficient at treating all types of cancers.  So if I were you, I would check out one of the top hospitals nearest you that ranks highly in Esophagectomies. 

    And a word about Herceptin—YES your husband should have been tested for this over-expressive oncogene as part of his initial workup to stage the cancer.  If he tests positive for HER2, then he should have been given HERCEPTIN as part of his initial treatment plan.

     No it is not customary to wait until after the treatments to test for this. Herceptin is not chemotherapy or a hormone therapy.  It is called a monoclonal antibody which utilizes the natural immune system to kill tumor cells!  HER2 stands for “HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR 2.”  If a person tests positive, then they have an over-expressive oncogene that will cause the person’s cancer to spread more rapidly.  That’s why it is so important to be tested.  Initially, it was thought that only breast cancer patients had this gene, then later it was found that gastric cancer patients (both stomach & esophageal) also possessed this same overactive gene.  The FDA approved the use of Herceptin for gastric cancer patients in 2010!  Seemingly there are some doctors that do not know this.

    So it certainly seems you need another opinion.  I know that as a rule insurance companies pay for a SECOND opinion, but not knowing how many your company allows you to go to for consultation, I would be certain of where I wanted to go to initially if possible. 

     Just so you’re familiar with the facts about HERCEPTIN, I will list those references below my name as well.  I just sent them to another young woman whose oncologist did NOT know that Herceptin was approved by the FDA 7 years ago!  What a shame? 

     I surely hope that the spot on the Liver turns out to be benign.   If the Esophageal Cancer has spread to the Liver for sure, then it would become a Stage IV disease, and typically no surgery would be possible, even though palliative treatments would still be given.  However, there is a procedure called “Radioembolization” that can treat cancers in the Liver, but I don’t know if that’s a possibility in your case, because first of all, you’re not certain of the exact stage it would appear.

     I’m no medical person, just the wife of a Stage III Esophageal Cancer Survivor.  He had his Ivor Lewis Minimally Invasive Esophagectomy at the University of Pittsburgh Medical Center.  (UPMC) Dr. James D. Luketich pioneered the totally laparoscopic esophagectomy in the mid-90's.  It is the surgery of choice there and carries with it the best record for a quicker recovery, etc.  So while you’re checking, you might consider Pittsburgh.

     Incidentally, there is a Houston Methodist in Houston, TX that ranks #12 in Esophageal Cancer treatments, unlike MDAnderson in Houston, who does not enjoy a top ranking for Esophagectomies.  Hope this isn’t confusing.  One hospital simply can’t be all things to all people.  So if you check out the rankings as given by the USNews Report, it will help you make the wisest decision, I do believe. 

     There are places where you can check up on doctors for their credentials and their training.  Another way to find out how much they really know is to see how many peer reviewed articles have been published by major medical journals.  Dr. Luketich has written all or parts of literally hundreds of articles.  So you can check on their “publications” list on places like

    Here are other websites where I can compare and contrast physician’s qualifications for their treatment of different types of cancers.  They are:,,

    There should also be a biographical page listed in the hospital where they are currently employed.  And then there is the USNews Health Report which gives a rating on doctors.  So there are multiple places that you can conduct research.  Tina, I’ve given you everything but the “kitchen sink.”  Hope you’re a fast reader.  You will know a lot more when you take a look at all these references.  Granted it isn’t a quick read, but you will be better equipped to make wise decisions once you’re more familiar with an Esophageal cancer diagnosis. 

     No one has to tell you how it is a heartbreak to hear these words, “Your husband has cancer.”  But where do we go from there, makes all the difference.  Best wishes in finding a good oncologist and a highly-ranked hospital for treating Esophageal Cancer patients.

     Loretta (Wife of William Marshall, DX 11-02, Pre-op chemo/radiation, Minimally Invasive Esophagectomy @ UPMC May 17, 2003, by Dr. James D. Luketich @ the University of Pittsburgh Medical Center.) UPMC ranks #6 by USNews Health report.

     P.S.  All the references below are filled with good information.  Newbies need help.  Thank God, my husband is still cancer free.  So find one of the best hospitals that has Esophagectomies as their specialty. (Preferably a totally laparoscopic MIE)   They will have their own team of doctors that will check out the patient in every respect, that will include a great thoracic surgeon and oncologist together with all other doctors needed to make up a team that can treat the whole person. 








    “Rankings & Advice

    Life's Decisions Made Here…”



    “U.S. News Hospitals Rankings and Ratings

     The U.S. News Best Hospitals analysis reviews hospitals' performance in clinical specialties, procedures and conditions. Scores are based on several factors, including survival, patient safety, nurse staffing and more. Hospitals are ranked nationally in specialties from cancer to urology and rated in common procedures and conditions, such as heart bypass surgery, hip and knee replacement and COPD. Hospitals are also ranked regionally within states and major metro areas. The Honor Roll recognizes 20 hospitals with outstanding performance across multiple areas of care…”



    “2017-18 Best Hospitals Honor Roll and Overview

    U.S. News ranks the top 20 hospitals in the nation, plus the best hospitals in each state and metro area. - By Avery Comarow and Ben Harder |Aug. 8, 2017, at 12:01 a.m.

     Somewhere in America, at a pace of about once per second, a patient checks into a hospital. With more than 33 million hospitalizations a year and so many patients on whom to sharpen their skills, hospitals could be expected to meet the most demanding standards for quality and safety.

    Yet too many hospitals fail even those whose medical needs are relatively straightforward – such as hip replacement, uncomplicated heart bypass surgery or removal of a cancerous section of colon. The hospital that makes treating patients like these its bread and butter is the very definition of a community hospital, and it should perform at a high standard.

    Even fewer hospitals excel at caring for patients with especially challenging or complex diagnoses, for whom the stakes may be a matter of life or death. For those patients, venturing beyond a trusted community hospital to seek care at a truly exceptional medical center, even one farther from home, may be the wisest option.

    To help readers narrow their search for hospitals that best match their needs, U.S. News ranks hospital performance in 16 areas of complex specialty care and also rates hospitals in nine bellwether procedures and conditions such as heart bypass, hip and knee replacement, heart failure and lung cancer surgery.

     [See: FAQ: How and Why We Rank and Rate Hospitals.]

    The Best Hospitals Honor Roll takes both the specialty rankings and the procedure and condition ratings into account. Hospitals received points if they were nationally ranked in one of the 16 specialties – the more specialties and the higher their rank, the more points they got – and also if they were rated "high performing"in the nine procedures and conditions. The top 20 point-getters made up the Honor Roll, which has a maximum total of 480 points.

     [See: The Honor Roll of Best Hospitals 2017-18.]

    U.S. News 2017-18 Best Hospitals Honor Roll…”



    “Best Hospitals for Gastroenterology & GI Surgery

    You can find information here about 1,566 hospitals in Gastroenterology & GI Surgery that see many challenging patients; listed hospitals had to treat at least 438 such Medicare inpatients in 2013, 2014 and 2015. The 50 top-scoring hospitals are ranked. The rest are listed alphabetically.

    How We Rank Hospitals…”






    By Melissa Turtinen - April 4, 2017 12:17 pm

    The Mayo Clinic in Rochester did a study (published in a medical journal Tuesday) and found as many as 88 percent of patients who came to the clinic for a second opinion for a complex condition left with a new or more refined diagnosis, a news release says.

    The Mayo Clinic says a different or more detailed diagnosis can change someone’s care plan “and potentially their lives.”

    The study looked at 286 patients who were referred from primary care providers to Mayo Clinic’s General Internal Medicine Division in Rochester between Jan. 1, 2009, and Dec. 31, 2010. Here’s how the types of diagnostic errors breaks down:

           Only 12 percent of patients left the Mayo Clinic with the same diagnosis.

           In 21 percent of cases, the diagnosis was changed completely.

           In 66 percent of patients, their diagnosis was refined or redefined.

    “Effective and efficient treatment depends on the right diagnosis,” Dr.  James Naessens said in the release. “Knowing that more than 1 out of every 5 referral patients may be completely [and] incorrectly diagnosed is troubling – not only because of the safety risks for these patients prior to correct diagnosis, but also because of the patients we assume are not being referred at all.”

    A lot of people don’t consider getting a second opinion because they either don’t know that’s something you can do, or because it can be expensive for people to see another doctor who may not be in their health insurance’s network, the Mayo Clinic says.

    “Total diagnostic costs for cases resulting in a different final diagnosis were significantly higher than those for confirmed or refined diagnoses, but the alternative could be deadly,” Naessens said.


    It may seem a little awkward to ask your doctor for a referral to get a second opinion, but don’t worry – asking for a second opinion is pretty normal, U.S. News and World Report says, noting any doctor who is good at what they do will welcome a second opinion.

    Here are some tips about seeking a second opinion:

    – Don’t worry about asking for a second opinion for the minor things. Instead, seek a second opinion for serious or chronic issues, especially if you’re unsure about your doctor’s diagnosis or if the treatment for the issue is experimental or risky, U.S. News and World Report notes. But it’s important not to wait too long to get a second opinion, because you don’t want to delay treatment for too long, the Patient Advocate Foundation says.

    – When asking for the second opinion, tell your doctor you just want to be fully informed about your diagnosis, prognosis and treatment, Compass Healthcare Solutions suggests. You can ask your doctor for a referral to see a specific doctor you have in mind, but WebMD says don’t see a doctor that is affiliated with your initial doctor – they probably won’t contradict them.

    – Before you go see the new doctor, make sure you get a copy of your medical records and test results, the Patient Advocate Foundation says. Sometimes tests can be wrong, though so WebMD says you can ask for a second medical opinion and for the lab or pathologist to do the tests again.

    – When you go in for your second opinion, remember you’re looking to confirm your current diagnosis – the second opinion isn’t always right, U.S. News and World Report says. Doctors may differ on your diagnosis or a treatment plan, and ultimately it’s your choice to decide what’s best for you, the Patient Advocate Foundation says.

    For more information on when and how to get a second opinion, click here."


    [My note:  This is a 3:55 video to tell how Herceptin works.  Remember that it was first thought that only BC patients had this over-expressive oncogene, but more recently it was found to also be found in Gastric cancer patients as well, and thus it HAS BEEN APPROVED FOR ESOPHAGEAL CANCER PATIENTS!


    [My note:  As stated often before, it was first thought that this over-expressive oncogene was only found in BC patients, then it was later discovered that EC patients and stomach cancer patients had the very same oncogene prevalent in practically 22% of their diagnoses.  See the Mayo Clinic article to know more about how a monoclonal antibody works.]

      “The Herceptin drug works by attaching itself to the HER2 receptors on the surface of breast cancer cells and blocking them from receiving growth signals. By blocking the signals, Herceptin can slow or stop the growth of the breast cancer. The Herceptin drug is an example of an immune targeted therapy produced by scientist working in the biotech laboratories.  In addition to blocking HER2 receptors, Herceptin can also help fight breast cancer by alerting the immune system to destroy cancer cells onto which it is attached. Blog



    “Media Release - Basel, 21 October 2010

    FDA approves Herceptin for HER2-positive metastatic stomach cancer

    First targeted medicine shown to improve overall survival in HER2-positive stomach and gastroesophageal junction cancers

    Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced the U.S. Food and Drug Administration (FDA) has approved Herceptin (trastuzumab) in combination with chemotherapy (cisplatin plus either capecitabine or 5-fluorouracil [5-FU]) for HER2-positive metastatic cancer of the stomach or gastroesophageal junction, in men and women who have not received prior medicines for their metastatic disease.

    People diagnosed with metastatic stomach cancer should have the HER2 status of their tumors determined, as only patients with HER2-positive disease are eligible for treatment with Herceptin plus chemotherapy.

    “Since Herceptin’s approval in HER2-positive, advanced breast cancer more than a decade ago, we have continued to study how the HER2 pathway contributes to the growth and spread of other cancers, such as stomach cancer,” said Hal Barron, M.D., Head of Global Development and Chief Medical Officer at Roche. “Today’s approval of Herceptin in combination with chemotherapy provides an important new, personalized medicine for people with this life-threatening disease, who have few treatment options.”

    The European Commission approved Herceptin in combination with chemotherapy for use in patients with metastatic stomach (gastric) cancer exhibiting high levels of HER2, in January 2010.

    About the ToGA study - The FDA approval is based on positive results from an international Phase III study, known as ToGA, which showed that people who received Herceptin plus chemotherapy lived longer compared to those who received chemotherapy alone…

    About Herceptin - Herceptin is a humanized antibody, designed to target and block the function of HER2, a protein produced by a specific gene with cancer-causing potential...”



    “This page lists cancer drugs approved by the Food and Drug Administration (FDA) for esophageal cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries. There may be drugs used in esophageal cancer that are not listed here.

    On This Page

    Drugs Approved for Esophageal Cancer

    Drug Combinations Used in Esophageal Cancer

    Related Resources



    National Cancer Institute --  Esophageal Cancer—Patient Version



    Monoclonal antibody drugs for cancer: How they work

    If you're considering monoclonal antibody therapy as part of your cancer treatment, learn about these drugs and carefully weigh the benefits against the potential side effects.

    By Mayo Clinic Staff

    Monoclonal antibody drugs are cancer treatments that enlist natural immune system functions to fight cancer. These drugs may be used in combination with other cancer treatments.

    If you and your doctor are considering using a monoclonal antibody drug as part of your cancer treatment, find out what to expect from this therapy. Together you and your doctor can decide whether a monoclonal antibody treatment may be right for you.

    How does the immune system fight cancer?

    The immune system is composed of a complex team of players that detect and destroy disease-causing agents, such as bacteria and viruses. Similarly, this system may eliminate damaged or abnormal cells, such as cancer cells.

    One factor in the immune system is the work of antibodies. An antibody attaches itself to a specific molecule (antigen) on the surface of a problematic cell. When an antibody binds to the antigen, it serves as a flag to attract disease-fighting molecules or as a trigger that promotes cell destruction by other immune system processes.

    Cancer cells may outpace the immune system, avoid detection, or block immune system activity.


    Monoclonal antibodies are laboratory-produced molecules engineered to serve as substitute antibodies that can restore, enhance or mimic the immune system's attack on cancer cells. They are designed to bind to antigens that are generally more numerous on the surface of cancer cells than healthy cells.

    How do monoclonal antibody drugs work?

    Monoclonal antibodies are designed to function in different ways. A particular drug may actually function by more than one means. The role of the drug in helping the immune system may include the following:

    • Flagging cancer cells. Some immune system cells depend on antibodies to locate the target of an attack. Cancer cells that are coated in monoclonal antibodies may be more easily detected and targeted for destruction.
    • Triggering cell-membrane destruction. Some monoclonal antibodies can trigger an immune system response that can destroy the outer wall (membrane) of a cancer cell.
    • Blocking cell growth. Some monoclonal antibodies block the connection between a cancer cell and proteins that promote cell growth — an activity that is necessary for tumor growth and survival.
    • Preventing blood vessel growth. In order for a cancerous tumor to grow and survive, it needs a blood supply. Some monoclonal antibody drugs block protein-cell interactions necessary for the development of new blood vessels.
    • Blocking immune system inhibitors. Certain proteins that bind to immune system cells are regulators that prevent over activity of the system. Monoclonal antibodies that bind to these immune system cells give the cancer-fighting cells an opportunity to work with less inhibition.
    • Directly attacking cancer cells. Certain monoclonal antibodies may attack the cell more directly, even though they were designed for another purpose. When some of these antibodies attach to a cell, a series of events inside the cell may cause it to self-destruct.
    • Delivering radiation treatment. Because of a monoclonal antibody's ability to connect with a cancer cell, the antibody can be engineered as a delivery vehicle for other treatments. When a monoclonal antibody is attached to a small radioactive particle, it transports the radiation treatment directly to cancer cells and may minimize the effect of radiation on healthy cells. This variation of standard radiation therapy for cancer is called radioimmunotherapy.
    • Delivering chemotherapy. Similarly, some monoclonal antibodies are attached to a chemotherapeutic drug in order to deliver the treatment directly to the cancer cells while avoiding healthy cells.
    • Binding cancer and immune cells. Some drugs combine two monoclonal antibodies, one that attaches to a cancer cell and one that attaches to a specific immune system cell. This connection may promote immune system attacks on the cancer cells…”



    “This page lists cancer drugs approved by the Food and Drug Administration (FDA) for stomach (gastric) cancer. The list includes generic and brand names. This page also lists common drug combinations used in stomach (gastric) cancer. The individual drugs in the combinations are FDA-approved. However, the drug combinations themselves usually are not approved, although they are widely used.

    The drug names link to NCI's Cancer Drug Information summaries. There may be drugs used in stomach (gastric) cancer that are not listed here.

    On This Page

    Drugs Approved for Stomach (Gastric) Cancer



    [A 4 min. video explaining how HER2+ patients have an oncogene that can grow uncontrollably.]

    “Genentech VP of Clinical Oncology Dietmar Berger discusses the role of the HER2 receptor in metastatic breast cancer.”

    “The HER Pathway and Cancer”



    [My note:  This is a 5-minute video explaining how Herceptin works.]

    “This presentation outlines the research and development that led to Herceptin, the first effective monoclonal antibody treatment for cancer. A power-point version of this presentation can be downloaded from our website: http://www.understandinganimalresearc...



    This is a 2 min. video that further states what Herceptin does.



    [A 12:43 minute video on how Herceptin came to be] by Susan Desmond-Hellmann (UCSF): Herceptin and Drug Development]


    iBiology Science Stories

    Published on Jun 18, 2011

  Desmond-Hellmann discusses the drug development process and shares her experience with the targeted cancer therapeutic, Herceptin.

     ________________________End of references_____________


  • Deathorglory
    Deathorglory Member Posts: 364 Member
    Hello Tina

    Hello Tina,

    I saw your post on another thread with some questions.  I'll answer you here b/c it'll be easier for you to just have to manage one thread.  I live in the Philadelphai suburbs, so I have several great cancer centers available to me.  I go to Thomas Jefferson in Philly.  Herceptin can be administered alongside other treatment and there's no need to wait to complete treatment to test for it.  My oncologist actually explained to me how herceptin can increase the effectiveness of my chemo.  You didn't mention the results of your husband's test, though.  If he's not HER2+, then there's no point in it.

    I sure hope what is on his liver isn't cancer.  That would probably rule out surgery (which you want to be eligible for, no matter how unpleasant it sounds/is).  They don't generally operate when the cancer is "on the loose".  

    As Loretta mentioned, getting a second opinion is important.  I always stress to folks that the single most important thing they can do is go to a quality cancer center.  Half of all doctors and hospitals are below average.  You want to be cared for by the better ones.  EC is not a sprained ankle where you can get equal quality care at the hospital down the street as you can get at the Mayo Clinic.  Frequently, you only get one chance to get this right and it is actually life and death stuff.  Sounds like you guys are doing the right things to get your husband the best care and to give him the best chance at success.

    Best wishes to you,


  • Bridgit Sims
    Bridgit Sims Member Posts: 3
    Best surgeon for cancer of the esophagus?

    Christmas Day! My husband had chemo and radiation here in Seattle for cancer of the esophagus, stage 1, with no further evidence after Petscan and CT. I am looking for the best surgeon we can find. Looking at John Hopkins, Mayo What else.

    Could do with some help. Mu email is [email protected].


  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member

    Best surgeon for cancer of the esophagus?

    Christmas Day! My husband had chemo and radiation here in Seattle for cancer of the esophagus, stage 1, with no further evidence after Petscan and CT. I am looking for the best surgeon we can find. Looking at John Hopkins, Mayo What else.

    Could do with some help. Mu email is [email protected].


    Bridgit~Glad U R willing 2 travel 2 find best 4 your husband :)

    Dear Bridgit

    The best I can do for you is to give you the link for the best hospitals for gastroenterology and GI series.  Looks like the hospitals you mention are on our “side of the world”.  Hopkins and the Mayo Clinic in Rochester are both a long way away, but Esophageal Cancer patients should go the distance to find the best.  Since you’re willing to travel, check out the top listings in the USNews list for best hospitals for treating Esophageal Cancer.  There will always be a team at that medical facility that includes all the specialists, testings and treatments that one needs to obtain a proper EC diagnosis. 


    Not that there is anything “good” about an EC diagnosis, but it’s just always better for the patient when it is “detected” at an “early” stage. The Ivor Lewis Minimally Invasive Esophagectomy (MIE) is the way to go.  If I were you, I would only choose one of the leading hospitals that has surgeons on board trained in the totally laparoscopic procedure.  And even then, I would want to know how many he performs on a yearly basis, and where he received his/her training.  I’ve found that in many hospitals, there will be some surgeons who specialize in one type of Esophagectomy so I would always request an appointment with a thoracic surgeon whose specialty is the MIE.  That’s my best advice. 


    In checking the map and comparing it with the best hospitals for Esophagectomies according to the USNews health report, you’re a long distance from the ones listed near the top.  I would say, however, that I know of a Dr. Ninh Nguyen in UCIrvine in California that is an excellent MIE thoracic surgeon.  He was in training with Dr. James D. Luketich in the mid-90s when Dr. Luketich first pioneered the Ivor Lewis Minimally Invasive Esophagectomy at the University of Pittsburgh Medical Center.  UPMC is where my husband received his MIE surgery by Dr. Luketich on May 17, 2003.  They rank 6th according to the USNews report.  My husband was first diagnosed with Adenocarcinoma @ the GE junction in November of 2002.  He then had pre-op treatments of chemo and radiation and then the successful surgery.  We couldn’t be more thankful for 15 years of still being free from cancer of the Esophagus. 

    It goes without saying that all of us here wish you every success in finding the very best surgeon for your husband. 




    You can read all about Dr. Ninh Nguyen here.



    This is a 1 hour and 26 minute video showing excerpts from the Ivor Lewis MINIMALLY INVASIVE ESOPHAGECTOMY as performed by Dr. Nguyen.

    ___________________End of references_________________

  • griffinmike
    griffinmike Member Posts: 5
    edited December 2017 #6

    If you want competent healthcare go to MD Anderson (multiple locations), I went to CCWNC in Asheville  to be treated for esophageal cancer (EC).  I was given radiation and a high dosage of 5FU and cisplatin chemo drugs. The 5FU is a lethal toxic drug. A test has been developed to determine if your system can tolerate the 5FU. I was not given this test because the oncologist said he doesn’t believe in it. As a result of the oncologists personal opinion I ended up being hospitalized for 3 weeks and then 2 weeks of inpatient therapy. While hospitalized   Fluid was taken from my lungs and tested and I was told I had 6 months to live, I was told a couple of weeks later that what I was told was not true. I had another doctor review the records and was told I was nearly dead while I was hospitalized. I was left disabled by the medical staffs incompetence. After getting out of rehab I contacted MD Anderson in Houston and was treated there. During three week long trips I was given a minor surgical procedure and was told I was disease free. MD Anderson is rated as the number 1 cancer hospital in the nation. MDA has a lot of different treatments and many doctors meet weekly to review the cases and determine the treatment needed.