Looking for Surgeon

Dear David

          It’s never good news to know that yet another person has been diagnosed with Esophageal Cancer and I wish you didn’t have to be writing here.  However,   I’m delighted to be able to share a story of success from one of Dr. James D. Luketich’s patients.  The credentials of Dr. James D. Luketich at the University of Pittsburgh Medical Center are impeccable.  He has written hundreds of articles relative to Thoracic surgery that have been accepted and published by top medical journals as noted in my references.   

          At my insistence, my husband went to have an Endoscopy by a local  Gastroenterologist.  We first went to see our regular physician because William was having a small hiccup each time he began to eat.  He had no other symptoms, but after a couple of months, I said, “Something’s wrong with you.”  Our GP said he had no idea what could be the problem, but surmised that it was something of a gastric nature.  So he set up an endoscopy.  Two days later we went for the Endoscopy.  The nurse gave me a pink slip about after care…don’t let him drive for 12 hours…blah… blah… blah.  Okay, we went home.

          The next day my phone rang about 2:30 P.M.  I answered.  The voice on the other end said, “This is Dr. Ryan.  I do wish you had stayed around yesterday.  I needed to talk with you. Your husband has CANCER!”  After I picked my heart up off the floor, I asked how to spell “Esophageal and Squamous.”  Well this started the whirlwind tour that I’m sure you’re familiar with.  In the end the diagnosis was “Adenocarcinoma at the GE Junction” Stage III (T3N1M0).  Believe me, we all relate to the shock and bewilderment of not even having heard of Esophageal Cancer, much less having IT!

          William had pre-op chemo/radiation of Carboplatin & 5-FU (25 sessions of radiation.)  Even though scans showed complete eradication of the tumors, the surgeon had already said, no matter the results of the pre-op treatments, surgery will be necessary.  Now I know the wisdom of that because some cancers go undetected even by scans until the surgeons are actually operating.  Also Dr. Luketich removed 23 lymph nodes that were tested by a pathologist.  All the nodes were found to contain no residual cancer, so no post-op chemo was recommended.

           Actually, we were only 10 days away from having the most invasive type of Esophagectomy, the Ivor Lewis Esophagectomy, first performed in the mid 1940s by Dr. Ivor Lewis.  In 2003, no one here in the Tidewater Virginia area knew how to perform the MIE.  Then we learned about Dr. James D. Luketich at UPMC.

          Dr. Luketich pioneered the Ivor Lewis Minimally Invasive Esophagectomy in the early 1990’s.  We traveled to Pittsburgh for the surgery in May of 2003.  My husband was in and out of the hospital in 5 days and downtown shopping with me on Day 8.  That’s the long and short of it.  Now don’t get me wrong, just want to let you know that it’s entirely possible that one can have the MIE without serious side effects.  We were so blessed.  That’s not to say that there isn’t a great deal of adjustment to a new way of eating and sleeping.  But none who are survivors are complaining about being ALIVE!

           We would be glad to talk with you via phone directly if you want to ask more questions.  You can send us a message.  I won’t go into the detail of how the post-op procedure goes because your brother is not there yet.  The most important next step is to find the top surgeon that can perform this totally laparoscopic procedure. 

          The UPMC facility has 4 facilities for housing out-of-state patients and family members.  We have stayed at all 4 at one time or another.  The cost is minimal compared to a hotel room.  Furthermore, there is a shuttle bus that runs on a regular schedule and picks up patients from each home, and takes them to the desired destination.  When Bill was operated on we had to be there at Presbyterian Hospital at 5:00 A.M. on the day of surgery.  Security sent a special driver to pick us up and take us to the hospital, free of charge.  Just park your car once you arrive and “leave the driving to UPMC.”  They will take you everywhere you need to go for medical treatment and/or consultations.  And when you’re able, you and your brother can catch one of the busses that goes to town if you want to “get out of the house!” 

          We had all our follow-up consultations at Hillman Cancer Center which was only two blocks from Family House Shadyside, a great place to stay.  If you choose to go there, reservations should be made as soon as possible.  Simply tell them when you plan to arrive.  They will call you and let you know which homes have vacancies on your particular arrival date.  That will always vary depending on patient checkouts.   I say all that to say this, my husband is now into his 14^th year of surviving Esophageal Cancer – Adenocarcinoma at the GastroEsophageal junction.  (EC Stage III T3N1M0). 

          A word of advice here.  If your brother is finishing up his chemo, he will want to make a good decision but soon.  You see chemo has an approximate 3-week window of residual effect.   Surgeons like to schedule surgery as soon as possible after that 3-week period before scar tissue buildup begins.  So you don’t want to “wait”.

         Might I suggest also that if Pittsburgh is too far away, why not call Dr. Luketich’s office and ask what surgeons in the NYC area have trained under him to perform the MIE? They will gladly recommend those that they think are competent. Although I must tell you that knowing what we know, distance would NOT be the pre-requisite if travel is not prohibitive.  This is major, MAJOR surgery! You want to go to a hospital where Esophageal Cancer is one of their top specialties.  All surgeons and all EC surgeries are NOT the same.  The more surgeries they have performed, the more experienced they are quite naturally.

          Dr. Luketich required no “special referral” from another physician.  We simply called on the phone.  We were told to gather all our records and bring them with us, and if my husband were a good candidate for the MIE, they would gladly perform the surgery.  Unless your brother can find the “equal” of Dr. James D. Luketich in NYC, I would be packing my bags and heading for Pittsburgh.  We simply love Dr. Luketich.  He is a gifted and world renowned Thoracic Surgeon.  Now that we know the different types of surgeries and the possible repercussions of each, we are absolutely sold on Dr. Luketich and the Ivor Lewis Minimally Invasive Esophagectomy.   Both of us would place our lives in his hands without a second thought!

          Below my name will be some references submitted for your consideration of UPMC.  Consider excellence of the surgeon first, and the distance to see him secondly is my best advice.  My husband’s surgery consisted of small “Band-Aid” size cuts—NO massive incisions!

          In any event, we wish for you the very best for the days that follow.  Believe me, your brother is blessed to be a surgical candidate. There are success stories and I thank God my husband is one of them so far.

Sincerely,

Loretta, wife of William, (EC “T3N1M0”) now into his 14^th year of survival without complications—MIE @ UPMC May 17, 2003, by Dr. James D. Luketich.  

1. http://www.upmc.com/Video/Pages/default.aspx?vcat=937;#3753ef4c-73b8-4be7-b0c7-9c5fd91b952c|Lung+and+Thoracic+Surgery

Short Video by Dr. James D. Luketich explaining many advantages of minimally invasive surgery and quicker return to normalcy of one’s lifestyle.  My husband is one of the first 1000 patients he speaks of in this video.  UPMC exhibits a high standard of excellence.  

“Esophageal Cancer: Surgical Innovations

​James D. Luketich, MD, highlights advances in esophageal cancer treatment through innovative surgery. The UPMC Esophageal and Lung Surgery Institute is a leader in developing novel surgical approaches to minimize recovery time and scarring while maximizing results and quality of life for patients after surgery. “

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2.  Hillman Cancer Center
5115 Centre Ave., Pittsburgh, PA 15232--Phone: (412) 692-4724

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3.     http://health.usnews.com/doctors/james-luketich-272568

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4.  http://www.mirm.pitt.edu/our-people/faculty-staff-bios/james-d-luketich-md/

(Note: Red highlights are mine for emphasis.)

“James D. Luketich, MD

          Dr. James Luketich is the Henry T. Bahnson Professor of Cardiothoracic Surgery, the Chairman, Department of Cardiothoracic Surgery, the Chief, Division of Thoracic and Foregut Surgery, the Director, Thoracic Surgical Oncology, the Co-Director, Lung Cancer Center, the Associate Director of Surgical Affairs, University of Pittsburgh Cancer Institute, and the Director, Mark Ravitch/Leon C. Hirsh Center for Minimally Invasive Surgery.

          Dr. Luketich received his MD from the Medical College of Pennsylvania in 1986 and completed his general surgery residency in 1992 at the Hospital at the University of Pennsylvania, where he was the Chief Resident of Surgery from 1992-1993. He completed his cardiothoracic and thoracic training at New York Hospital, Cornell Medical Center, and Memorial Sloan-Kettering Cancer Center. Prior to joining UPMC in 1995, Dr. Luketich was a Senior Instructor in Surgery at Memorial Sloan-Kettering Cancer Center in New York. He has additionally held academic positions at Cornell University Medical College and the University of Pennsylvania.

           Dr. Luketich’s areas of interest include thoracic and esophageal surgery. These include gastroesophageal reflux disease, management of hiatal hernias, management of giant paraesophageal hernias, and other disorders of the esophagus, including diverticulitis, strictures, and many others. He has particular expertise in the multi-disciplinary management (combined chemotherapy/radiation and surgery) of esophageal and gastroesophageal cancer, Barrett’s esophagus, and lung cancer. He performs numerous complex operations on disorders such as these using minimally invasive techniques, for which he has become world renowned, performing over 1,500 minimally invasive esophagectomies.

          In addition, Dr. Luketich has pioneered numerous minimally invasive approaches for the resection of lung cancer. He has personally performed over 1,000 minimally invasive operations for lung cancer and more recently, he and his group have led the field in using ablative therapies for resectable lung cancer which include such technologies as Cyberknife, Radiofrequency ablation, and microwave ablation. Dr. Luketich is the principal investigator or co-investigator on numerous research grants and has published over 275 peer-reviewed manuscripts, 162 invited reviews, textbook chapters, and editorials, and over 400 abstracts. He is frequently invited as an honored speaker around the world to present topics that relate to his research and minimally invasive techniques. Dr. Luketich serves on the editorial boards of the Annals of Surgery, Journal of Thoracic and Cardiovascular Surgery, and the Journal of Gastrointestinal Surgery. Dr. Luketich is a Fellow of the International College of Surgeons, and is a member of many prestigious surgical societies including the American Surgical Association, the American Association for Thoracic Surgery, and the Society of Thoracic Surgeons, among many others. Most recently, Dr. Luketich was named to “Best Doctors in America” (2011-2012), an Honorary Professor, Fudan University Cancer Hospital (2011-2013), “Best Doctors,”Pittsburgh Magazine (2012-2013), the recipient of the Ralph C. Wilde Leadership Award, Allegheny County Medical Society (2012), and the “Faculty of the Year” presented by UPMC Cardiothoracic Surgery Residents (2013). View a list of Dr. Luketich’s publications here.”

5.  http://www.ncbi.nlm.nih.gov/pubmed/?term=Luketich+JD[Author]

Publications by Dr. Luketich ................Items: 1 to 20 of 347…”

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6.  http://www.upmc.com/Video/Pages/default.aspx?vcat=517;#529b680b-addf-4282-965d-77f04bf8daee|Cancer

Short video by my surgeon, Dr. David Bartlett, explaining how patients can be seen by UPMC in an expedited fashion.  He performed Cytoreductive Surgery on me July 1, 2013, for Peritoneal Carcinomatosis/Ovarian Cancer Stage IV.  I was first diagnosed here in my hometown, then was seen by UPMC 3 weeks later for a SECOND opinion.

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Davd - I have tried to send you a private message and this site keeps rejecting it with a SECURITY error.  Can you send me a pvt. message with your regular e-mail on it, and I will speak with you that way.  This has been so aggravating.  It has happened to many since this site was "improved."  We need to talk further, and I am so upset about not being able to write.  I had some web link addresses in it, and many of my posts always have references.  So if you see this note. Please answer me.  You obviously aren't having problems on your end, but I sure AM!

Loretta