Dear Walt:

Although you are “short on statistics” we are glad to know that you have successfully completed chemo and radiation treatments and that surgery has been scheduled for Monday, April 24, 2017.

We are a cancer “family” here and when we ask lots of questions, it is not because we are “nosey”, it’s because we care and want you to have the very best.

It is always best to have a SECOND opinion because an Esophagectomy is a “life-changing” event in many ways, yet there is “life after the Esophagectomy”, but the path to that point is difficult for many.  We’re glad that you have written here because there are survivors here and each have a different experience, but the one good thing is that they are all survivors. 

So if you don’t mind, would you mind sharing the name of your oncologist and your thoracic surgeon, and where you are being treated?  Not all hospitals are the same when it comes to this type of surgery and not all surgeons are thoroughly trained to perform the very latest surgeries.  Some surgeons are only able to perform the Ivor Lewis Esophagectomy because that is the procedure they were initially trained to perform. 

Older surgeons, while they are very adept, at the operation they perform, have often not upgraded their skills to perform the latest techniques.  I would hope that you have had a 2^nd opinion, and that you are at a major medical facility, which specializes in Gastrointestinal surgery.  And believe it or not, all hospitals are not the same.  Some are more up-to-date with the latest equipment and are using totally laparoscopic surgeries to perform what were once major surgical procedures involving sometimes massive incisions.  Esophagectomies are one example.  So I’m hoping that you are aware that there are different types of surgeries to remove the diseased Esophagus.

My husband, at age 65, was diagnosed with “Adenocarcinoma at the Gastroesophageal (GE) junction in November of 2002.  His official diagnosis was Esophageal Cancer, Stage III, (T3N1M0).  This is an advanced stage.  His only symptom was one hiccup each time he began to eat anything.  He didn’t experience drastic weight loss as do so many people that are subsequently diagnosed as having Esophageal Cancer. 

He had pre-op chemo of 5FU and Carboplatin via “fanny pack” infusion and 25 radiation treatments.  While the results indicated total eradication of the cancer in the Esophagus and in the local lymph nodes, still surgery would be necessary for this reason.  Sometimes scans do not detect all the cancer that is actually present.  And only when surgery is performed will the exact condition of the patient become known.  Sometimes there is cancer that was not picked up on the scan.  And it’s extremely important that no trace of cancer remain.  And should there be any cancer in the lymph nodes that are removed during surgery and tested by a pathologist, a post-op chemo regimen is necessary. 

• Now the wonderful ending to our story is this.  While he had his chemo/radiation here at home, we traveled to the University of Pittsburgh Medical Center for his totally laparoscopic surgery to remove the diseased Esophagus.  There were no massive incisions.  He is a “poster child” for this type of surgery known as the MIE for short. He was in and out of the hospital in 5 days and shopping with me in downtown Pittsburgh on Day 8. 

• Those who have the MIE recuperate in a shorter amount of time.  It stands for the laparoscopic procedure officially called the “Ivor Lewis Minimally Invasive Esophagectomy.”  His surgery was performed by Dr. James D. Luketich, a world renowned gifted thoracic surgeon who pioneered this totally laparoscopic procedure in the mid l990s.  Today, it is the surgery most often performed at UPMC.  Thousands of esophagectomies have been performed there. 

• Here is just a 30-second video to let you know who Dr. James D. Luketich is.  https://www.youtube.com/watch?v=mFboj87THJE

So I would just want you to know that patients should be made aware of the different types of surgical procedures available today to remove a cancerous Esophagus.  Now sometimes people have never heard of it, while many surgeons have not upgraded their skills to perform it.  However, you are the patient who has go through the recovery, and that makes all the difference in the world. 

You will be pleased to know that my husband, William, is now into his 14^th year of being cancer free.  We have been truly blessed.  Our mission now is to let others who are dealing with this same kind of cancer, that if surgery is possible, that the “Minimally Invasive Esophagectomy” is the least invasive procedure.  If you would like to share any more info, or ask any more questions, we will try to be of help.  Meanwhile, we wish you all the best.

1. http://www.webmd.com/women/tc/getting-a-second-opinion-topic-overview#1

“…How do you get a second opinion?

Ask your doctor for the name of another expert, someone with whom he or she is not closely connected. Explain that this is how you like to make big medical decisions. Don't worry about offending your doctor. Second opinions are expected…”

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2.http://www.upmc.com/Services/esophageal-lung-surgery-institute/treatments/esophageal-surgery/Pages/minimally-invasive-esophagectomy.aspx

 “Minimally Invasive Esophagectomy at UPMC

Recently, doctors in the United States are diagnosing more esophageal cancers.

Obesity and long-term irritation from gastroesophageal reflux disease (GERD) seem to be contributors to this increase in new cases.

What Is Minimally Invasive Esophagectomy (MIE)?

MIE is surgery to remove cancer in the esophagus.

Surgeons at the UPMC Esophageal and Lung Surgery Institute mainly use MIE surgery to treat esophageal cancer, along with chemotherapy and radiation.

We perform MIE robotically through small incisions.

Benefits of Minimally Invasive Esophagectomy

The ultimate goal of MIE is to help you get back to a normal lifestyle.

Compared to traditional open esophageal cancer surgery, using minimally invasive techniques — including robot-assisted surgery — greatly:

• Reduces the risk of complications.
• Lessens pain.
• Shortens hospital stays.

Minimally invasive techniques have made the procedure safer and provided patients with improved quality of life.

The expertise of the medical center performing MIE surgery makes a big difference in the patient experience.

UPMC surgeons are among the most experienced in the world, performing nearly 2,000 MIEs…”

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3.  http://www.laparoscopic.md/minimally-invasive-esophagectomy

“…Esophagectomy requires the removal of almost the entire esophagus as well as a portion of the stomach. This operation requires access to both the chest as well as the abdomen. The esophagus and stomach pictured above were removed with a minimally invasive approach using laparoscopy to address the dissection in the stomach and thoracoscopy to perform the dissection in the chest as well as reconstructing the connection, a process known as an anastomosis…”

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4.  http://www.cancer.net/cancer-types/esophageal-cancer/introduction

 5.  http://www.cancer.net/cancer-types/esophageal-cancer

Esophageal Cancer

“This is Cancer.Net’s Guide to Esophageal Cancer. Use the menu below to choose the Overview/Introduction section to get started. Or, you can choose another section to learn more about a specific question you have. Each guide is reviewed by experts on the Cancer.Net Editorial Board, which is composed of medical, surgical, radiation, gynecologic, and pediatric oncologists, oncology nurses, physician assistants, social workers, and patient advocates…”

 6.  http://www.cancer.net/cancer-types/esophageal-cancer/questions-ask-doctor

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