University of Washington Esophageal Center

Dear Bob:

You’ve written on your about me page: “How and when did you learn about your cancer?  Diagnosed August 24, 2017. Was found during a more or less routine endoscopy.

What types of treatment(s) have occurred?

Have had Endoscopic Resection -- but, pathology shows no margin”. 

Bob would you care to elaborate and tell us anything else as to why you are going to be having an Esophagectomy? 

Have you had a thorough workup and have you been given a definite stage of Esophageal Cancer? 

Has that testing included being tested to see if you are one of the Esophageal Cancer patients who has an over-expressive oncogene that causes the cancer cell to multiply more rapidly?  (HER2+)  If so, “Herceptin” should be part of your treatment regimen. 

Where have you been treated? 

Are you familiar with the different types of Esophagectomies? 

Have you had a SECOND opinion?  There are so many questions that come to mind when one doesn’t give us a bit more detail. 

The references I’ve listed below are limited to the two doctors you referenced and their experiences.  You’ve asked about the Swedish Medical Ctr. and the University of Washington.  So for the time being, I will try to confine my remarks to your questions.  Since I know nothing about either thoracic surgeon, I consulted the USNews&Health report to see the rankings of these 2 medical facilities relative to “ranking” in the specialty of Esophageal Cancer.  Many may not know but hospitals are ranked differently, depending on their expertise relative to different types of diseases.

Remember now, we are talking about the best hospitals that treat Gastrointestinal diseases, and that includes Esophageal Cancer.  For instance, many seem to think that while MDAnderson is the #1 hospital for CANCER, they must be tops in everything—not so!    That’s because there are a myriad of cancer diagnoses, and one hospital cannot possibly excel in treating every one of them.  MDA does NOT rank in the top 50 hospitals whose specialty is Gastrointestinal Surgeries!  Actually, according to USNews&Health report, Mayo Clinic in Rochester, MN ranks #1 in the field of Gastrointestinal diseases.

Meanwhile, many may not know that there is another hospital in Houston, TX—Houston Methodist that ranks #12 in performing Gastrointestinal surgeries.  That may surprise many, so it’s important to be very precise when researching a hospital for the cancer that you have.  So you can check out the rankings of all the hospitals who rank high on the list for Esophageal Cancer.  So according to the rankings of USNews&Health report, the Swedish Med. Ctr. does not enjoy a ranking in the field of Gastroenterology, and the University of Washington only commands a #45. 

So Bob, the most I can do for you presently, is to give you the rankings as outlined by USNews&Health.  If I were limited to only these 2 surgeons, I like Dr. Louie as well as I do Doctor Brant Oelschalger, even though Swedish Med. Ctr. doesn’t rank at all, but remember MDAnderson is not ranked among the top 50 medical facilities that have Esophageal Cancer as one of their SPECIALTIES.

So if the choice is between these two only, I would want to know how many esophagectomies they have performed in a year—their mortality rate-their leak rate—and most importantly what type of Esophagectomy they perform.  I would not want to be operated on by a surgeon that doesn’t perform at least 25 or so a year.  The least invasive esophagectomy with the fastest recovery is the totally laparoscopic Ivor Lewis Minimally Invasive Esophagectomy. 

Lastly, I will tell you that my husband, William now age 80, was diagnosed with Adenocarcinoma @ the Gastroesophageal Junction (GE) (EC Stage III - (T3N1M0) at age 65 in November of 2002.  He had pre-op chemotherapy of Carboplatin & 5-FU, plus 25 radiation treatments, and then had his totally laparoscopic esophagectomy (MIE) performed by Dr. James D. Luketich at the University of Pittsburgh Medical Center on May 17, 2003.  My husband and I are still rejoicing over that successful surgery, and he is still cancer free as of this date – November 13, 2017. 

USNews&Health report ranks UPMC #6 out of the top 50 hospitals who have Gastrointestinal Surgeries as one of their specialties.  Dr. James D. Luketich pioneered the Ivor Lewis Minimally Invasive Esophagectomy, commonly called the MIE, in the mid90s and it is their main surgical procedure for those who have been diagnosed with Esophageal Cancer.

When one has been diagnosed with Esophageal Cancer, they want to hear from survivors, and that’s why I remain on this particular link.  You can read more about “us” on my about me page.  Here is wishing you a successful Esophagectomy with no recurrence!  That’s the ultimate dream for all who come to be diagnosed with this cancer.

Loretta Marshall (William’s wife)

P.S.  Hope you find these references useful in making a determination.  __________________________________________________________ 

1.      https://www.swedish.org/services/cancer-institute/cancer-types/esophageal-cancer/treatment-at-different-stages

“Introduction to Esophageal Surgery

In the video below, Thoracic Surgeon, Dr. Brian Louie discusses the procedures described above to treat esophageal cancer.  (7:51 minute video)  I appreciate his frankness as to treatments, and survival according to stage.”

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2.      http://www.swedish.org/services/thoracic-surgery

“Thoracic Surgery

Contact us - Contact us

 Swedish Thoracic Surgery / First Hill

Phone 206-215-6800

See all - Our Doctors - Locations

Thoracic Surgery Services

• ·Airway Program
• ·Center for Pleural Diseases
• ·Esophagectomies
• ·Foregut Oncology Program
• ·Gastroesophageal Reflux Disease (GERD) & Swallowing Center
• ·Hyperhidrosis Sympathectomy
• ·Lung Cancer Program
• ·Lung Cancer Screening Program
• ·Mediastinal Diseases
• ·Minimally Invasive Thoracic Surgery
• ·Pectus Excavatum Repair
• ·Rib Fracture Clinic (Acute Adult)
• ·Robot Assisted Surgery (da Vinci)
• ·Video Assisted Thoracic Surgery (VATS) Lobectomy

About Thoracic Surgery

Swedish Thoracic Surgery at Swedish Cancer Institute was established in 2000 in response to a growing need for advanced thoracic surgical care. It has emerged as the largest program in the Northwest, which offers a comprehensive range of thoracic surgical procedures.  Our focus is on the thorough evaluation and tailored surgical treatment in the areas of airway diagnostics, pleural disease, foregut oncology, GERD and swallowing, lung cancer, minimally invasive thoracic surgery, thoracic oncology, mediastinal diseases and hyperhidrosis…”

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3.      https://www.researchgate.net/profile/Brian_Louie/2?page=2&sorting=recent

[A helpful indication of the thoracic surgeon’s abilities is how many medical articles they have authored or contributed to that have been published by peer review journals.  I see that according to this link, his name is mentioned in 149 publications.  He does perform the Ivor Lewis Minimally Invasive Esophagectomy. 

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4.      https://www.bing.com/search?q=Swedish+Medical+Center+%28+Seattle+%29+by+Doctor+Brian+Louie.&form=EDNTHT&mkt=en-

Here is a page of different web links relative to the practice & experience of Dr. Brian Louie

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5.      https://health.usnews.com/doctors/brian-louie-797750

"Overview

 Dr. Brian Louie is a thoracic and cardiac surgeon in Seattle, Washington and is affiliated with Swedish Medical Center-Cherry Hill. He received his medical degree from University of Toronto Faculty of Medicine and has been in practice for more than 20 years. Dr. Louie accepts several types of health insurance, listed below. He is one of 7 doctors at Swedish Medical Center-Cherry Hill who specialize in Thoracic & Cardiac Surgery.

 Quick Stats

• (206) 215-6800 Phone Number
• 21+ Years in Practice
• M Gender

Hospital Affiliation

Dr. Louie is affiliated with the following hospitals. Affiliation usually means doctors can admit patients to a hospital.

Swedish Medical Center-Cherry Hill - Seattle, WA

 Swedish Medical Center-Cherry Hill in Seattle, WA is not nationally ranked in any specialty. more - 8/10 Survival - 5/5 Patient Safety

 - Fewer SEE ALL TOP RATED HOSPITALS »

 Specialties & Qualifications - Specialty: Thoracic & Cardiac Surgery

 Cardiac and thoracic surgeons specialize in the surgical treatment of diseases of the chest and heart. Thoracic surgeons and cardiac surgeons have the same general training and certified by the same board. Cardiac surgery deals with the heart, and thoracic surgery focuses on the lungs. Cardiac surgeons deal with heart transplant, heart disease, coronary artery disease, heart valve blockages, heart failure. Thoracic surgeons focus on the lungs, esophagus, and other chest organs and they treat lung cancer and emphysema.

 Subspecialties: General Cardiac/Thoracic Surgery, Adult General Thoracic Surgery …”

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6.      https://health.usnews.com/doctors/brant-oelschlager-985892

“Dr. Brant Oelschlager MD - Surgery | Seattle, WA

 Dr. Brant Oelschlager is a surgeon in Seattle, Washington and is affiliated with multiple hospitals in the area, including UW Medicine/Harborview Medical Center and University of Washington Medical Center. He received his medical degree from University of North Carolina at Chapel Hill School of Medicine and has been in practice for more than 20 years. He is one of 38 doctors at UW Medicine/Harborview Medical Center and one of 69 at University of Washington Medical Center who specialize in Surgery.

 Quick Stats

• (206) 598-4477 Phone Number
• 21+ Years in Practice
• M Gender …”

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 7.      https://www.doximity.com/pub/brant-oelschlager-md?show_more=true#other_publications

 [MY NOTE:  One way to determine the qualifications and experience of a thoracic surgeon is by the number of medical articles that he/she has authored or contributed to that have been accepted for publication for peer review medical journals.  Both Dr. Louie and Dr. Brant Oelschlager have written many articles that have been published.  So this speaks well for both of them.  However as noted above, the Swedish Medical Center does not rank at all in the field of Gastrointestinal surgeries- the category under which Esophageal Cancer is rated. 

 However, the University of Washington ranks #45 in a list of 50 top hospitals who specialized in Gastrointestinal Surgeries.  So frankly, this is not impressive, but YOU are the one who has to make the decision. Are these your only two choices?]

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 8.      https://health.usnews.com/best-hospitals/area/wa/university-of-washington-medical-center-6910750

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9.      https://health.usnews.com/best-hospitals/area/wa/university-of-washington-medical-center-6910750/gastroenterology-and-gi-surgery

• “Health Care - Best Hospitals - University of Washington...

University of Washington Medical Center Rankings & Ratings

#45 in Gastroenterology & GI Surgery | Overall Score 64.9/100…

Gastroenterology & GI Surgery Scorecard

A hospital's overall Gastroenterology & GI Surgery score is based on various data categories, including volume of high-risk patients, nurse staffing and patient survival. The 50 top-scoring hospitals are nationally ranked. See the full U.S. News national rankings in Gastroenterology & GI Surgery or hospital ratings in colon cancer surgery.

Ovrall - National Rank #45 - Overall Score 64.9/100…

 Reputation with physicians in specialty - Percentage of gastroenterology and GI surgery specialists in 2015, 2016 and 2017 who named hospital as among best for very challenging patients. - Average ? - Reputation with physicians in specialty

 Average score of 1.6% - Most hospitals are named by a few specialists or not at all…”

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 10.  https://health.usnews.com/best-hospitals/area/wa/university-of-washington-medical-center-6910750/cancer

 [MY NOTE:  Please note that there is a VAST DIFFERENCE in the rankings of hospitals ACCORDING TO THEIR SPECIALTY.

 Note that Univ. of Washington ranks #5 in the treating of cancer, but barely ranks in the top 50 hospitals noted for the treatment of Esophageal Cancer, which falls in the category of Gastrointestinal surgeries.  Univ. of Washington ranks #45 when treating GI cancers!  The USNews&Health report ranks the top 50 hospitals in different specialties. ]

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11.  https://health.usnews.com/best-hospitals/area/wa/university-of-washington-medical-center-6910750

 “See all hospitals nearby

This Hospital's Performance

Adult Specialties Rankings and Ratings

U.S. News evaluates each hospital in up to 16 medical specialties. In most specialties, the top 50 hospitals nationally are numerically ranked. Hospitals that nearly made the top 50 may be recognized as high performing. U.S. News includes Seattle Cancer Care Alliance in evaluating the performance of University of Washington Medical Center.

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12.  https://health.usnews.com/best-hospitals/rankings/gastroenterology-and-gi-surgery

“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 …”

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Hi Bob,

I was facing the operation and did my homework on finding an excellent surgeon in the NW since I live in Bend, OR.  A good surgeon is a person who does a lot of operations a year, with a high success rate of post-operative survival. Dr. Oelschlager has great stats on all sides, is very talented with his hands in the operating room. Getting chewed up in this type of operation is no small thing. One stat to check out, besides survival rates, is the leakage rate of the anastamosis (connection of the stomach to what's left of the esophagus.) I have the name of another Dr. O. patient who had his operation 2 months ago and who lives in Seattle. I've also written up my experience on the whole journey from discovery of EC through the post-op after the operation -- eating, sleeping, etc. Since I can't advertise in this forum, if you are interested in having that information, please write me at <Content removed by CSN Support Team>. And please write me there too if you have further questions about Dr. O or some other aspect of the operation. In the final analysis, the choice is yours and you must feel confident and comfortable with your choice.  (My operation was on March 14 at the Seattle hospital under Dr. O. who I highly recommend. I'm doing great on all fronts at this time.)

Dave

Hello,

I had Dr. O for my esophectomy. He was absolutely awesome.  If you have specific questions please ask.