Esophageal Cancer: A Brutal Diagnosis
It was December 1999 when I first went to the doctor complaining about food getting stuck in my esophagus. She immediately sent me for an upper GI series which came back with a brutal diagnosis: Esophageal Cancer.
A follow-up endoscopy performed by a gastroenterologist confirmed the bad news. I had a Stage III, 5-centimeter esophageal cancer tumor of the GI Junction (where my esophagus and stomach meet).
I immediately went to the internet to learn everything I could about esophageal cancer and was horrified by what I read. According to the statistics, I had about a 10% chance of living 5 years. The shock shattered my dreams of retirement, of enjoying leisure time with my wife and watching my grandchildren grow up.
But I was determined not to give into the fear fueled by those bleak statistics. At age 57, I felt physically strong enough to fight this cancer, but I needed a plan of action.
Had The Esophageal Cancer Spread?
I immediately scheduled a consult with a surgeon at Memorial Sloan Kettering Cancer Center. I trusted that the medical team at MSKCC would know how to fight back against this monstrous disease.
The surgeon was thorough in his examination. A CAT scan revealed that, in addition to the primary esophageal cancer tumor, I had enlarged lymph nodes in both lungs. A biopsy was necessary to determine if these were related to the esophageal cancer.
I went into the hospital for 3 days in mid-January while the surgeon performed the procedure to determine if the cancer had spread to my lungs.
Waiting And Wondering
The time spent waiting to find out my future was unbearable. Should I prepare for my demise by getting my estate in order, or should I be planning to wage the fight of my life?
I was relieved when the biopsy results determined that the esophageal cancer had not spread to my lungs. Now that we understood the scope of the battle, the medical team at MSKCC put together a plan of attack that drew on the specialized skills of an oncologist, a radiologist and a surgeon.
A Personalized Treatment Plan
The first phase of the treatment plan proposed by the MSKCC team called for a simultaneous course of chemotherapy and radiation. Cisplatin and Taxol, both chemotherapy drugs, would be administered 24 hours a day, 5 days a week for 6 weeks, and during the same time frame, I would receive 28 radiation treatments.
In preparation for chemotherapy, they placed a mediport in the upper part of my chest, below my shoulder on my right side. The drugs would be administered through a tube connected to a vein that led directly to my heart.
Radiation treatments also required serious preparation. I needed to be “mapped” so that the radiologist could accurately focus the radiation beams.
As part of this mapping process they marked the area to be radiated by placing 3 tatoos in a straight line on my chest and 2 additional tattoos on my right and left sides.
This gave them the marks they needed to line up each radiation treatment. In order to make sure I was in the same position each time, they also made a cast of my body by asking me to lie on a bag full of molding material for what seemed like an eternity!
In addition to these procedures, I also underwent PET scans, an endoscopic ultra sound (EUS) and multiple blood tests before all of the preparations were complete and I was ready to begin treatment.
But Would It Work?
From my initial diagnosis in early December until all of the preparations were complete in mid-February, I worried about the delay in starting treatment. Was my tumor getting larger by the day? Was the treatment plan aggressive enough? Perhaps I should have had surgery first, then follow-up with chemo and radiation?
Despite my fears, the MSKCC team assured me that the plan they had set was the right approach for me, and that the long preparation period would not have a major affect on the course of action.
I prayed they were right.
Bart Frazzitta is an esophageal cancer survivor and the founder of the Esophageal Cancer Education Foundation (ECEF). Read more of his story here >