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How dangerous is it to have Cancer of the esophagus?
This weekend I learned that in January one of my patients, Bill G, had passed away. When I first saw him in 1983, he was referred to me as a last ditch treatment effort of what was thought to be an incurable disease: Carcinoma of the esophagus. At the time, very few surgeons in Northern New England were involved with this type of surgery; the operation had a high complication rate and even if successful, the survival afterwards was estimated at less than six months to a year. In fact, most physicians were so pessimistic about the survival chances that one of my colleagues recommended to my first patient to buy a gun, take one last walk on the beach at sunset and do himself in! He saw me with that one question, should he?
He, Bill and many others entrusted himself to my care and became long term survivors of a disease that so often indeed has a lethal and painful outcome. Bill was unique in that he and I had a passion for sailing in common, and over the years I made it a point to look him and his wife up when sailing up to Boothbay and Christmas Cove, Maine, where they lived.
Treatment for cancer of the esophagus has not changed very much since I stopped practicing. At the time I was a strong proponent of combining surgery with chemo-radiation therapy, as the disease was invariably advanced when the diagnosis was made. It was a novel concept and oncologists in particular were hard pressed to agree with that approach. Each case became an immediate struggle to convince the other cancer specialists to do their thing. It was further complicated by the fact that, invariably, there was a new chemo therapy flavor of the month and thus little consistency in treatment. Despite that, long term survival and a cure in patients with advanced cancer became a reality in my practice, something I am particularly proud of.
Bill died earlier this year, 27 years after surgery of what is often still believed to be an incurable disease. When I looked his case up for this epitaph, I confirmed his cancer had most of the indicators of incurability: Stage III, with large tumor size and positive lymph nodes as well as a number of other bad outcome predictors. Yet he was cured and able to live a full life since. I am so grateful to have been able to help him with that.
Dear Bill, Rest in Peace,
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