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,

Dr T



I was very interested to read about your patient Bill who survived 27 years after you operated on his oesophagus you mentioned that you used unconventional theraphy combined with Chemo and radiotheraphy.  I have been diagnosed with Oesophagus cancer and am seeing the oncologist tomorrow to get my PET scan results and I would like to know how your treatment varies than the norm that a oncologist would use.

Hi JG,

It has been a long time since I have talked about my patients! If you followed the links you have read the scientific analysis of my approach to treatment for adenocarcinoma:

If the tumor size is <5 cm, this was the treatment:

  1. Resection, followed by
  2. Chemotherapy w/i 6wks after surgery followed by 
  3. Radiation therapy

All my patients except one had lymph nodes involved with cancer and it didn't prove to be a risk factor. Long-term overall survival 40% (65% @ 10 years for a specific sub group). I have not seen these results duplicated with any other treatment plan since I last reviewed this in 2010.

For larger tumors the prognosis is not so good and I'd recommend preoperative chemo-radiation therapy followed by a resection if possible:

The only way I could convince the oncologists to treat my patients this way, was because I referred them (they were my patients). I had a major problem with the fact the chemo was always different from one patient to the next and therefore meaningful comparisons impossible.

The result: I had many long term survivors (cures) - even with advanced cancers and I strongly believe this was a direct result of this approach.

Hope this helps,

Dr T

Post new comment

The content of this field is kept private and will not be shown publicly.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Allowed HTML tags: <a> <em> <strong> <cite> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Lines and paragraphs break automatically.

More information about formatting options

This question is for testing whether you are a human visitor and to prevent automated spam submissions.
1 + 1 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
By submitting this form, you accept the Mollom privacy policy.