Removing Esophageal Cancer without Cracking the Chest
Minimally Invasive Esophagectomy Spares Patients Pain and Trauma
November 10, 2016
(Washington, D.C.) Edward Eckenhoff recalls putting up with heartburn for many years. He says he would often take a few over-the-counter medications before a meal to ease his symptoms.
All of this caught up to him in February 2016 when, on vacation in Florida he suddenly had trouble swallowing.
“I said, ‘oh boy, I have a problem,’” recalls Eckenhoff. “So I went to a gastroenterologist in Florida who diagnosed me with esophageal cancer. Fifteen to 20 years of acid reflux resulted in a tumor at the base of my esophagus near my stomach.”
Figures from the American Society of Clinical Oncology say the five year survival rate, overall is around eighteen percent; forty percent if the disease is caught early and four percent if the cancer has spread to other parts of the body.
When Eckenhoff got back to Washington, D.C. he consulted with physicians at MedStar Georgetown University Hospital. He received chemotherapy and radiation. Next, the surgery to remove the cancerous portion of his esophagus.
At most centers, surgeons crack open a patient’s chest to gain access to the esophagus.
But MedStar Georgetown’s chief of Thoracic Surgery Blair Marshall, MD has pioneered a minimally invasive procedure to remove esophageal cancer that is easier on patients in several ways.
“Instead of a large incision that breaks the patient’s chest bone, I use tiny incisions and cameras that allow us to remove the esophagus with the cancer and then make a new one,” said Dr. Marshall. “Patients do not go to the Intensive Care Unit (ICU). They have less pain, blood loss and return to eating normally much sooner than with the standard approach. This is a procedure that is rarely performed by surgeons at other institutions. ”
Eckenhoff is a patient with a unique situation. He is paralyzed from the waist down due to an accident and uses crutches to get around. He is the founder of the MedStar National Rehabilitation Hospital which has helped patients to be empowered to overcome disabilities caused by disease or injury for more than 30 years.
“I’m 6’ 2” and a couple of hundred pounds,” says Eckenhoff. “The old way of removing my cancerous esophageal tumor would have destroyed the musculature I need to get around. In my case, the minimally invasive surgery meant I was back on my crutches weeks after hospital discharge and it allowed me to be back on the golf course in 22 days. Now I am back to independence and I’m on the golf course three to four times a week!"
James Pease Blair, a retired National Geographic photographer who has traveled the world covering stories got a similar diagnosis of esophageal cancer in September 2012 when he was in his early 80’s.
“I was having scallops for dinner one night at a restaurant and suddenly, they came right back up. I couldn’t swallow,” recalls Blair. “I don’t remember having recurrent heartburn but I ate a lot of funny food from all around the world because of my work and I know I ate a lot of antacids over the years.”
An upper endoscopy revealed an esophageal tumor measuring approximately four inches in size.
“I looked at it as just another assignment, but one that would take a lot longer than usual. I just had to get out there and get it done,” says the award winning photo journalist who is now retired and living in New England.
Blair had chemotherapy before his surgery, which was a minimally invasive esophagectomy performed by Dr. Marshall.
“At this point in time, we have operated on several patients in their early to mid 80’s with excellent results,” says Dr. Marshall.
“Dr. Marshall showed me beforehand what the surgery using cameras was going to be like, says Blair. As a photographer I could see precisely what she was talking about. It was a major operation and I was 82 years old! I don’t think I would have survived the old method of having the surgeon crack open my chest to get to the tumor.”
Blair recalls that he never stayed in the ICU after his surgery and while he wasn’t eating when he left the hospital, his recovery was not painful.
“I’m doing perfectly now. And this is really serious stuff because this surgery allowed me to continue exhibiting photography and to give public talks about my work. I’m having a fulfilling life and that’s really important to me. I appreciate that she not only did a good job as a surgeon but also felt concern for me as a patient.”
“Both of these gentlemen are examples of patients who can benefit from a surgical technique that might take longer in the operating room, but results in a quicker and easier recovery from a very serious cancer,” Dr. Marshall said.
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