After a Cancer Diagnosis, One Patient Dramatically Changed His Life

Mitchell Posner, MD, and Ed Robinson
Left to right: Mitchell Posner, MD, chief of surgical oncology, performs a follow-up examination with patient Ed Robinson, of Cedar Lake, Indiana. Posner treated Robinson for a malignant tumor at the base of the esophagus. Robinson made lifestyle changes, lost a dramatic amount of weight and traded his holiday role as Santa Claus for a healthier lifestyle.

Ed Robinson doesn’t take what he calls his "second chance at life" lightly; he lives every moment of every day to the fullest. Diagnosed with advanced stomach cancer in 2005 with what many thought was a slim chance for survival, Robinson now leads an incredibly robust and productive life centered around Rita, his wife of 28 years; his family and friends; his full-time career; and his commitment to giving back through service to his community.

At the time of his diagnosis, Robinson, then director of public works for the town of Dyer, Indiana, was 50 years old, weighed 358 pounds, had a 52-inch waist and was on 12 different medications for blood pressure, diabetes and related conditions. After experiencing trouble swallowing and an initial misdiagnosis, he received the definitive news that he had cancer.

Once the first wave of shock had worn off, Robinson resolutely made up his mind. "I’m going to fight this thing," he thought. "I’m not going to let it beat me." True to form, Robinson kept his word.

With his own no-nonsense, methodical approach to problem solving, Robinson carefully researched his medical options. He became convinced that the University of Chicago Medicine and, in particular, its chief of surgical oncology, Mitchell C. Posner, MD, could best provide the advanced treatment his condition required.

Not sure what to expect from a big-city, academic medical center, Robinson said after his first visit, "It was the friendliest hospital I’d ever seen. My wife and I felt an immediate connection with Dr. Posner. I know he’s one of the world’s best oncology surgeons, but he’s got a big heart too. He didn’t hold anything back about my condition; he gave me all the facts and told the truth. That gave me even more confidence."

"My wife and I felt an immediate connection with Dr. Posner," said Robinson.

Posner, an internationally recognized expert and researcher in gastrointestinal cancers, recalled that after an endoscopic procedure and biopsy, staging workup and a CT scan, the oncology team diagnosed a malignant tumor at the base of Robinson’s esophagus invading both the stomach and the esophageal walls. Posner added that although gastric cancers such as this are fairly uncommon in the United States, only about 25,000 diagnoses a year, he sees a fairly large number because of the highly specialized nature of his practice.

The challenge in Robinson’s case, according to Posner, was twofold--technical and nutritional--and was made more complex by the patient’s weight. The team had to decide what surgical technique would result in an outcome that not only would remove the tumor, but also allow Robinson to have the nutritional intake he would require to sustain life post-surgery.

The team opted to remove the entire stomach and a portion of the esophagus and then use part of the small intestine to recreate continuity between the esophagus and the rest of the gastrointestinal tract. A portion of the small intestine acts as a "stomach" in the digestion of food.

Estimated to take about six hours, the actual surgery lasted nearly eight. Immensely concerned about the protracted procedure, Rita Robinson was surprised and reassured when an exhausted Posner came to her at 6 pm and spent an extended period of time going over in detail the procedure and what to expect next. She later told her husband that before he left for the evening, Posner had given her a big hug and his personal pager number just in case she had a concern.

Apparently Robinson himself had few concerns. Although he’d been told he would remain hospitalized for up to 14 days, his "never give up" attitude had him on his feet walking by 10:30 the next morning, and he was discharged from inpatient care and at home in only nine days.

Following the surgery in October 2005, he faced months of radiation and chemotherapy as well as having to learn a whole new way of eating because of his restructured GI tract. Despite those challenges, he returned to part-time work in March 2006 and resumed his full-time career in September that year in a new position as director of operations for Cedar Lake, a fast-growing community in northern Indiana.

Posner noted that not everyone with Robinson’s stage of the disease can expect his degree of recovery. Yet, he added, outcomes are improved when patients seek treatment with high-volume surgeons and institutions. "It’s not a secret," he said, "the chances of doing better are much higher."

Never one to remain idle, Robinson also now serves as an assistant administrator for the Cedar Lake Police Department Volunteers in Police Service (VIPs) Unit. He makes public appearances on behalf of cancer-support groups and takes an active role in several local community service organizations serving children. His overall health has improved significantly. His blood pressure is normal and he is free of diabetes.

However, one aftereffect of his surgery, a significant weight loss, seems to have interfered with a favorite children’s charity role Robinson used to play during the holidays. With a chuckle, he said, "It’s kind of hard to come off as a convincing Santa Claus now that I only weigh 198 pounds and have a 34-inch waist."

February 2011