Doctors Offer Treatment that Spares Patient's Esophagus

Back in 2006, Tom Flint, then 53, learned that his Barrett's esophagus had developed into cancer. He went to a major medical center in Chicago and was told he only had one option: surgery that would mean losing his esophagus.

Tom, an avid runner and active Elgin resident, could not imagine having such dramatic treatment that would affect his quality of life. In fact, his diagnosis was already having a major impact because he had stopped eating--afraid that doing so would cause some of the cancer to break off and spread to other parts of his body.

Irving Waxman, MD, and Tom Flint Gastrointestinal interventional endoscopy expert Irving Waxman, MD, and Tom Flint.

Despite the stress of the diagnosis, Tom and his family weren't going to be satisfied without exploring other options. So they enlisted an army of relatives and friends to research his options on the Internet. They found that one of the country's best places for patients with GI cancer was in Chicago--the University of Chicago Medicine Center for Gastrointestinal Oncology.

The "Quiet Confidence" of Experts

Learning that the medical center's gastroenterology and medical and surgical oncology programs were among the best in the nation impressed Tom and his family. "With the University of Chicago medical center, I had somebody in the top 10 in my own backyard," he says. "Going in, it made me much more comfortable."

In less than a week, Tom was able to see Mitchell Posner, MD, chief of surgical oncology. "His approach was to explore the least invasive options first, which was certainly good news to me," Tom says.

That same week he also saw Irving Waxman, MD, a gastrointestinal interventional endoscopy expert who treats early esophageal cancer without surgery. Dr. Waxman performed an endoscopic ultrasound that revealed that the cancer hadn't penetrated beyond a certain layer in his esophagus. This meant Tom was a candidate for an organ-sparing treatment called endoscopic mucosal resection (EMR).

This was good news. In addition, Dr. Waxman reassured Tom that he could eat without causing a problem. "This was a real emotional turning point for me," Tom says. "They encouraged me to maintain my weight in the healthy range so that I could get through this."

Organ-Sparing Treatment

In EMR, Dr. Waxman uses advanced endoscopy and minimally invasive procedures to remove early cancers while retaining organ function. Dr. Waxman told Tom there were risks to the procedure, but the patient felt he was in excellent hands. "Dr. Waxman did not rule out an esophagectomy [surgery to remove the esophagus], but he said they were going to take it one step at a time. The doctors weren't going to jump from point A to point Z. They were going to go through A, B, C, D and E first," Tom says.

Tom has had EMR treatments to strip out the cancer tissue. During each procedure, Tom receives light sedation, and doctors check for any cancerous tissue in his esophagus. They also remove any additional tissue that could turn cancerous down the road. All of the new tissue in his esophagus has been normal and he's resumed his aggressive exercise schedule. He goes back to the University of Chicago Center for Gastrointestinal Oncology every six months for treatment.

During his time at the medical center, he's been impressed by the care he's received from the staff. "They act as though you're the only person they're dealing with at the time," he says. "Their focus is on you as a patient."

A Hopeful Forecast

Today, Tom, a consultant, is very optimistic about his health and says he's learned a lot from having cancer. He's learned to take life easier, scheduling more three- and four-day weekends with his family. "I realize now how fragile life is. I value people and relationships more now," he says.

Tom has also learned the importance of getting second opinions. He offers this advice to other patients: "If you have cancer, don't settle for the first diagnosis or treatment option you hear from a doctor. Understand your options. You may have a great doctor, but he or she may not be up on the newest procedures and treatments. Less invasive options may be available. So get out there and do your research."

October 2007