Stage-3 Esophagus Cancer Discovered After Heart Attack

A few weeks after having a stent placed as a result of a heart attack, James Adams, 54, of  Independence, Ky., began having trouble swallowing. 

"I have acid reflux, but when they went in to stretch my throat they found cancer,” he recalls. In February 2011, Adams was diagnosed with stage-3 esophagus cancer that had spread to the lymph nodes. 

"I was dumbfounded. I didn’t know what to do, who to talk to … it was overwhelming,” says Adams. "Everyone at UC Health has been excellent. It’s been a long road to get rid of the cancer and, frankly, I think it was even scarier to my family than me.” 

As he began an aggressive regimen of chemotherapy followed by radiation, he was referred to Sandra Starnes, MD, a UC Health thoracic surgeon and chief of the thoracic surgery at the UC College of Medicine, to discuss surgical options. 

Starnes suggested a three-hole esophagectomy to fully remove the cancer. It’s a big procedure—requiring incisions in the neck, chest and abdomen and typically six to eight hours in the operating room—but necessary to address larger tumors in this difficult-to-reach part of the body. Starnes performed the surgery collaboratively with Jeffrey Sussman, MD, a UC Health surgical oncologist and surgical oncology division chief at the UC College of Medicine.  

The goal of an esophagectomy is two-fold: to remove the cancerous tumor and enough surrounding tissue to ensure cancer-free margins and to re-establish gastrointestinal continuity. Adams spent 10 days in the hospital recovering from the procedure and remained on a feeding tube for about three months at home while his body adjusted and healed. 

"Everyone at UC Health was amazing—I love this place,” Adams says, looking back on the experience. "Dr. Starnes was able to coordinate my surgical treatment at UC Health with chemotherapy and radiation doctors in Kentucky so I didn’t have to travel far from home.”

"Despite all the chemo and radiation, I was only really sick about three days. I had surgery in June 2011 and was back to work in September,” Adams says. "My sister Kay was my rock throughout the care process. I prayed a lot throughout this journey—and so did my family.”

Adams is back to his job as a tractor-trailer parts salesman and gradually rebuilding his physical strength and endurance. He’s focused on spending time with his three kids and looking forward to welcoming his first grandchild soon. 

The National Cancer Institute estimates that about 17,500 people will be diagnosed with esophagus cancer in 2012. Tobacco and alcohol use as well as chronic acid reflux and a pre-cancerous condition known as Barrett’s esophagus may increase a person’s risk for the disease. 

»Minimally Invasive Surgery Options 

UC Health is the only team in the Greater Cincinnati region to offer minimally invasive esophagus cancer surgery for early stage disease. Surgical oncologists use laparoscopy to completely mobilize the stomach and other associated steps in the operation. Thoracic surgeons remove the tumor in the chest and any necessary surrounding tissue using video-assisted thoracoscopic surgery (VATS). Both techniques require only a few small incisions in the abdomen and chest to insert the minimally invasive tools used to operate. The procedure is offered at University Hospital. The UC Health Thoracic Surgery team treats about 300 patients with esophagusl or lung cancer annually, with 75 percent of those currently performed using minimally invasive techniques such as VATS or laparoscopy.

»More Information 

Appointments with thoracic surgery can be made by calling 513-475-8787. Hematology oncology can be reached at 513-584-8500. Radiation oncology can be reached at 513-475-7775.