Almost 5 years, and counting

With that random, yet holy, date of five years looming just six months away, I received some great news from Long Island oncologist Dr. Paul Hyman of Bay Shore on the Great South Bay.


Dr. Paul Hyman

The doc, an avid Mets fan (in contrast to Dr. Lee Zehngebot of Orlando, an insanely avid Yankees fan) yesterday told me to come back in a year. I think that's the Holy Grail for cancer patients. It's the time, converging with that five-year mark, a Mets no-hitter after 50 years and the transit of Venus across the Sun, that means I'm out of the woods for all intents and purposes. It means my tests showed up looking good, all the numbers should be about where they are and all the dots are there and the T's crossed.

So Dr. Hyman looked over the bloodwork, added information to his practice's new computer and software upgrades and then said, "everything looks good." Ah. Magical words to a person who has pretty much gone through hell, looked Satan, or whomever he was, straight in the eyes, kneed him in the hoo-has and walked slowly back home.

So it's been a long, bumpy journey, and there's more, I'm sure, to come. But Dr. Hyman's proclamation that he doesn't need to see me until past my five-year-out date of late December means I'm that much closer to the light than to the dark. It means my expiration date has not yet arrived. 

Dr. Phil Styne



Dr. Lee Zehngebot

 Along this trek, there have been several ups and quite a few downs. I've lost  my mother, gained two granddaughters and two sons-in-law, though one of those has since left the herd, gained three siblings and a bunch of nieces and nephews (see kohnzone.blogspot.com), and lost a couple of friends, one to this exact disease. I've met people via the interwebs with cancer of the esophagus who I later lost and I've made some remarkable friends, some in unexpected places, like hospitals and doctors' offices.


Dr. Joe Boyer

 And though I tried to avoid doctors most of my life, it all caught up with me in September 2007, when I was diagnosed with cancer of the esophagus, which until that year was pretty much a death sentence, killing 87 percent of the people unfortunate enough to receive the diagnosis.

Dr. Z, Dr. Joe Boyer, Dr. Phil Styne and a cast of thousands at Florida Hospital in Orlando, thankfully, were all part of a conspiracy to save lives, working on a grand experiment, a series of trials to figure a way to up the odds for esophageal cancer patients. I lucked out and caught them after they doubled survivability to more than 30 percent via their participation in a major study by the Minnie Pearl Cancer Research Network. As Catherine put it, I'm one of the 30 percent.



Dr. Z, for example, is not exactly a friend (never met outside of the office or hospital) though I do consider him one. But he is the man who almost more than anyone saved my life. (Yes, Joe Boyer was a big player, too, wielding a big scalpel and now a bunch of little robots even as he instructs at UCF and leads the thoractic surgical unit at Florida Hospital.)

Dr. Z and I have each other's cell numbers, and use them from time to time. He texted me a photo of him dropping down a slope on skis last year after one of his extreme vacations. I texted him yesterday in the car (no, I wasn't driving) after my visit with Dr. Hyman. I wrote: "Just saw oncologist who said all looks good and wants to see me in a year. Thank you for saving my life. Seriously."

And this die-hard, lifelong Yanks fan replies: "Anytime. You look better than the Yankees."

Hear that, A-Rod?

Happy reunion

Dr. Joe Boyer and I visit briefly in one of his exam

rooms. (Photo by Susan Jacobson)

I had a couple of brief visits with two of the several men who saved my life four years ago.

Dr. Joe Boyer, the thoracic and robotic surgeon, was my first stop Tuesday afternoon. I kind of felt bad because when I arrived the office across from Florida Hospital was packed, and I took up almost 10 minutes during our brief reunion.

Then I visited Dr. Lee Zehngebot, who was in his Winter Park office. When he saw me, he gave me a hearty hug and said my docs up North seem to be giving me a clean bill of health.

During my visits with each, I gave the two major-league Yankees fans a few parting gifts courtesy of friend Mindy Levine, who has a couple of friends of her own in the Yankees organization.

It was great seeing the docs, and I was glad to be there as a "former" patient, not a current one.

Keep up the good work, gentlemen.

posted from Bloggeroid

The birthday that almost wasn't

This truly is the birthday that almost wasn't.

A little over four years ago, after my diagnosis of esophageal cancer that September, I questioned whether I'd make it to age 50, let alone 52.

I remember telling myself over and over that failure was not an option. Going through chems and rads, then the intense surgery were better than the alternative, which was basically a quick death via starvation.

My many friends and family kept my spirits up. My friends at work made me feel like a million bucks. I have a wonderful table book of notes and well wishes from my friends at work compiled by Katherine Ramirez Massey, well, before the Massey was added.

So age 48 came that November. We celebrated that I'd made it that far. A few days later, daughter Jennifer married Chris Kuz, with my Mom at the ceremony after months of hospitalization and rehab. All was going pretty well as my body recovered from the radiation and chemicals that helped save my life during a monthlong cooling off period leading up to surgery.

Surgery finally came the Saturday before Christmas 2007, and then I was stuck in Florida Hospital for several weeks, some of that time unconscious or so well drugged I don't remember most of it.

After that was recovery, return to work and my friends -- another excuse for a party -- and my desk surrounded by my alter egos called Battle Keiths, wonderful inspirations created by Jonathan Walton, a/k/a Peter Parker, and Sara Fajardo, a soon-to-be amazing mom now living in Kenya of all places.

Soon after, daughter Aimee married Luis Nunez and later added Emily and Riley to the family. Years continued to pass. Age 50 came and went. I've made new friends, lost a couple to this and other diseases and changed jobs.

And as each birthday comes and goes, they are both reminders and blessings. They remind me of the crap I went through -- and humbling because they almost didn't happen. Each is a blessing, which shouldn't be squandered.

So I will end this post with a reminder to take care of yourselves. Especially when it comes to the potential for cancer of the esophagus. So many of my friends work in high-stress environments. Heartburn is rampant in our business -- and heartburn can cause cancer. (http://cancervivor.blogspot.com/2007/10/about-esophageal-cancer-and-me.html) The best way to avoid the problem is to treat heartburn early. See your doc and get screened. Don't do what I did -- ignore the symptoms for years and years. That way you can think about other things on your birthday other than a moment in time that almost didn't include you.

Four years -- 80% of my goal, at least

In the past four years I've:

• Seen two daughters married;
• Gained two wonderful granddaughters;
• Seen all my children blossom into amazing adults;
• Reconnected with friends and family from years ago;
• Connected with my West Coast family of two sisters, a brother and niece and nephews galore;
• Moved from Florida to New York for a better job;
• Made new friends;
• Educated people I'd never met, and hopefully saved a couple of lives;
• Met people I never would have under different circumstances; and
• Had some downers, too, such as losing my mother and several aunts; lost friends to cancer; found out I lost a brother a year before I met my family in California; lost one son-in-law to divorce; and had far more medical visits than any one person should have in a lifetime.

Still, as I've said during the past four years, it sure beats the alternative. As in not being around during the past four years. And that nearly happened.

It was about this time in 2007 that I agreed to see my doctor, John Pfeiffer in Celebration, Fla. I'd been distracted by an apparently very successful diet and my mother's illness, and put off seeing the doc until I was persuaded to get a checkup.

That's what my esophagus looked like when it was sick.



I was having difficulties swallowing and often spit up what I did consume. Weight loss was another concern. While I was dieting, I was losing weight faster than expected. Together things started to make sense.

It was the start of this disaster known as cancer of the esophagus -- a disease that nearly killed me. It claims about 88 percent of its victims, data show. Let's catch up.

I guess I've been the lucky one. In just the past few weeks, I lost a friend to this ailment and made a new acquaintance who is coping with it at a rather advanced age. Lucky. Depends on your definition. If surviving is luck, then so far I'm pretty damned lucky. But acquiring it in the first place was anything but luck.

Rather, it took years of hard work and practice. Overeating. Gaining weight. Spicy foods. It was the triple crown needed to acquire Barrett's esophagus, a pre-cancerous condition in which the lining of the organ alters to cope with the poor dietary choices. My hiatial hernia didn't hurt the cause either.

So with luck, or the lack thereof, it's been four years since I saw Dr. Pfeiffer, who said I most likely had to have the sphincter of my esophagus dilated. He referred me to Dr. Phillip Styne for an endoscopic exam. I made the appointment and underwent the endoscopy.

I knew something was wrong as soon as I awakened about 20 minutes after the five-minute procedure was supposed to end. "There was some swelling. You may need surgery," Dr. Styne told me when I woke up. He'd taken biopsies of my lower esophagus, where this swelling was really a cancerous mass.

That was a Thursday and I wasn't going to hear back until the upcoming Monday. The weekend really sucked.



My Port after it was removed.



Monday, Dr. Styne called to say he'd made contact with Dr. David Diamond and Dr. Lee Zehngebot, a radio oncologist and medical oncologist, respectively. Dr. Z was no-holds-barred. He told me this was not good, that I was in for a really crappy few months, at the least.



The prediction was not incorrect.

Nutren 1.5. The breakfast of champions, if champions have

no taste buds and can't eat anything else. Anything. Else.

 

A "port" was implanted in my chest and to my carotid artery; a "g tube" was implanted in my belly so I could consume liquid nutrition (mmm, Nutren) when the radiation was expected to swell my esophagus and I couldn't swallow; I was tattooed and set up for my radiation treatment; and began seven weeks of misery: rads five mornings a week and chemo 24/7 pumped into my port, plus three half-day infusions of chemicals designed to kill my cancer.

All the while, I tried to eat as much as I could even as I was losing weight. We went to TooJays and Outback as often as possible to reward me for putting up with the crap and to fatten me up, so to speak.

A month after the chemo and rads ended, I was tested out to see if I was ready for surgery. A PET scan showed my cancer may have spread to a lymph node in my chest and to my liver. Such a development would rule me out of having surgery because it would have meant my cancer had spread and there wasn't much hope for me. Biopsies of my liver and the hylar node found the so-called "hot spots" were just residuals from my radiation. Basically, they cooked my liver a bit.

A laser is used to align my tattoos to the proper position

for radiation treatments.



So within months of discovering I was being attacked from the inside by cancer of the esophagus, the tumor appeared to have been defeated and the next step was surgery to remove the slain tumor and most of my esophagus, which would be re-created by skilled surgeon Dr. Joe Boyer in Orlando, who had to slice and dice my stomach to mimic my esophagus and still work as a stomach.

My new organ is called a neo-esophagus.

OK, that was then. Since, the road to recovery has been bumpy. Bumpy for my body and bumpier, still, for friends and family who have had to put up with what's left of me.


That's what my belly looked like after

surgery. You don't want this to happen

to you. Trust me.

Along the way, mainly through this blog, I've met some amazing people. A few have gone through this. Some know others who did. And a few are ongoing patients and newcomers to the torture wheel.

For example, just a few weeks ago I received an email from a woman in Georgia about her father. Veleta Floren told me all about her dad, Jack Holley, who was diagnosed in June. He's had a rough go and is still consuming just the wonderful liquid diet I was provided called Nutren 1.4 (artificially flavored vanilla for me, see post at http://cancervivor.blogspot.com/2007/10/is-it-soup-yet.html). But the thin tunnel down his esophagus is opening and he can swallow a minimal amount of liquids. You can read about Jack at http://www.caringbridge.org/visit/jackholley.

There were others, as well. Including friends and family. Friends like Jim Solomons, an amazing and brave man who I met through work; he was a spokesman for the Orange County Sheriff's Office and I was an editor at the Orlando Sentinel. He learned about my cancer after his own diagnosis, when a mutual friend, Bianca Prieto, a Sentinel reporter, told us both about each other's plights.

Jim passed away a few weeks ago after his cancer re-appeared a few months ago by attacking his neo-esophagus and liver. He put up a hell of a fight, something he really didn't want to do. He stuck it out and is one of the bravest men I've known.

I've also done some more research. While cancer of the esophagus is continuing its march of death, the survival rate isn't really improving through advances in treatments. Docs now do the surgery that kept me hospitalized for weeks laproscopically. The length of hospital stays is down and the chemo therapies are being refined.

Yet, last year there were 16,640 new cases of esophageal cancer and about 14, 500 deaths. Thus, the survivability rate isn't very high, based on those numbers. Just 12-13 percent. Officially, the five-year relative survivability rate for localized staged cancer of the esophagus is 37 percent, and the relative rate for all stages is 17 percent.

If you're affected by this disease, there also are numerous trials of chemo and radiation therapies going on right now. You can go to this link and find out about them.

Try not to be among those who acquires the disease. Trust me, it sucks. Americans have experienced a rapid growth of incidence in the disease. Our dietary habits have huge role. And by huge, I mean filling our bellies. We do that with all kinds of crap and then wonder why we get heartburn. Greasy and fatty foods are the behind the growth of our large rears that are, well, behind us. They lead to the heartburn that leads to the Barrett's esophagus that leads to cancer. Sort of like the neck bone's connected to the back bone, etc.

If you've been eating like this, think about it and change your habits. You may also experience some signs that you are developing problems, and if you do please see a gastroenterologist. For examplie, heartburn and acid reflux lead to esophageal damage. Your heart isn't burning. Your lower esophagus is. It's literally being digested by your stomach fluids, and it reacts by adding, over time, scar tissue and then protective cells to block the acid. But these mutations, called Barrett's esophagus, are pre-cancer cells and without treatment will result in cancer. PPIs, or proton-pump inhibitors, which help keep your stomach from creating acid,  are drugs that can protect you. They're meds like Prilosec, Kapidex, AciPhex and others. They work. See your doc.

 

So unless you really want years of horror stories to tell friends, family and children, or worse, I encourage you to see a gastroenterologist and take care of yourself.
 

If you want a scared-straight type of experience, go to this link, start from the bottom and work your way back up to here. My journey might just keep you from taking the same path.

My buddy Jim needs your help



Not the best image of Jim Solomons, but he's working.

 My friend Jim isn't asking for any help, and he is in need of nothing physical.

But he needs your help. In the form of prayer, well wishes, positive thoughts, good vibes or whatever you want to call it. And he needs this karma now.

Jim has gone through the same cancer treatments I did, just a few years later. The technology and surgery used to fight cancer of the esophagus had been honed by the time it got to Jim. He made it through the chems and rads seemingly fine. His doc was my doc, Dr. Lee Zehngebot. His surgeon was my surgeon, Dr. Joe Boyer.

I was in the hospital a bit over three weeks after my surgery before Christmas of 2007. So when I went to visit Jim a week after his surgery, I figured he was just out of ICU, which was my timetable. One week in the ICU and then it's off the the cardiac care unit for recuperation.

Rather, Jim was being prepped for discharge. One week after surgery. Miracle Man. The esophageal cancer terminator. He'll Be Baaack (insert Arnold's voice here) -- to work.

That was the first time we'd met face to face. As he was preparing to leave Florida Hospital. We'd known one another from the zillions of calls we at the Orlando Sentinel made to the Orange County Sheriff's Office public-information team, which Jim, a civilian, helped direct.

So it was a great day. His wife Judy was there and Jim was in pain but all smiles.

Since then, Jim did get back to work, and I think the Orlando media collectively sighed -- he's the best that office has or had for quite a while. But he's has had a rough go since. He had some kidney issues. He had a minor -- if you can call it that -- stroke. He's tried hard to bounce back.

Unfortunately, so did his cancer.

Jim is back on chemo and as bad as the first batch was -- and take it from someone who knows, it was bad -- this batch is worse. He's home. He can't really eat, so he gets his nutrition from a bag in a backpack and an IV drip. Yum. He's nauseous and couldn't even hold down a milkshake today, he said. Trust me, that means it's rough going.

Jim has another major infusion of chems in a week or and he's hoping things will improve.

So am I. And so should you, because Jim truly is one of the most caring and kind individuals I've ever known. And I know many kind, caring people -- and you all know who you are. Seriously.

So when I heard Jim today I know he was feeling bad, down in the dumps, ill and sick to his neo-esophagus (formerly known as his stomach).

Right now, Jim can use your positive vibes. As you know, I'm not big into the prayer thing. But like I've said during my treatments and follow-up surgeries, prayer may not help but it surely will never hurt.

So if you take a moment when you read this, think of Jim and his family and all he's going through. And let's see if this positive feedback helps.

It certainly can't hurt.

Filling in missed months, and a morning mashup

It's been five months, give or take, since I've updated but there's a good reason. The dog ate my homework.

Actually, it's a bit more complex than that. Basically, since December I:

• Was offered a new job in Long Island;
• Accepted the new job in Long Island;
• Left the Orlando Sentinel but kept many friends;
• Left the comfort of insurance for 24 uninsured days with Cobra as a backup;
• Was diagnosed with cancer based on pathology taken from my pleura;
• Was told I needed a PET scan;
• Was told by my longtime caretaker Florida Hospital Orlando they wanted $10,000 down before they'd conduct a PET scan, even knowing Cobra would cover it (note, Florida Hospital is on my poo-poo list -- that's where I encourage anyone who would listen to boycott the hospital and Adventist Health);
• Was given a PET scan at M.D. Anderson Cancer Center at Orlando Regional Medical Center with no money down, with the anticipation of Cobra coverage;
• Was told I am cancer-free based on the PET scan;
• Dr. Z asked pathology to re-evaluate my sample, and the conclusion was no cancer was actually there; 
• Started work in Long Island with Newsday;
• Was covered with insurance starting Day 1 -- which was Jan. 24, 2011;
• Found doctors to care for me; they're a good group and I'm confident all will be well;
• Love my new job, new colleagues, new bosses and new residence in Bohemia, N.Y. (yes, we're Bohemians);
• Found out after a follow-up CT scan that I have a desmoid tumor outside my right chest wall and attached to a rib;
• Will undergo surgery in about eight hours at Southside Hospital in Bay Shore.

Well, that is the quick version that led me from then and there to the here and now.

So, I am now off food and water until surgery in the morning at the hands of Dr. Brian Fallon, the hospital's chief of thoracic surgery at the hospital. I'll be at the hospital overnight and then go home. By Sunday, I should be mostly as good as new.

I'll have my smart phone and laptop in the hospital, but I don't think I'll be able to tweet or blog from the O.R.

So until my drug-induced update tomorrow afternoon, behave yourselves.

Thanksgiving for me: Two years ago, I was not sure this day would arrive

It's amazing how the future looks.

Two years ago I was not certain my future would include today, Thanksgiving 2009, or my birthday a couple of days later.

In my mind, the future looks like today.

Two years ago, I'd just been removed from my 24/7 chemo pump and was preparing -- as I am now -- for tests on Dec. 7. I was thankful then for my doctors, my family, my friends and for life.

Still, I remember telling my cousin David Spitz, the popular Connecticut chiropractor, that I feared I would not make it to age 50. I was panicked, often tearful. But 50 became a goal. At the time, it seemed distant, remote, unattainable.

Today, it's a bit closer -- just a few days away.

So on this Thanksgiving, I feel truly blessed with that family, those friends, my wonderful doctors, their wonderful staffs, and the knowledge that I've reached another milestone, another goal on the road to recovery from esophageal cancer.

And as a way of paying it forward, I'll reiterate as I have probably too often in this blog: If you get heartburn, if you have acid reflux or even if you take a few Tums or Rolaids every day, you could get cancer. See a doctor, have an endoscopy, consult your family doctor or gastroenterologist.

Heartburn and acid reflux could lead to Barrett's Esophagus, a precursor to esophageal cancer. There are treatments at that stage to help avoid cancer. But doing nothing is not one of them.

Be thankful for what you have today, as I am, and celebrate with your loved ones. Be kind to those loved ones and take care of yourself.

Oh, another tip here -- moderate amounts of turkey, sweet potatoes, corn on the cob and pumpkin pie are not known causes of Barrett's Esophagus or esophageal cancer. So eat up and celebrate, with your loved ones of course!

The check was in the mail

Finally, I was able to follow through on a pledge to make a donation to Florida Hospital Cancer Institute.

That happened this morning.

In the name of transparency, I just endorsed the check to the Florida Hospital Foundation.

It wasn't a massive amount, just $149 and change. But it felt good to pass the money along from -- you, my friends, family, colleagues and complete strangers. It was all your doing. And I thank you.

Jaclyn Lindsey, a development specialist, was in the Foundation's Orange Avenue office when I arrived this morning. She's a good person and was honestly very happy to have the check. It will be bundled with other, similar small donations and will be used to purchase equipment for the Cancer Institute that might just help save someone's life.

Maybe even my own. Or yours.

There are other ways to donate small amounts. I learned a couple of weeks ago that the Foundation set up a way for cell-phone users to text in $5 donations from their cell phones. Just text the word FIGHT to 90999. The $5 donation will be billed to your cell phone account.

So let's keep up this fight against cancer of all kinds. One of the best ways is by checking out this blog regularly.

Check out this site -- it's worth the click

A few weeks ago I was asked to write an essay for a wonderful Web site that focuses on survivors of cancer, in all its many forms.

My essay was published today. The site is http://www.voicesofsurvivors.com/, and I encourage everyone to check it out not just today, but everyday.

That's because each day, site manager Lynn Lane posts another story by another survivor. Lynn, a documentary filmmaker, also records these tales visually on video. These also are available on the site.

So please give Lynn's site a read. And if you have any comments, I'm sure he'd love to hear them.

A little Botox goes a long way

Well, I'm back on solid food -- thank goodness for that -- and breathing a sigh of relief after may endoscopic exam yesterday, July 20.

Dr. Phillip Styne and his crack team of nurses, assistants, anesthesiologists and aides at Florida Hospital Orlando injected a dose of Botox into my pyloric valve, also known as the pylorus, to make it easier for me to digest food.

It was kind of quirky because I was taken into the procedure room at 1:19 p.m. Monday but Dr. Styne couldn't do the procedure yet -- the Botox hadn't yet arrived from the hospital's pharmacy.

I was slightly doped up on anesthesia when the doctor told the nurse anesthesthetist to hold off on fully loading me up. I had the mouthpiece in place for the endoscopic tube to be used, and I was allowed to remove it until the drug arrived. (Good thing, because I was drooling a little; sorry if that's tmi.)

One of the nurses joked that if there's extra they could use it elsewhere if I wanted.

Then folks started getting a little peeved at the pharmacy. I even offered to phone down and complain that 'I'm here lying on the gurney, the the stuff up here!' But a few minutes later, it arrived and about 1:32, if I recall correctly, I went lights out.

I woke up about 20-25 minutes later in the recovery room with Catherine in attendance. She'd already spoken with Dr. Styne, who said all went well. (She even snapped a photo or two of me unconscious. Tweeters can find my images on Twitter if you search for my live-at-the-time tweets under #endoscope.)

I'm adding the above photo here as a sample.

So in the end, all went well, the Botox seems to be working, I'm eating again -- though being a bit gentler with my dining -- and as I tell people all the time I'm happy to be here.

There's always room for Jell-o

I'm on Day 2 of a three-day clear-liquid diet leading up to an endoscopic sojourn down my gullet by Dr. Phillip Styne on Monday afternoon.

This means soup, Jell-o and water. It's pretty bad that Jell-o is about as solid a food as I can consume. (Kind of a glimpse into the future if I don't keep my teeth in good order.)

Dr. Styne thought I'd be able to make it to January without needing another endoscopy, but I missed by several months because I think my pyloric valve, known as the pylorus, isn't cooperating.

In simple terms, the pylorus opens to let food travel from the stomach (in my case, what is left of the stomach) into the intestines. (More at http://en.wikipedia.org/wiki/Pylorus) Because of the surgery to my stomach to replace by cancerous esophagus, nerves were severed that control the pylorus and other aspects of the stomach's function.

So, Dr. Styne & Co., will use his endoscopic device to peer into my stomach and see if the pylorus isn't opening as it should. If so, he'll inject Botox into the valve to deaden some of the nerves keeping it closed. This should open it up, hopefully for good.

I'll Twitter from Florida Hospital on Monday, but I don't think the good doc will let me bring the phone into the procedure room. Besides, I'll be on some good drugs and won't be able to spell my name -- or put a cohesive sentence together. (I can barely do that on a good day.)

But I will get a photo of the doc before the procedure. Styne is a good and decent man -- and one hell of a doctor.

So until then, I'll be swilling coffee sans cream; tea, both hot and iced; chicken noodle soup (yes, the doc says the noodles won't be an issue because they're quickly digested); and, of course, good old Jell-o.

After all, there's always room for Jell-o. Especially on the other side of my pylorus.

Time sure flies when you're having fun?

It's really hard to believe, but two years ago this week I first started noticing something wrong.

Catherine and I were on our vacation -- a drive from Central Florida to Yellowstone National Park and back via Baltimore, Chicago, Minneapolis, Mount Rushmore, Badlands National Park and several other stops -- when I became nauseated at a Ruby Tuesday restaurant. It happened again the following night after a late meal. And again later at a casino in South Dakota.

I dismissed the symptoms. I was on a diet. I was traveling and not drinking enough. I thought the two were causing food to just not make it all the way down.

After the two-week trip, I traveled to South Florida, where my mother was about to have a cardiac catheterization. I dismissed the symptoms more in the coming weeks and months as my mother was swept into a deeper illness following open-heart surgery. My inability to even eat a doughnut as I drove to or from South Florida was ignored as a diet issue. I actually kept extra grocery bags in my car in case I gagged while driving. I was that ignorant as to what was happening to my body.

I couldn't check in to see a doctor; I had work during the week and on weekends I was visiting my ailing mother. I just didn't have the time.

But Mom was falling deeper and deeper into a medical nightmare and I finally listened to my wife Catherine and went to see my doctor.

Dr. John Pfeiffer in Celebration, Fla., suggested I needed to see Dr. Phillip Styne. He suspected the sphincter of my esophagus was not dilating properly and that Dr. Styne could enlarge the opening during an endoscopic exam. There was a very small chance I had cancer of the esophagus, Dr. Pfeiffer said, but I was too young and he'd never come across an esophageal cancer patient. He doubted that's what I had, though the chance was there.

I'll never forget Dr. Styne's greeting to me as I awakened from the anesthesia of that endoscopy. He told me there was some "swelling" and -- drum roll -- he took a biopsy.

This was on a Thursday. Talk about a miserable weekend.

But by Monday it was confirmed. Dr. David Diamond, who would become my radio-oncologist, called to say I did have cancer and I needed to get in pronto. I needed to see Dr. Lee Zehngebot, my oncologist. Together, this team -- Styne, Zehngebot and Diamond -- plus, later, Dr. Joseph Boyer, would be the men who saved my life.

But I digress.

Dr. Z explained that esophageal cancer was rare and deadly. In my case, it was likely caused by a combination of factors, including years of heartburn treated with antacids but no real medicines. My odds were not good, but the docs were not ready to write me off just yet.

Dr. Diamond initially told me I was stage 2 to 3. Not good. He said I had a 50-50 chance of survival. Again, not good. But each step of my treatment could lead to a new assessment. As I passed a new threshold, I'd be re-assessed. Still, 50-50 meant I had as good a chance to live as to die.

I chose to live -- though later during treatments I briefly questioned the sanity of that choice.

In the weeks that followed I underwent daily zaps of radiation, heavy-duty jolts of X-ray-like doses of isotopes I'm not too familiar with that, weeks later, I'd learn affected my liver and other hot-spots in my body, which resembled new cases of cancer. Thankfully, biopsies would find that not to be the case.

I also was attached 24/7 for seven weeks to a chemo pump injecting poison directly into my jugular vein.

This one-two punch sapped me of my strength and, at times, my will. But I didn't want to let depression get the best of me. I tried to remain focused and positive. I would not be distracted by my condition or the deteriorating state of my ailing mother.

After these treatments were completed I had about a month of a "cooling-off period" to recover before major surgery to dissect and resect my esophagus, stomach and lymphatic system in my chest. Also during this time, my Mom seemed to be getting mildly better. We were able to move her from the hospital in Fort Lauderdale to a rehab center in Boca Raton, then, days before daughter Jennifer's marriage to Chris Kuz, to a rehab center in Orlando.

I finally told Mom about my cancer and how I was doing pretty well. I mean, I hadn't died during the chemo (several people had during trials of the treatment) and I was still standing. We moved her belongings from her apartment in South Florida to our garage. A week before my surgery the weekend before Christmas 2007, I traded in my beloved Mazda RX-8 sports car for a larger and easier to enter Saturn Vue SUV. I'd never be able to squeeze into the RX-8 after my surgery, and I'd need the SUV to haul Mom's oxygen tanks after she was discharged from treatments.

Mom had a couple of setbacks in the interim, and on Dec. 21 I underwent surgery. I had an esophago-gastrectomy -- basically, most of my esophagus was cut away. To replace it, my stomach was cut, spliced, pasted and pureed into a faux esophagus and a smaller stomach, now planted in my chest not far from my heart.

It took about three weeks to be discharged from the hospital and another several weeks to recover before returning to work.

Since then, I lost my mother, I've regained about 15 pounds but still am far lighter than I was during those days of dieting two years ago.

Like I tell friends and others, I like the results but I would not recommend the diet program.

So, friends, it comes down to this as CancerVivor.blogspot.com has reached more than 19,000 page views, if you have heartburn, then lose it; if you have problems swallowing; if you suspect something amiss in your digestive system, please see a doctor and be open to treatments. Even if the dreaded "C-word" -- cancer -- is the diagnosis.

Two years later and I'm still here.

Another day, another scan

I have a confession. I forgot about an appointment for a CT scan on Monday. I just went about my business and realized it only when I had my first cell call of the day and noticed the notification.

So I go to Florida Hospital on Tuesday afternoon for the scan. No biggie. I've done these things every four months for nearly two years, and even more frequently prior to my surgery. By now I should glow in the dark.

The scan will allow my doctors to see if anything is growing inside of me. Well, let me rephrase that. The doctors will see if anything bad is growing inside. I don't think so; there's no blockage that I can tell.

So I feel pretty good going into this scan. I see Dr. Z in mid-April and I feel certain I'll have a relatively clean bill of health.

As I go through this scan, this Web site is about to be visited by its 18,000th viewer. With that milestone, I hope to remind everyone that esophageal cancer is among the fastest-growing cancers in the United States and around the world. Primarily affecting men, it now also is crossing the gender gap and striking more and more women.

But there are ways to avoid it. It all centers on seeing a doctor regularly and -- unlike what I did -- tell the doctor if you have persistent heartburn. Further, tell the doc if your persistent heartburn goes away, because that's not normal either. It could indicate an advanced condition known as Barrett's Esophagus, which is a precursor to cancer.

Take your medications as if your life depends on it. If your doctor put you on any of the meds that keep your body from making acid, use it. It could save your life and is a small price to pay to watch your children grow up, celebrate holidays or enjoy a spring afternoon.

So, going to the CT scan Tuesday is just a small inconvenience, and hopefully it will confirm to my doctors that they did an outstanding job in 2007 and 2008 keeping me alive.

New news about esophageal cancer

In recent weeks, there have been a few developments in the fight against cancer of the esophagus.

Esophageal cancer in general is among the fastest growing forms of the disease. And a study by the National Institute on Alcohol Abuse and Alcoholism, first reported in The New York Times, indicates even a small amount of alcohol -- a glass of wine or half bottle of beer -- could increase the chance of developing squamous cell esophageal cancer. This is even more so if the patient is of Asian ancestry.

Squamous cell cancer is most often at the upper end of the esophagus, while the type of cancer I had, adenocarcinoma, generally affects the lower end of the esophagus near the stomach. Squamous cell carcinoma also can be caused by smoking, or in combination with drinking.

Here's a link to the New York Times article. 

The other development was the death earlier this month of the actor Ron Silver. Silver had been in a two-year battle with esophageal cancer. He died Sunday, March 15.

His death opened my eyes to the fact that even though I feel pretty good now, I'm not out of the woods 18 months after my initial diagnosis.

I'll continue to update on a more regular basis.