Esophageal Cancer and the Power of Being Positive

By Gary W. Chmielewski, MD

No patient represents the importance of the “mind-body” connection like Jeff Galas.

When I saw Mr. Galas in the fall of 2011 for his newly diagnosed cancer of the esophagus, for all practical purposes on the surface he looked like he would proceed directly to surgical for treatment. On further staging workup, though, he was found to have possible liver metastasis on PET scanning, and at that point surgery was off the table. Chemotherapy would likely be his only option.

When given the dire news, Mr. Galas was his usual positive self and said “Don’t worry, doc,  I am going to be the poster child for esophageal cancer. You will be operating on me yet.”

We already had a multidisciplinary team in place consisting of a surgeon, radiation oncologist and a oncologist — so Dr. William Leslie from oncology weighed in on the treatment options. To his credit, instead of recommending the standard agents, he suggested a new regime consisting of FOLFOX that has shown promise in metastatic GI cancers. Mr. Galas sailed through this regime, and when we restaged him, there was no evidence of metastasis.

Being cautiously optimistic, the Coleman Clinic GI team reviewed his case and presented his options of proceeding with radiation treatment or the original option of a minimally invasive esophagectomy if liver biopsy confirmed no disease. Mr. Galas opted for surgery and the minimally invasive approach. At time of laparoscopy, liver biopsy showed no signs of cancer spread to the liver, and a minimally invasive esophagectomy was completed. Mr Galas was home 10 days later, tolerating a diet and resuming many of his normal activities. Because a minimally invasive approach was used, he was able to restart his chemotherapy after only four weeks post-operatively. I am certain Mr. Galas’s positive mindset contributed to his excellent response to date.

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Gary W. Chmielewski, MD, is a thoracic surgeon at Rush University Medical Center.

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