Published Aug 12, 2026

74-Year-Old Man Thought His ‘Ice Pick’ Chest Pain Was A Heart Attack—It Turned Out To Be Stage 3 Esophageal Cancer

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Understanding Esophageal Cancer

Bradley Dreyfus, 74, thought the sudden “ice pick” pain in his chest was a heart attack—but after doctors cleared his heart, an endoscopy revealed stage 3 esophageal cancer.
Esophageal cancer, which is often difficult to diagnose, causes cancer cells to form in the tissues of the esophagus, a hollow, muscular tube that food and liquid move through when traveling from the throat to the stomach.
Catching esophageal cancer at an earlier stage is, of course, most optimal. But even with advanced esophageal cancer, a serious diagnosis, there is much more hope with the latest medical advancements.
If you have a cancer screening coming up or have recently had one, you may have questions you want answered. SurvivorNet’s proprietary AI tool “My Health Questions” is designed specifically for patients and caregivers.

Bradley Dreyfus, a 74-year-old man from Brookhaven, Georgia, was diagnosed with esophageal cancer after initially fearing the sudden “ice pick” sensation in the center of his chest was a heart attack.

Sharing his story with Northside Hospital Cancer Center, Dreyfus, admitted knowing the importance of him getting the symptom checked as his father had passed away from a heart attack.

Dreyfus, who experienced the sharp chest pain in fall 2024, decided to see cardiologist, but after two weeks of various testing he was found to have no issues with his heart.

He recounted, “They said I have the heart of a 50-year-old and that I need to get an upper endoscopy.”

Bradley Dreyfus (Northside Hospital Cancer Institute)

Dreyfus was then scheduled time to meet with Dr. Luis Galvez of Atlanta Gastroenterology Associates for an endoscopy, a procedure doctors use to examine your upper digestive system.

The test ultimately led to a second endoscopy, during which doctors were able to collect tissue for a biopsy.

“He sent me directly to the cancer unit at Northside Hospital Atlanta for another endoscopy where they could also remove a sample for biopsy,” Dreyfus said.

Soon after, an oncologist diagnosed him with stage 3 esophageal cancer, which came as a shock due to his lack of family history of the disease or prior health issues.

Dreyfus, who noted how he’s “always been a heavy drinker” and often enjoys “spicy tequila,” was found to have a 19-millimeter tumor located just above his stomach.

According to the National Cancer Institue, people who drink heavily have about five times the risk of developing esophageal cancer, while those who drink lightly have about 1.2 times the risk compared with people who do not drink.

Dreyfus ultimately underwent a three-month course of FLOT chemotherapy—a regimen combining fluorouracil, leucovorin, oxaliplatin, and docetaxel that is commonly used to treat certain types of cancer in the esophagus and gastroesophageal junction, often administered both before and after surgery.

After several rounds of treatment, Dreyfus’ tumor had shrunk enough for him to become a candidate for an extensive surgery to remove it.

Following his recovery, he underwent four additional cycles of FLOT chemotherapy to help eliminate any remaining cancer cells.

Now cancer-free, Dreyfus is grateful that he was able to keep working and maintain his gym routine throughout his recovery.

He praised his doctor for encouraging him to stay active and continue doing “everything I felt able to do.”

“It’s rare these days that I just do surgery for a patient with esophageal cancer. They’ve often gotten other treatments,” Dr. Brendon Stiles, a thoracic surgeon at Montefiore Medical Center, previously told SurvivorNet.

“Remarkably, with very early stage disease, stage one, a patient can often have their tumor resected endoscopically, through a scope down their esophagus, without the need for invasive surgery. That’s a very selected group of very early, invasive cancer, but increasingly, as we do more endoscopies, we’re able to find those patients,” Dr. Stiles added.

WATCH: Explaining an Endoscopy Procedure

“The normal esophagus on endoscopy looks similar to the inside of your lips or cheeks,” Dr. Whit Burrows, a thoracic surgeon with the University of Maryland Medical System, told SurvivorNet in an earlier interview. When doctors perform an endoscopy to check for esophageal cancer, they’re looking for changes in that smooth, uniform lining.

Signs that may raise concern include:

A loss of the esophagus’s usual uniform appearance
Lesions
Irregular or uneven areas
Disrupted symmetry

In stage 1 esophageal cancer, symptoms are often absent, and the disease is typically found during an endoscopy, Dr. Burrows explains. At this early stage, the cancer hasn’t penetrated the esophageal wall.

“It’s a very local problem,” Dr. Burrows says. “If it’s very, very superficial, you don’t even need surgery. You can actually treat it through the endoscopy.”

Chemotherapy plays a vital role in treating esophageal cancer, whether it’s adenocarcinoma (a type of esophageal cancer) or squamous cell carcinoma (a type of esophageal cancer). The specific drugs used depend on the cancer type and individual patient factors.

“Chemotherapy is typically a drug that swims through your body, killing off cancer cells wherever they are—whether they are in your esophagus, in your great toe, in your hip, or in your liver,” Dr. Burrows said.

“So, [it’s] very different from surgery, where we locally remove the cancer, or radiation therapy, when we don’t remove it, but we locally treat it.”

The goals of chemotherapy include:

Shrinking tumor size
Reducing the number of cancer cells in the body
Lowering the risk of cancer spreading
Easing current symptoms

Treatment is typically given in cycles, allowing the body time to recover between sessions. Duration and dosage vary based on the patient’s condition and response.

Understanding Esophageal Cancer

Esophageal cancer is a disease that causes cancer cells to form in the tissues of the esophagus, a hollow, muscular tube that food and liquid move through when traveling from the throat to the stomach. The wall of the esophagus is made of up several layers of tissue; cancer begins on the inside lining and spreads to the outer layers of the esophagus as it grows.

Several lifestyle factors, like smoking or heavy alcohol use, can increase a person’s risk of developing esophageal cancer. Approximately 22,530 new cases of esophageal cancer are diagnosed in the U.S. every year, according to American Cancer Society estimates, and it is more common among men.

“Esophageal cancer, we know is a tough one,” Dr. Stiles told SurvivorNet. “It’s one of the cancers with some of the lowest cure rates out there, but like many cancers, if we find it early, we can often treat it effectively, either with surgery, with surgery and chemotherapy, with chemotherapy and radiation.”

Dr. Stiles recommended that patients report any symptoms that may indicate esophageal cancer to their doctors right away, since there are more treatment options when the cancer is caught early.

Esophageal Cancer Symptoms

Unfortunately, symptoms can be a bit vague, so those experiencing them may not think cancer right away. Still, it’s important to be aware of signs of this disease, which include:

Pain/difficulty swallowing
Weight loss
Pain behind the breastbone
Hoarseness/cough
Indigestion/heartburn
A lump under the skin

“Try to get diagnosed early,” Dr. Stiles said. “For esophageal cancer, that means getting screened, getting endoscopies if you have any symptoms. The problem with esophageal cancer is it can mimic a lot of other things. You lose a little weight, have a little trouble swallowing, have a little heartburn, those are tough symptoms to pin down sometimes and often leads to patients with esophageal cancer presenting with later disease.”

Dr. Sofya Pintova, who practices hematology and oncology at Mount Sinai Cancer Center, also stressed the importance of getting checked up when these symptoms, which may not immediately indicate cancer, arise.

“Symptoms include things like … they’re losing weight, they’re having some burning in their esophagus or their chest, they’re having trouble or pain with swallowing and that will often lead to a medical evaluation,” Dr. Pintova explained.

Dr. Sofya Pintova explains how esophageal cancer is diagnosed.

“It includes an endoscopy, which is when a gastroenterologist puts a camera down the esophagus in the stomach and if they see an area that is suspicious for a mass, or if they see a mass, they may biopsy it. And if the biopsy confirms cancer, the next stage is usually staging,” she added.

Diagnosing & Staging Esophageal Cancer

Several tests may be used when diagnosing a patient with esophageal cancer. These include:

Physical exam/health history – An exam of the body to check for general signs of health as well as signs that may indicate disease
Chest X-ray – An X-ray of the organs and bones in the chest
Upper endoscopy – A test that allows doctors to examine the walls of the esophagus using a small camera that is attached to a thin tube and passed down the patient’s throat

Other tests may be used as well to help get an accurate diagnosis. The upper endoscopy is particularly important because it helps your doctor to clearly see if there are any abnormalities in the wall of your esophagus.

Dr. Whit Burrows, a thoracic surgeon with the University of Maryland Medical System, explains what happens during an endoscopy.

Usually if a suspected esophageal cancer is found during an imaging test or an endoscopy, it will be biopsied, which means your doctor will remove a small piece of tissue using a cutting instrument that is passed though the scope. That will then be tested.

The two most common types of esophageal cancer are:

Squamous cell carcinoma (which forms in the thin, flat cells lining the inside of the esophagus)
Adenocarcinoma (cancer begins in the glandular cells, or the cells in the lining of the esophagus that produce and release fluids like mucus)

After you receive an esophageal cancer diagnosis, your doctor will need to determine the type, as well as the stage. Both types of esophageal cancer are broken up into five stages (0, 1, 2, 3, and 4).

“Once you do get diagnosed, ask what’s the stage,” Dr. Stiles said. “Patients should never be afraid to push doctors and say, ‘What is my stage? What are the treatment options at my stage? Do I have less invasive treatment options? Do I need multi-modality therapy?’ That means therapy with more than just surgery or more than just radiation with chemotherapy.”

Dr. Stiles stressed that patients with esophageal cancer must be advocates for their own disease and speak up about treatment concerns, and what other treatment options or routes may be available in their situation.

Getting a diagnosis of metastatic esophageal cancer means that the cancer has spread to distant parts of the body.

Esophageal Cancer Surgery: What to Expect

“This is the esophageal cancer that started in the esophagus and spread to other organs,” Dr. Pintova said. “In general, that type of stage is not curable but it is treatable.

“The goal of treatment is to help people live longer and better, of course balancing that very carefully with the potential side effects of the treatment,” she added.

In this stage, Dr. Pintova explained that a “systemic” treatment is often given which may include chemotherapy, immunotherapy, targeted therapies, or combination approaches.

“An oncologist has to analyze the cancer in a lot of detail. It’s no longer enough to know that it’s esophageal cancer. We really get into the nitty gritty in understanding the different proteins the cancer expresses, the genetics in the cancer itself, and then choose the best type of treatment,” she said.

The Importance of a Good Support System Amid Esophageal Cancer

Getting the news that you have cancer, especially a disease that is known for being difficult to treat like esophageal cancer, can be a very traumatic experience. When it comes to treating cancer, making sure the patient feels healthy mentally is part of the process as well and that may look different from patient to patient.

Esophageal cancer is more commonly diagnosed in men, who stereotypically have a more difficult time asking for help when they are struggling mentally.

“The esophageal cancer population is a unique population,” Dr. Raja Flores, a thoracic surgeon with Mount Sinai Health System, told SurvivorNet in an earlier in interview.

“Many of the people who develop esophageal cancer are men who are taking care of their families, who are proud, who are strong, who are self-reliant. So when they get faced with this diagnosis and this real vulnerability, they get depressed in a way that can make them crawl up in bed and not want to get out and that’s when the family comes into play.”

WATCH: Esophageal Cancer: Getting Emotional Support

Dr. Flores stressed the importance of having a good support system in place. Having close friends or family members there to rally for you when you feel the lowest can make a huge difference in how a patient handles treatment.

He also stressed the importance of having a solid doctor-patient relationship. Patients should feel comfortable bringing their concerns about their disease and treatment to their doctors, and that includes struggles they may be going through mentally.

“There’s a lot more connected with this disease than just your body getting harmed,” there’s your soul, your emotions. There’s a lot that goes with it,” Dr. Flores said.

“I think it’s very important to understand that about your patients so you can treat them appropriately. Once they know you see them and where they’re coming from, that’s when you get the, ‘Doc, I’ll do whatever you say, whatever you tell me.’ That’s when you can really get them to the best treatment that they need.”

There are also plenty of resources available for people living with cancer who feel like they’re struggling mentally, from traditional therapy to support groups to integrative medicine that may include treatment approaches like acupuncture or meditation. Check out SurvivorNet’s resources on mental health for cancer survivors.

Questions to Ask Your Doctor

If you have a cancer screening coming up or have recently had one, you may have questions you want answered. SurvivorNet’s proprietary AI tool “My Health Questions” is designed specifically for patients and caregivers.

WATCH: How One Cancer Survivor and Her Sister Used “My Health Questions” to Navigate Care

This powerful resource is embedded across the SurvivorNet website and delivers structured responses grounded in clinical guidelines and medically reviewed research to help people better understand their treatment options and feel more confident navigating care.

My Health Questions can also help patients come up with useful questions ahead of their next appointment.