Always Seek Multiple Opinions
- Sam Kelley, 76, was originally told he had no options after receiving his esophageal cancer diagnosis in 2009. But after seeking a second opinion, he was involved in a clinical trail and achieved the cancer-free status he still holds today.
- Esophageal cancer can be treated if caught early. The common symptoms like difficulty swallowing, weight loss and heartburn can often mimic other diseases, so it's important to bring any changes to your body up with your doctor.
- One of the greatest cancer researchers of our time tells SurvivorNet that people should get "multiple" opinions following a cancer diagnosis.
Maine resident Kelley, 76, was diagnosed with stage four esophageal cancer in 2009 after seeing a doctor with concerns about a sore throat and some acid reflux. And that initial diagnosis came with a grim prognosis.
Read More"They weren't saying we can fix this," Kelley said. "They said we have a possible solution. So, there was no certainty to it at all, but at least it was another opinion."
The ensuing treatment path for Kelley was rough, but it worked. He had chemotherapy and a surgery to remove part of his esophagus and stomach followed by more chemotherapy. In 2014, Kelley reached the five-year mark and was declared cancer-free. Today, he’s feeling "wonderful" and playing as many rounds of golf as he can.
"I'm 76, I feel very good, I play a lot of golf," he said. "And the really wonderful thing is because they removed a lot of my stomach, I can eat only a tiny amount of food. As a result, I lost about 50 to 60 pounds, which I needed to do."
Understanding Esophageal Cancer
The esophagus is a tube that goes from the throat to the stomach and plays an important role in your digestive system. When cancerous cells form inside the tissues of this organ, you have esophageal cancer. Overall, this cancer is rare, often difficult to diagnose and more common in American men. Risk factors for esophageal cancer include smoking, alcohol consumption, acid reflux disease and obesity.
Some people confuse esophageal cancer with throat cancer, but they are, in fact, different. The cause of most esophageal cancers is unknown though some risk factors like tobacco use can increase the likelihood of developing this cancer but human papillomavirus, a sexually transmitted virus also known as HPV, is a known cause of throat cancer. Treatment options for esophageal cancer include surgery, radiation, chemotherapy and immunotherapy.
Treatment Options for Esophageal Cancer
In a previous conversation about treating esophageal cancer, Dr. Raja Flores, chair of thoracic surgery at Mount Sinai School of Medicine, told SurvivorNet the disease is often diagnosed in the later stages meaning it has already spread to distant parts of the body.
"Of [all the cases diagnosed in the U.S. per year], only about 1,000 get surgery, because the majority of them are identified at such a late stage," he said.
Dr. Brendon Stiles, chief of thoracic surgery at Montefiore Medical Center, previously shared his expertise on this disease with SurvivorNet.
"We know that esophageal cancer is a tough one, it's one of the cancers with one of the lowest cure rates out there," he said. "But like many cancers, if we find it early, we can often treat it effectively. Either with surgery, or surgery and chemotherapy surgery, chemotherapy and radiation sometimes. My message to patients is the same as it is for most cancers, try to get diagnosed early."
Esophageal Cancer: Signs to Look Out For
But why is it often diagnosed so late? One reason could be that its symptoms weight loss, difficulty swallowing and heartburn often mimic that of other diseases, according to Dr. Stiles. Things like heartburn are generally not cause for any serious concern, but it's important to communicate any issues with your doctor. The more proactive you are about your health, the more likely you are to have an early diagnosis if something serious were to arise.
The Importance of Getting a Second Opinion
After receiving a cancer diagnosis, it’s important to remember that you can, and should, talk to other cancer specialists about your disease.
"If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care," National Cancer Institute Chief of Surgery Steven Rosenberg told us in a previous interview. "Because finding a doctor who is up to the latest of information is important."
RELATED: Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options. Also, in some instances the specific course of treatment is not clear cut. That's even more reason why understanding the potential approaches to your disease is crucial.
At the National Cancer Institute, there is a patient referral service that will "guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments," Rosenberg says.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. "So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility," Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn't listening to you, or isn't giving you good advice
- You have trouble understanding your doctor
- You don't like the treatment your doctor is recommending, or you're worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn't improving on your current treatment
Be Pushy, Be Your Own Advocate, Says Leading Expert
Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
Contributing: Marisa Sullivan
Learn more about SurvivorNet's rigorous medical review process.