Esophageal Cancer 101

Esophageal Cancer 101
Part 1
by Terry Ratner, RN, MFA

Part 2, 3, 4, 5 & 6 recently added

A day to remember

It was a Thursday, October 9—my birthday, when my husband, Michael, underwent an endoscopy procedure. For thirty long minutes, I sat in a waiting room, looking around at the starkly decorated walls, wondering how everything happened so fast. I tried to think positively about his recent symptoms: difficulty swallowing, a dry cough when drinking, and an early feeling of fullness while eating a meal. It might be attributed to a hiatal hernia, or narrowing of the esophagus, or perhaps it’s just nerve involvement. As a nurse, my imagination went wild.

I felt alone as I sat in the waiting room, listening to the hum of the air-conditioner and the conversation between two receptionists about restaurants and dating. The doctor had squeezed our appointment in during his lunch hour. That was my second hint that something was very wrong. I wondered what all the hurry was about. I tried to stay calm, but my stomach felt skittish, light, like it was being forced up to my neck and then down into my chest cavity.

A nurse came out to the waiting room. “You can come back now, Mrs. Ratner,” she said without looking up at me. “Your husband’s back in recovery.” I asked her how it went and suddenly this friendly preop nurse didn’t want to talk. “The doctor will be out shortly to explain his findings,” she said.

The Diagnosis

“Your husband has a 2.5 cm tumor at the junction of the stomach and the esophagus. I sent several biopsies to pathology. I believe your husband has adenocarcinoma.”

Being a nurse, it wasn’t necessary for any further explanation to understand the doctor was saying the unspeakable—telling me my husband has cancer, a fast growing cancer in the esophagus. My head started to spin and my legs felt like rubber as I tried to keep them from shifting side to side.

“Maybe you need to sit down and discuss this,” I replied as I stared at the doctor’s white coat focusing on his last name, embroidered in black thread above the pocket. I glanced at my husband’s face; his eyes were closed and he looked relaxed for the first time since his symptoms began to surface—six days ago. His body lay hidden under a cream-colored blanket and I wondered if he heard the word, “cancer.” I needed to let him rest for a while and not worry about anything, as there would be plenty of time to agonize in the weeks to come.

The talk

The gastroenterologist had biopsied enough tissue from the tumor site to feel confident about his diagnosis of cancer. “The pathology report will be here in a couple of days,” he told me, giving me some hope that he might be mistaken.

“This is not a good time,” came out of my mouth as I began to sob. “There never is a good time for this type of diagnosis,” he told me with compassionate eyes. I must have asked him three times, “What is the size of the tumor?” His response was a number I won’t likely forget—2.5 centimeters.

I lived with a secret for the weekend—Michael had esophageal cancer. It was one of those secrets I chose to keep to myself until we had a definitive diagnosis. We played word games Saturday and Sunday, never once uttering the unspeakable word—cancer. Our lips formed the words tumor, swallowing disorder, and hiatus hernia, but we shied away from the ‘C’ word.

The pathology report came back on a Monday. When the gastroenterologist phoned me at home, I already knew what he was about to say. Our life, as we knew it, was about to change.