Esophageal Cancer Survivor
- Suffered from heartburn for many years before later learning she had Barrett’s esophagus (risk factor for cancer)
- Diagnosed with esophageal cancer at age 47
- Treated with chemotherapy, radiation, and surgery to remove most of her stomach and esophagus
When you’re a busy working woman in your mid-forties, there are a million things to do and worry about other than your own health. But when a nagging symptom becomes more than just an annoyance, most women, even the busiest, finally stop and listen to what their bodies are trying to tell them.
Brenda Carr of Wasilla, Alaska, is one of these women. Career minded and occupied with seeing her children and grandchildren, playing sports, and enjoying her life with her husband, John, she figured heartburn came with her busy schedule.
“I always had an issue with heartburn,” Brenda said, recalling it beginning during her pregnancies. But it never really went away. “I took Tums to deal with it. Then I took Pepcid-AC and other over-the-counter antacids,” she said. “I tried lots of things.”
In March 2010, Brenda realized she was rubbing and kneading her upper abdomen after she ate, trying to help her esophagus push her chewed food into her stomach. She decided it was time to see a doctor. She had an esophagogastroduodenoscopy (EGD), a diagnostic endoscopic procedure that allowed her doctor to see the upper part of her gastrointestinal tract and take a biopsy sample.
“To this day, I am very thankful that the doctor didn’t just dismiss my symptoms with a prescription-strength antacid and send me out the door for a few weeks,” she said.
At her follow-up appointment in April, Brenda learned she had a type of esophageal cancer called adenocarcinoma, which is aggressive and fast growing. She was 47 years old at the time.
Choices for Treatment
At her doctor’s recommendation, Brenda made an appointment to see a surgeon in Alaska. After introducing himself, Brenda said, “he told me that if he’d had to pick a cancer, he wouldn’t have picked this one.”
The surgeon told Brenda that the operation she needed to remove her cancer wouldn’t be easy or simple and would take six months to a year to recover from. Brenda asked for details about the procedure. “Without any compassion, he motioned with his hands that he would be splitting me from my breastbone to my belly button and would have to break some ribs on the side to be able to get to my esophagus!” she said.
Brenda, her husband, and her parents left the surgeon’s office never to return.
Compassionate Health Care
Brenda’s niece, Katie, and Katie’s husband, Abe, were medical students at the University of Washington (UW) School of Medicine at the time and told Brenda about Brant K. Oelschlager, MD, a UW Medicine surgeon who specializes in gastric and esophageal surgery.
Brenda was on the phone with Dr. Oelschlager’s scheduler and on a plane within a week for an appointment. At UW Medical Center, Brenda received an in-depth EGD. Her diagnosis was confirmed, and she learned that her cancer, located at the junction of the esophagus and stomach, was stage II or III, too advanced for surgery to work initially. She would have to have chemotherapy and radiation therapy first to shrink the tumor.
Brenda then saw Seattle Cancer Care Alliance (SCCA) medical oncologist Veena Shankaran, MD, who specializes in caring for patients with pancreatic and gastrointestinal cancers.
“Dr. Shankaran set the bar so high,” Brenda said. “From the moment she entered the room and introduced herself she had my attention. She was just so ‘real.’ Friendly, with a wonderful smile. I think that was the most important thing. She didn’t walk in somber and all serious. For someone who has a cancer diagnosis, a smile, especially early on, is something that helps to give you hope that all is not lost and that you can win.”
During her appointment with Dr. Shankaran, Brenda received a complete medical work-up, and they decided on a treatment plan.
“Dr. Shankaran said I could have chemotherapy and radiation up in Alaska. However, once I got home, the doctors there wanted to start the entire process over. They wouldn’t accept my records from SCCA, and the process of making appointments before treatment could start was going to take several weeks,” Brenda said.
She wasn’t willing to wait. Instead she worked directly with Dr. Shankaran to start the ball rolling to have treatment at SCCA. In mid-May Brenda returned to SCCA with her mother for treatment.
Life-Saving Treatment Begins
Brenda began treatment with six weeks of daily radiation therapy under the care of SCCA radiation oncologist Wui-Jin Koh, MD, and two rounds of chemotherapy four weeks apart with two drugs. Cisplatin was administered by infusion through a port in her chest over eight hours. Then Brenda was hooked up to a home infusion pump that administered fluorouracil (5-FU) continually for a week.
“I consider myself very lucky when it came to the side effects of both the chemo and the radiation,” Brenda said. “I was blessed with a very thick head of hair to start with. While I did lose some, it was just really thin.”
Fatigue was hard to deal with. One of her most severe side effects was mouth sores that occurred about a week after each round of chemotherapy. They lasted about week and went away. A metallic taste in her mouth lasted for several months after treatment ended.
She spent more than two months in Seattle receiving treatment at SCCA, living at her niece’s house while her mother and children took two-week intervals caring for her. John came down for the last two weeks of treatment and was there when she was unhooked for the last time from the home infusion unit. He stayed until she finished her radiation treatments and felt well enough to travel home on the Fourth of July.
“My family could help me during this time only because we were blessed with friends and family who donated their airline miles to us,” Brenda said. “I couldn't have done this without every single member of my immediate family, my extended family, and all of my friends,” she said.
In August, Brenda returned to Seattle and had surgery with Dr. Oelschlager to remove her esophagus and 25 percent of her stomach. The surgeon then used part of Brenda’s remaining stomach to create an esophagus and a little stomach for her. She was in the hospital for two weeks, “the longest two weeks of my life,” she said, “but what a fabulous facility and staff I was blessed with.”
She went home on September 1, in time to enjoy her grandson’s birthday, and she went back to work as an accountant for the Finance Department for Chugach Alaska Corporation half-days during the last week of September and full days starting in November. “It was quite the recovery,” Brenda said, “one I thought would never end.”
Although she went home with a feeding tube, which has long since been removed, Brenda can now eat anything she wants to, just not as much as she used to. “I feel like I eat all the time. It’s just literally a little bit at a time,” she said.
Brenda takes an acid-reducing medication daily. She finds it uncomfortable to lay flat on her back and sleeps at an incline.
“I am 5 foot 7 inches tall and weighed over 200 pounds before cancer,” Brenda said. “I was healthy and active. Now I can do most of the things I could prior to April 20, 2010—the day I was diagnosed. I weigh 165 pounds now; the 35-pound weight loss is my ‘half-full’ glass.”
“Cancer changes a person instantly,” Brenda said. “The moment you hear those words, ‘You have cancer,’ you will never be the same or ever be able to go back to the way it was before. I do my best to remember not to ever take little things for granted.”
September 2012 was her two-year cancer-free mark. Chance for recurrence drops significantly after the first two years.
“I am thankful for each of my doctors, each resident, medical student, all of them during the whole process from treatment to inpatient hospital care,” Brenda said. “UW and SCCA are the best team ever—and being a competitive team player, I know it takes a full team of 100 percent dedicated players to win the game, and I am going to win this game. I feel I had the No. 1 draft picks for players at UW and SCCA.”