Esophageal Cancer: Ken Light's story

Ken Light had come to know OhioHealth Riverside Methodist Hospital inside and out as a facilities worker there for the past 34 years. Yet it was when he learned he had esophageal cancer that he got an altogether different look inside the hospital.

“It’s the best hospital there ever was,” said the 54-year-old husband and father of three. “The work of the doctors – their professionalism and what they are able to do, and the technology they have available to them. I’m glad I came here.”

The shift from associate to patient at Riverside Methodist Hospital began for Light in the summer of 2009. Self-described as a “pretty heavy fellow,” he was having difficulty swallowing and in less than six months had dropped 150 pounds.

“Even though I was still going to work, I was getting weaker by the day. It got to the point where I couldn’t even drink water,” he recalled. “I didn’t have a family doctor, so I got an appointment at the Family Practice Center here on campus. They did lots of tests and then sent me straight over to endoscopy at the main hospital.”

Light was officially diagnosed with a form of esophageal cancer called adenocarcinoma in August 2009, and a team of doctors at Riverside Methodist took over his care. Keith Nichols, MD, and Steven Duff, MD, were his surgeons. Brent Behrens, MD, was his medical oncologist, and Mark Crnkovich, MD, was his radiation oncologist.

“I remember Dr. Behrens telling me, ‘We’re going to throw the book at you,’” Light said.

“The book,” if you will, was neoadjuvant therapy – chemotherapy and radiation therapy, followed by a transhiatal esophagectomy, followed by more chemotherapy.

“The literature shows now that the better the response patients have to neoadjuvant therapy, the better the chances of survival,” Dr. Nichols said. “And Ken had a good response.”

Developed about 10 years ago, neoadjuvant therapy is an approach often used in treating patients with tumors that have deeply penetrated the esophagus and lymph nodes involved (stage II or III). The therapy does two things: It attacks microscopic malignant cells, and it helps shrink the tumor. It also sterilizes the operative field, to some degree, Dr. Nichols said.

“Nodal malignancy does not preclude a curative re-section, provided these nodes are not outside the surgical field,” Dr. Nichols said. “That’s why we stage people very carefully.”

Staging involves an upper endoscopy, followed by an endoscopic ultrasound for determining how deeply the tumor is penetrating the esophagus. In addition, a CAT scan of the chest and abdomen reveals the extent of the disease locally and any evidence of distant disease. A PET scan also helps determine the extent of the disease and identifies any distant metastases not typically found by a regular CAT scan.

Once physicians staged his cancer, Light received a standard protocol of chemotherapy and radiation therapy over a six-week period. He then was given six more weeks to recover – long enough to reduce any inflammation and build back the strength he would need for surgery.

In January 2010, Drs. Nichols and Duff removed two thirds of his esophagus and a third of his stomach and with the remainder of his stomach, created a gastric tube that connected to his collar bone. (The procedure decreases the capacity of a patient’s gastric reservoir by 50 to 70 percent.) More chemotherapy followed the surgery.

Two years later, Light continues to have follow-up testing every six months and shows no evidence of the disease. He went back to work at Riverside Methodist in September 2010, building his way back to full-time status with no limitations.

He has had to make a few adjustments – like eating smaller meals more frequently and waiting several hours afterward before going to bed. He also doesn’t take anything for granted anymore.

“You can be here today and gone tomorrow,” Light said. “Knowing the odds, I should never have lived through this one. I thank God every day that through the doctors, I was able to be healed. It was a total miracle.”

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