Esophageal Cancer: "You Don't Have to Go Through It Alone"

As a teenager, Rick Megaro had heartburn a lot. He managed it with over-the-counter medications, but it always came back. He just figured he would have to live with it.

When he was 28, Rick began to have difficulty swallowing, and made an appointment with his doctor.

“He figured I was eating too fast, and advised me to slow down my eating and cut my food into smaller bites,” remembers Rick. “A few years later, I had a lot of trouble eating spaghetti, and I knew something was not right. I began eating liquid and soft foods to compensate for my swallowing issues and lost 25 pounds. My wife finally convinced me to go see a doctor.”

Rick Megaro ready for a ride

Rick came to Penn Medicine where he was examined by Penn physician Robert Cato, MD. Dr. Cato ordered an upper GI test and barium swallow – both diagnostic GI tests.

An endoscopy with Penn gastroenterologist Michael Kochman, MD, revealed Rick had stage 3 esophageal cancer (cancer was found in his lymph nodes). Rick was only 30.

“I was married with young kids at the time,” says Rick. “It was really a shock for all of us and I was scared to death”.

About Esophageal Cancer

Esophageal cancer is cancer that develops within the lining of the esophagus, the muscular tube through which food passes from the mouth to the stomach.

There are two types of esophageal cancer:

• Squamous cell carcinoma: Cancer that begins in the flat skin-like cells lining the esophagus.
• Adenocarcinoma: Cancer that begins in the intestinal-type cells that make and release mucus and other fluids.

Researchers believe chronic irritation of the esophagus, like years of heartburn as was the case with Rick, may affect esophageal tissue and put some people at higher risk for developing esophageal cancer.

Barrett’s esophagus can also increase a person’s chance of developing esophageal cancer.
Barrett’s esophagus is a condition in which the lining of the esophagus is damaged by stomach acid, and cells within the lining are replaced by cells normally found lower in the GI tract.

Life After an Esophageal Cancer Diagnosis

Rick had an esophagectomy, as well as lymph nodes removed, to remove the cancer.

An esophagectomy is the most common form of surgery for patients with esophageal cancer. In this procedure, the part of the esophagus affected by cancer is removed. The healthy part of the esophagus is then connected to the stomach. Lymph nodes near the esophagus are also removed and examined for cancer. If the esophagus is blocked by a tumor, an expandable stent, or tube, may be placed prior to surgery to help keep the esophagus open to improve nutritional status, or after surgery for palliation.

Rick says: “After surgery, I had six weeks of chemotherapy, and six weeks of radiation. I was supposed to have a second round of 6 weeks of chemotherapy but my white blood count did not recover and my oncologist, David Vaughn, MD, thought I had enough. It took a good year to start eating normal foods again and adapt to the physical changes my body went through after surgery.”

Like many patients who have had esophagectomies, Rick had to re-learn how to eat and manage uncomfortable gastrointestinal side effects while trying to regain his health.

“The Esophagectomy Support Group at Penn really helped me adjust and relate to others going through the same side effects I was experiencing,” says Rick.

The support group meets quarterly at the Abramson Cancer Center of The University of Pennsylvania. Rick still goes to the support group meetings today after more than 16 years and has made many wonderful friends and connections.

Rick says, “The support group is run by the best nurses on the planet and is supported by a complete staff of doctors and medical professionals that help the patient from surgery to recovery. It is a wonderful place for patients, families, caregivers and survivors to talk with each other and share the experiences they all go through. It is so comforting knowing that you are not alone through this experience.”

The support group is also reaching out to patients before their surgery so they know what to expect and this helps relieve their fears and anxiety.

“If someone is going through their cancer treatment or someone that is scheduled to have an esophagectomy, it’s important to come out to these meetings and listen to other people who have been through it,” says Rick. “Being a part of a group of people who have been through this can relieve a lot of anxiety and worries, which is really important because having a good attitude is a big part of the recovery process.”

Now, 16+ years after his diagnosis and surgery, Rick gets an endoscopy every year and continues to enjoy a healthy and active lifestyle.

“If you have esophageal cancer, you don’t have to go through it alone,” says Rick.

For more information about the Esophagectomy Support Group at Penn, visit their Facebook page.