Robotic Esophagectomy Offers Better Outcomes to Esophageal Cancer Patients

Like many people diagnosed with esophageal cancer, Todd Nierwinski wasn't showing any symptoms when he received his diagnosis. Because he has acid reflux, he had an endoscopy every three years to check his esophagus. But what was previously an inconvenience turned into a lifesaving procedure when Todd's doctor noticed a three-centimeter mass. Follow-up testing revealed that Todd had Stage Three esophageal cancer.

In the face of a cancer diagnosis, everyone needs a reason to fight; for Todd that was his family. With their support and encouragement, Todd was ready to tackle his diagnosis. "If it wasn't for them I wouldn't be here," Todd says. A Bel Air, Md., resident, Todd started treatment at the University of Maryland Upper Chesapeake Medical Center. There he met Dr. Philip J Nivatpumin, Medical Director of the Kaufman Cancer Center, who worked with Todd to determine the best course of treatment.

Less than a month after he received his diagnosis, Todd started radiation treatments five days a week, with chemotherapy once a week. Dr. Nivatpumin also recommended Todd speak with Shamus R. Carr, MD, Associate Chief of the Division of Thoracic Surgery and Director of Robotic Surgery at The University of Maryland Medical Center.

Dr. Carr thought that Todd was a good candidate for a robotic esophagectomy. Similar to an open esophagectomy, the procedure is performed to surgically remove the diseased portion of the esophagus. However, the use of a robotic platform lowers the risk of complications and boasts a shorter recovery time, as well as a quicker return to full activity.

Todd's entire family was in attendance when Dr. Carr explained the surgery. "He makes you feel so relaxed and comfortable," Todd says of Dr. Carr, who answered all his family's questions. With the support of his family and Dr. Carr, Todd knew he wanted to move forward with the surgery. "I wanted the cancer gone."

Todd completed his radiation treatments in April, and prepared for surgery on June 1. On Memorial Day weekend, with his surgery just a few days away, Todd and his wife headed to their daughter's house to attend a holiday party. To his surprise, Todd was greeted by more than 30 friends and family members, all wearing T-shirts that read, "No one fights alone."

A few days later, Todd had surgery to remove part of his esophagus. He and his family found the care team to be attentive and supportive. Unsure of what to expect, Todd was impressed with his recovery, saying, "I expected it to be way worse."

Dr. Carr explains, "Most patients who undergo an open esophagectomy spend two weeks or longer in the hospital." Todd was back home in seven days. Todd was also pleased to find that he never needed a feeding tube, and with family pushing him, he quickly graduated to a regular diet, focusing on eating smaller portions, more often. "I can't speak highly enough of Dr. Carr and Dr. Nivatpumin. They saved my life," Todd says.

Todd returns to the Kaufman Cancer Center at Upper Chesapeake Medical Center every three weeks for chemotherapy and will continue to do so indefinitely. Having the opportunity to receive treatment right in his neighborhood is one simple convenience that makes treatment "so much easier," he says. It also helps Todd's family, who take turns accompanying him.

To prepare for treatment, Todd started playing "Fight Song" by Rachel Platten, every day in the car. One day, his granddaughter was in the car, observing his motivational ritual. She went home and learned how to play the song on her flute, sending her grandfather a video, which he now watches before his treatments. As his family's T-shirts promised, Todd has never had to fight this battle alone.

And his message to others facing the decision whether to have the surgery: "If I can do it, you can do it!" he says, hoping to support others, the same way his family inspired him.