EmailEmail
PrintPrint
Patient's persistence got him a new esophagus at UPMC
Wednesday, June 02, 2010
Happy patient

Just days after a doctor at Ohio State University recommended that Michael Wright have his cancerous esophagus removed, Mr. Wright saw a segment on "60 Minutes" that would change his life.

In the segment, which aired Dec. 13, Blair A. Jobe, director of esophageal research at the Heart, Lung and Esophageal Surgery Institute at UPMC, described how he had treated an esophageal cancer patient by inserting an instrument through his mouth and removing the cancerous lining of his esophagus, which routes food to the stomach, and then using pig tissue to help regenerate a new, cancer-free lining.

After seeing the segment, Mr. Wright, a 54-year-old quality control officer from Columbus, Ohio, bombarded Dr. Jobe with e-mails, faxes and FedEx messages begging for a chance to have the novel treatment. Although he knew that removing part of his esophagus, known as an esophagectomy, was an option, it was one he resisted because it would limit the foods he could eat, and he wanted to keep enjoying the steak and chocolate he loves.

As it turned out, Mr. Wright, who had very early stage esophageal cancer and another kind of damage known as Barrett's esophagus, was just the patient Dr. Jobe was looking for, and on March 10, he became the second person in the world to undergo the pig tissue procedure.

Doctors removed about 6 inches of his esophageal lining and then put in the scaffolding tissue from a pig's bladder, known as the extracellular matrix. The treatment is so new, experts in the field are still not quite sure how it works. They think that the matrix has the ability to help the patient's own stem cells repopulate the esophagus and prevent scar tissue from forming, but more research is needed.

Mr. Wright said it has been a whirlwind experience. "I've lived 10 years in six months," he said.

Dr. Jobe and James Luketich, director of the Heart, Lung and Esophageal Surgery Institute at UPMC, said they are excited about the possibilities of the procedure and intend to start a clinical trial. But both were quick to point out that the treatment is still in the early stages and is appropriate only for certain patients.

"We have great concerns about applying this too widely and to the wrong patients," Dr. Luketich said.

If the cancer has spread past the lining, then just removing the lining will not cure the patient, and the cancer can spread to the lymph nodes, making the prognosis poor.

Doctors at the institute are working to develop several different procedures for treating various stages of esophageal disease, from laser therapy to heat to minimally invasive esophagectomy, a surgery that has only a 1 percent mortality rate.

Since esophageal cancer is one of the fastest growing cancers, with 9,000 to 16,000 new cases each year, these new procedures have taken on increasing importance, Dr. Luketich said.

Dr. Jobe put it this way: the institute needs a quiver of procedures, with different size arrows for different circumstances.

It seems they found just the right arrow for Mr. Wright.

Since the procedure, Mr. Wright has had some mild narrowing at the junction between the matrix and his natural esophagus, and so his esophagus has been dilated twice, but he is currently cancer-free. And though Mr. Wright said he has trouble eating dry bread, he is otherwise eating normally, and particularly enjoying the Hershey's Kisses he likes so much.

Katie Falloon: kfalloon@post-gazette.com or 412-263-1723.
Looking for more from the Post-Gazette? Join PG+, our members-only web site. You'll get exclusive sports content, opinion, financial information, discounts from retailers and restaurants, and more. Our introduction to PG+ gives you all the details.
First published on June 2, 2010 at 12:00 am
Featured Homes