the Staten Island Post Office, where he worked for 19 years, to the Lakehurst Post Office. He and his fiancée Linda Mancini, a ‘Jersey girl,’ bought their dream home, complete with gardens, an in-ground pool, and a Tiki bar. “I like to take a dip after work on hot days,” says Keeley. “We sit by the pool, putter in the garden and I do some woodworking. It’s relaxing.” The only sign that something was amiss was frequent, persistent diarrhea, which began suddenly. Strong and fit from walking his 4-mile postal route every day, Keeley hadn’t noticed any lack of energy, but this ‘bug’ he’d picked up was inconvenient and uncomfortable, forcing him to make frequent bathroom stops. “I learned the location of every men’s room in every community center along my route,” he observed. He saw a gastroenterologist, who did a colonoscopy and other tests. When the results were normal, the physician suggested doing an endoscopy to examine the upper digestive system. “He didn’t see how my upper GI tract could be the cause of my problem, which was at the ‘other end,’ so to speak,” says Keeley. “But he wanted to check it out.” “I’m fortunate to have started this process with a super-careful 1970s, only about 5 percent of patients survived at least five years after being diagnosed. Today, some 20 percent survive beyond five years according to the American Cancer Society. The fiveyear survival rate of people with esophageal cancer that has not spread beyond the esophagus is about 40 percent, according to the American A pproaching the holiday season in 2014, Keeley showed no signs of serious illness. The native New yorker had relocated to Manchester, New Jersey, 11 years ago, transferring from P atrick Keeley and fiancée Linda Mancini in Association for Thoracic Surgery. Additional tests revealed that Keeley’s cancer was contained within the esophagus. He was referred to Rutgers Cancer Institute of New Jersey for further treatment. In late November he met with David August, MD, interim chief of the Division of Surgical Oncology and chief of the Section of Gastrointestinal Surgery. “Because of the early nature of his cancer, it’s not surprising he was asymptomatic,” says Dr. August. “One of the difficulties of esophageal cancer is that symptoms often don’t show up until it’s advanced.” August told Keeley he’d need an esophagectomy: surgery to remove the esophagus. He planned to do a transhiatal esophagectomy, where surgeons operate through small incisions in the throat and abdomen, rather than opening the chest. “There are a number of ways to do an esophagectomy,” explains August, who is also a professor of surgery at Rutgers Robert Wood Johnson Medical School. “Some involve opening the chest, some do not. their favorite backyard spot. doctor who did a test others might not think of,” he notes. After the endoscopy, the gastroenterologist showed him a suspicious spot on the images. He asked the couple to come to his office first thing the next morning. That’s when they learned Keeley had esophageal cancer. Contemplating his frightening diagnosis, Keeley worried how the news would affect his mother and adult son, as well as Mancini’s two grown children. Keeley’s father died of prostate cancer at 62, causing the family tremendous grief. His son’s mother (Keeley’s ex-wife) died of multiple myeloma almost a year ago to the day. “Losing his mom was devastating,” says Keeley. “Now he worried about losing me too.” Fortunately for Keeley, improved treatments have boosted survival rates. Almost 20,000 new cases of esophageal cancer are diagnosed every year, many more in men than in women. During the 1960s and 20 I Cancer Connection I Summer 2017 P HOTOS By: N ICK ROMAN eN KO