“From day one he was committed to doing everything he could to heal,” says August. “Also, and this is purely my own observation, postmen are among the patients I’ve had who recover most quickly from surgery. Maybe it’s because they’re on their feet and active all day long. To stay with this work, even in the worst weather, you have to enjoy it. I’ve noticed these folks just want to get back to work.” Keeley’s surgery was performed in January 2015 at Robert Wood Johnson University Hospital. The four-hour procedure is like a surgical P atrick Keeley learned more about his cancer by connecting with others through social media. “We became more hopeful, and it helped to know we weren’t alone,” he says. With the transhiatal approach, we stay out of the chest, limiting pulmonary complications. The same risk factors for lung disease are present in esophageal cancer — smoking and drinking alcohol. Therefore, many patients requiring esophagectomy don’t have great lungs.” Keeley is not a smoker and has only an occasional beer or glass of wine. At many medical centers, a single surgeon performs transhiatal esophagectomy. However, at Rutgers Cancer Institute, August does the procedure along with John Langenfeld, MD, co-director of the Lung Cancer/Thoracic Oncology Program at Rutgers Cancer Institute and associate professor of surgery at Rutgers Robert Wood Johnson Medical School. “We’ve operated together for almost 20 years with great outcomes,” says Dr. Langenfeld. “Our approach offers the benefit of two surgeons with expertise in both the chest and abdomen,” adds August. “We’ve long been the highest-volume team in the state and are proud of our record of success.” Through a Facebook group, Keeley learned more about his cancer and connected with others coping with the disease. “We became more hopeful, and it helped to know we weren’t alone,” he says. August too felt optimistic that Keeley would come through well. TOP R IGHT P HOTO By: JO H N O’BOyLe “O ur approach offers the benefit of two surgeons with expertise in both the chest and abdomen,”says David August, MD (top), interim chief of the Division of Surgical Oncology and chief of the Section of Gastrointestinal Surgery, who performed Keeley’s transhiatal esophagectomy along with John Langenfeld, MD, codirector of the Lung Cancer/Thoracic Oncology Program (bottom). “We’ve long been the highest-volume team in the state and are proud of our record of success.” symphony. While August frees up the stomach through an abdominal incision, Langenfeld operates through the neck, cutting the esophagus and leaving a small portion in the throat. The esophagus is pulled down through the chest into the abdomen, passing through the hiaBOT TOM R IGHT P HOTO By: N ICK ROMAN eN KO Summer 2017 I Cancer Connection I 21