Health Alert:

Starting Wednesday, Dec. 20, patients, visitors, and staff must wear a mask when entering a UPMC facility.

David Leech – Esophageal Cancer Patient Story

David Leech and his wife Gladys.

David Leech sat down for dinner one Friday night in May 2022. During his meal, he started having chest pains. A stress test and echocardiogram confirmed the 83-year-old wasn’t having a heart attack, but the tests didn’t reveal the cause of his pain.

That evening marked the start of months of appointments with specialists and countless tests. Plus dramatic weight loss and a steady decline in David’s health. “I was having a harder time swallowing, and it just got worse,” says David.

Initial tests ruled out a hiatal hernia. In late June, the Butler resident received a diagnosis of Barrett’s esophagus, a precancerous condition caused by repeated exposure to acid reflux. “The doctor prescribed some medicine and told us to come back in a few years,” says his wife Gladys.

Finding a Cancerous Growth

David’s pain and weight loss soon worsened. He underwent testing to rule out gallbladder problems, but the results spotted a growth low in David’s esophagus, near his stomach. Additional tests revealed it was cancerous.

The Leeches received a referral to UPMC Hillman Cancer Center at Butler Health System for care. “Thankfully, the oncologist there immediately referred us to Dr. Levy, who saw us the very next day at UPMC Passavant–McCandless,” says Gladys.

“David had a large obstructing esophageal cancer. By the time he came to us, he was in bad shape,” says Ryan Levy, MD, a thoracic surgeon with UPMC Hillman Cancer Center and chief of thoracic surgery at UPMC Passavant. “He was too weak to tolerate the standard treatment of chemotherapy and radiation to shrink the tumor before surgery.”

Before returning home, Dr. Levy inserted a feeding tube that gave David the critical nutrients he needed to shore up his strength before surgery. He then scheduled him for an esophagectomy, one of the most technically challenging, minimally invasive thoracic surgeries.

It involves removing part of the esophagus — the swallowing tube between the mouth and the stomach. Surgeons then recreate the esophagus using part of another organ, usually the stomach.
Every year, UPMC Passavant–McCandless performs nearly 1,300 thoracic surgeries, making it one of the region’s most experienced thoracic programs.

A Sudden Discovery During Surgery

David’s surgery took place at UPMC Passavant–McCandless on Nov. 7, 2022.

“As we began the process of starting to reconstruct David’s stomach into a new esophagus, we identified that part of the blood supply source we use for the new esophagus had been divided in one of his prior abdominal surgeries,” explains Dr. Levy. “David’s surgery was already very challenging in light of his age and poor health. But this was an unexpected and major anatomical problem that dramatically increased his risk.”

In less experienced hands, the discovery likely would have resulted in a need to end the surgery. The family decided to move forward with the procedure.

“I think our ability to pivot when unexpected challenges like this arise is what differentiates the quality of our care at UPMC Passavant,” notes Dr. Levy. “It’s a testament to the surgical team, the intensive care unit, the anesthesia team, and everyone else involved in high-risk cases like David’s.”

Dr. Levy rebuilt a smaller, shorter esophagus for David. Released from the hospital within one week, he was eating soft foods by mid-December. “His family had their husband and father back — just in time for Christmas,” says Dr. Levy.

“I am doing great — something none of us ever expected,” says David. “That’s all thanks to Dr. Levy and the amazing care I received at UPMC Passavant.”