Download Michele Rifkin Is Determined To Spread The Word About

… July 7, 2015
Michele Rifkin Is Determined To Spread The Word About Esophageal Cancer
Normally a day reserved for breakfast
in bed and family fun, Mother’s Day
2014 for Michele Rifkin was, instead,
filled with darkness.
Fresh off six months of grueling
treatment for esophageal cancer,
Michele found herself back in the
hospital with a collapsed lung,
pneumonia and a blood clot. Pumped
full of pain meds that left her dazed,
hallucinating, catatonic and battling
severe depression, Michele had given
up.
“I was really in a bad state. It was the worst days of my life,” Michele says. “I just wanted to die.”
The story of how this normally vibrant and jubilant woman – with a loving husband of 31 years, four
beloved children, and a job at Trader Joe’s she adored – had sunk to such hopeless despair is a
cautionary tale that stretches back more than a decade.
Having long suffered from chronic heart burn, Michele was on a regimen of medications that kept her
symptoms at bay. As far as she was aware, as long as she continued to fill her prescriptions every three
months, she was perfectly healthy.
“I felt great because I was on heart burn medicine,” she says. “In the meantime, all this stuff was
billowing in my esophagus.”
Then, in early January 2014, a new symptom arose. Michele described it as choking, but lower in her
stomach. Her primary care physician examined her and referred her to Dr. Chad Stepke, a
gastroenterologist at Columbia St. Mary’s Gateway Medical Clinic, who performed an endoscopy and
colonoscopy.
The next day, Dr. Stepke called Michele and asked her to come in right away – and to bring her
husband.
“I knew something was obviously wrong,” Michele says. “But I thought it was the colon because I didn’t
know anyone with esophageal cancer. You don’t really hear much about it. But I had stage 3
esophageal cancer.”
While rare – accounting for only about one
percent of all cancers in the United States –
esophageal cancer has one of the lowest
survival rates. Even with advancements in
detection and treatment, the survival rate is
still approximately 20 percent (up from as
low as 5 percent 40 years ago) since it often
goes undetected for so long. Symptoms
typically don’t arise until the cancer has
become advanced.
The most common symptom to be on the
lookout for is trouble swallowing or even
choking on food. This will typically get worse
as the cancer grows and spreads, narrowing
the esophagus further. Pain while swallowing
is also fairly common. Some people complain
of pressure or burning in their chest – and, in
cases such as Michele’s, this is often
mistaken for heart burn and treated as such.
Other symptoms can include a chronic cough,
hoarseness, vomiting, hiccups, bone pain and
bleeding in the esophagus (which would
present as black stools). If you have any
combination of these symptoms, you should see your doctor for a thorough check-up.
For Michele, in addition to the esophageal cancer, Dr. Stepke found she had a disease called Barrett’s
esophagus, a serious condition related to gastroesophageal reflux disease (GERD) that increases one’s
risk for esophageal cancer. Essentially, Michele had been suffering from GERD for more than 10 years
but had been masking the heart burn (the primary symptom) with medication.
“Had I been scoped along the way – nothing is guaranteed – but they would have probably found the
Barrett’s and treated it, and I wouldn’t have gotten cancer.”
There was no time to dwell on what-ifs, though, and Michele immediately started a six-week course of
chemotherapy and radiation at Columbia St. Mary’s Cancer Center.
“We walked through those big glass doors at the Cancer Center and I said to my husband, ‘This is the
start of our new life,’ and we both started crying,” she says. “The first person that met me when I sat
down was Sue Luedcke, my nurse navigator. She was more than amazing. I was crying. I was mean. I
was angry. And she stood next to me at every appointment, every treatment. We turned out to be best
friends at the end.
“The nurse navigators are one of the best things Columbia St. Mary’s Cancer Center has. Everyone was
so warm and hopeful. They acted like I was the only patient in their life. I couldn’t have gotten through
this without Sue and those doctors.”
From late January to March, Michele
received radiation treatment five days a
week and chemotherapy once a week.
With her stage 3 tumor reduced to a
stage 1 – thanks to the excellent care
provided by her medical oncologist, Dr.
Varsha Shah, and radiation oncologist, Dr.
Craig Schulz – Michele was ready for
surgery. On April 18, she underwent an
esophagectomy, which involves removing
the lower two-thirds of the esophagus,
then cutting the stomach in half and using
the stomach lining to create a new
esophagus that attaches by the throat.
The remaining stomach is then
repositioned higher up in the chest to
accommodate the shorter esophagus.
It was shortly after returning home from
her surgery when things took a sudden
turn.
“I went home and I wasn’t getting any
better. I wanted to go to inpatient. I told
my husband to put me in hospice care. I
couldn’t handle it anymore,” she says. “I
was in so much pain I couldn’t breathe. I’d
lie on the couch for eight hours a day not knowing what I was doing. I was so depressed.”
Thankfully, her friends were there for her. They staged an intervention and a doctor friend helped her
scale back the pain medication. Slowly, she emerged from the fog.
“Without my friends and family, I’d be dead. Honestly.”
Today, Michele’s life is back to normal – well, as much as it can be. She has to be careful about what
she eats and how she sleeps, but she’s her old energetic self again. “I’m back at work 47 hours a week
and feeling phenomenal.”
She’s also taken on a new cause. She’s committed to helping raise awareness about esophageal cancer
and ensuring no one else has to be blindsided by this disease like she was.
“If you have any of those symptoms – heart burn, acid reflux, a cough, change in your throat or
stomach, anything – go to a gastroenterologist,” she says. “You need to get scoped. It only takes a
minute and it can save your life.”