Three nights after two thirds of her esophagus and one third of her stomach were surgically removed and then reattached last year, Betty Durso went home to Geyserville, California.
Three months later, she went on an 11-mile hike in the eastern Sierras at 10,000 feet elevation.
The minimally invasive esophageal cancer surgery at Kaiser Permanente Oakland Medical Center, after which she was able to begin eating soft foods right away, is a breakthrough for what has historically been a brutal post-surgery recovery.
In Durso’s mind, the real post-surgery test was getting back on her road bike.
“When I got back on the bike for the first time, I was able to do 18 or 19 miles, including climbs,” said the 68-year-old Durso who underwent the surgery in February of 2024. “That was around the same time I did the hike. I was giddy with delight that I was able to do the things I love to do.”
According to her thoracic surgeon, Jeffrey Velotta, MD, FACS, the 3-hour minimally invasive procedure was perfected over the last several years with his partners in Oakland.
Performed outside of Kaiser Permanente, the surgery can still take up to 8 hours and involves open chest and abdominal incisions with patients staying in the hospital for at least 2 weeks afterward. They would then go home with a feeding tube and take 6 months to recover.
Betty Durso was able to ride her bike 19 miles just 3 months after surgery, the kind of recovery that was out of the question just a few years ago.
“I did my research before this surgery and asked a lot of questions,” said Durso, who was preparing for the worst after surviving chemotherapy and radiation. “I asked Dr. Velotta how many nights I would be in the hospital because I had read it could be long, like 2 weeks, and he said 2 or 3 nights at the most.”
Dr. Velotta is a surgical leader in the esophageal cancer program at Kaiser Permanente in Northern California and assistant professor in the UCSF Department of Surgery.
“This is a Kaiser Permanente technique that we have perfected here, and we are teaching others to do it,” said Dr. Velotta, who also is a clinical professor in the Department of Clinical Science at the Kaiser Permanente Bernard J. Tyson School of Medicine in Pasadena. “No one else outside of Kaiser is doing this, but we hope to change that.”
Dr. Velotta likes to talk about the technique that improves esophageal cancer patients’ quality of life and the data he has collected to prove it. But what he doesn’t advertise is his humanity.
Not only did Dr. Velotta deliver what he said he would in terms of rebuilding her stomach and esophagus, a short recovery, and a better quality of life, he also took the time to listen, answer all her questions, and check up on her after the surgery.
No one else outside of Kaiser is doing this, but we hope to change that.
— Jeffrey Velotta, MD
On one typical day leading up to her surgery, Durso posed 13 questions in an email to Dr. Velotta and “he answered every single question I had.”
“All my friends said they couldn’t believe I had a surgeon who made himself so available at all times, promptly answering my multitude of questions,” she said. “We probably had 50 email exchanges. When I went home, he was calling or texting me every morning for 2 weeks. I felt like I hit the surgeon jackpot.”
Esophageal cancer is very aggressive, explained Dr. Velotta, and if you don’t have the surgery, “you may have 3 to 6 months to live.” Even with the surgery, 5% to 10% of patients may die within 3 months, and there is a 30% to 50% chance of having a complication, he said.
Then there are people like Betty Durso.
“Now I’m back up to riding 45 miles,” she said. “Getting cancer was a complete shock to me. This was the first time I’d ever been hospitalized, and the first time I’d ever had surgery, so I was nervous. I was unsure if I’d ever get on my bike again. I’ve been bicycling for 40 years. Thanks to Dr. Velotta and all the extraordinary care from Kaiser, I can once again lead an active life.”
