Robert Mitchell

Mitchell describes Deloris, his wife of 50 years, as his rock. Deloris is also a Mayo Clinic patient.

There's a story about a man who, although the floodwaters are rising around him, refuses help in turn from the fire department, a rescue boat and a helicopter. He tells the Good Samaritans that he is trusting God to deliver him from the storm. He drowns, goes to Heaven and asks God, "Why didn't You rescue me?" God says, "I tried. I sent you the fire department, a boat and a helicopter."

One September afternoon in 2003, Harriett Grimsley, a nurse in radiation oncology at Mayo Clinic in Jacksonville, told that story to one of her patients and said to him, "I'm your helicopter." The Rev. Dr. Robert L. Mitchell had completed a physically arduous chemotherapy and radiation regimen. Weary from the ordeal, he was about to postpone the surgery necessary to finish his treatment. The pastor received the message of Grimsley's simple sermon and had the surgery. Today he is cancer free.

Mitchell, a Jacksonville native, is a longtime educator and presiding elder of the South Jacksonville District of the East Florida Conference of the African Methodist Episcopal Church. Early in 2003, he began having difficulty eating and swallowing. He came to Mayo Clinic to find out why.

After performing an endoscopic ultrasound, gastroenterologist Dr. Timothy Woodward told the reverend he had locally advanced esophageal cancer and that it needed to be treated immediately and aggressively.

Mitchell's oncologist, Dr. George Kim, discussed options, and Mitchell enrolled in a clinical trial that combined six weeks of continuous intravenous infusion chemotherapy with daily radiation followed by surgery.

"This is a curative therapy," Kim says. "It can be quite intense and, if not done properly, can have serious consequences. You're talking about depriving people of nutrients by interfering with their food intake and lowering their white blood count, making them susceptible to life-threatening infections. It's a long haul."

Mitchell remembers it as a "wilderness experience."

"The Lord is the strength of my life, of whom shall I be afraid? Wait on the Lord and be of good courage," Mitchell says, quoting Scripture from Psalm 27. "I would recite those verses over and over, especially in times of weakness." Mitchell became extremely weak, especially during the last week of radiation therapy. "That's when it really hit me," he says. "I could not walk on my own. I was in a wheelchair. I began to wonder if I was doing the right thing to suffer like this. It was not pain; it was weakness of the body. But with encouragement from my family and the Mayo doctors, praise be to God, I had the strength to make it through." With the first half of treatment behind him, Mitchell faced surgery. Surgeons have a six- to 10-week window of time following chemotherapy and radiation to perform an esophagectomy. They remove part of the esophagus and attach the stomach to the remaining portion.

Since chemotherapy damages both white and red blood cells, performing the surgery too early carries a higher risk of infection and anemia, says Mitchell's cardiothoracic surgeon, Dr. John Odell. But waiting too long can make the surgery more difficult.

After a follow-up endoscopy and magnetic resonance scan of the esophagus, there was no visible tumor. Mitchell hoped he could avoid the surgery — or at least put it off. "The three-modality approach is important for the best survival," Kim says. "We know that if we can bring a patient through chemotherapy, radiation and surgery, we have our best outcomes. That can be as high as 65 percent of patients cured."

If Mitchell didn't follow through with surgery, he risked the possibility that microscopic cancer cells remained and the cancer would reoccur. And because he was in a clinical trial, not completing it as prescribed would mean his results wouldn't help doctors trying to design better treatments.

With his surgical window of time running out, Mitchell and Deloris, his wife of 50 years, sat outside the clinic one day talking about postponing the operation. Grimsley saw the couple and told them the story of the rising floodwaters, convincing the reverend to talk with his doctors one more time.

"It's important not only to prescribe the therapy and deliver the therapy, but it's important to be there for the patient," says Dr. Craig Collie, Mitchell's radiation oncologist. "They need you to meet their needs — encouragement as well as the medical attention. There was a conference he wanted to go to that he goes to every year. I told him, 'It's very important if you want to go to the conference in the continuing years to continue with this protocol.'"

After that conversation, Mitchell scheduled surgery. He spent two weeks in the hospital recovering. "You really get the chance to assess yourself, to evaluate yourself, to determine what's important to you in your life," Mitchell says. "I love living. I love family and people who are close to me. I hear people say all the time, 'I'm going to retire so I can spend time with family.' I say to them, 'You spend time with them even though you are still working, because that's what's going to carry you through.'"

Mitchell was initially given about three months to live without treatment; now he's cancer free. Other than having to eat four to five small meals a day, he's had to make no lifestyle changes.

"There was something special about that medical team that I could relate to," Mitchell says. "I think that they gave me the very best care without wavering — even during those times when it was very difficult for anybody to work with me."

Kim points out that the patient is an important member of the team as well. "People think the medical profession cures them, and yes, we can," Kim says. "But we need our patients to help us do that."

(This story first appeared in the February 2005 issue of The Mayo Clinic Checkup, a complimentary newsletter available to anyone interested in the latest news from Mayo Clinic in Jacksonville, Fla.)