This case involves a sixty-five-year-old Caucasian male and a delayed diagnosis of gastroesophageal reflex disease (GERD). At age 50, this patient began to have symptoms including chest pain, nocturnal cough, and shortness of breath. The patient had a 30-year history of smoking and daily alcohol consumption. His primary care physician did an entire cardiopulmonary work-up, including cardiac enzymes and EKG, to rule out myocardial infarction, as well as pulmonary function tests to rule-out lung pathology. The patient began experiencing swallowing difficulties with some non-specific symptoms of fever, weight loss, and general malaise. Barium swallow showed obstruction in the lower 1/3 of the esophagus. Biopsy confirmed the diagnosis of stage 4 esophageal adenocarcinoma. The lesion was too advanced for surgery and the patient was initiated on chemotherapy. Six months later, the patient expired.