Clinical Conditions & Program Offerings
Tumors of the Gastrointestinal Tract
Tumors of the gastrointestinal tract include several types of cancers including esophageal, gastric (stomach), small bowel, colon and rectal.
Esophageal cancer has become more prevalent in the United States. The tumor frequently affects the lower part of the esophagus and upper stomach. A very aggressive treatment approach of combining chemotherapy and radiation (neo-adjuvant therapy) followed by radical surgery has recently shown great promise, drastically improving survival rates from this life-threatening cancer. The multi-disciplinary oncology team at The Institute for Cancer Care includes medical and radiation oncologists, and has significant experience in treating esophageal cancer with neo-adjuvant therapy and surgical treatment with excellent results.
Gastric cancer is another life-threatening tumor of the gastrointestinal tract. As in other cancers, the results depend on the stage of the tumor when it is found. A combination of surgery, radiation therapy and chemotherapy is the standard treatment in the United States; however, surgeons in Japan have achieved excellent results curing patients with gastric cancer with surgery only. They perform extensive removal of the lymph nodes along with the stomach, a procedure called lymphadenectomy. Dr. Gushchin studied this operation extensively and learned how to perform the procedure safely and effectively through a fellowship study in Tokyo, Japan. Mercy’s surgical oncology team offers this leading-edge surgery as the best treatment for gastric cancer.
Small bowel tumors are rare and difficult to diagnose because the middle portion of the gastrointestinal tract is not easily accessible to conventional tests. Today, new technologies such as capsule endoscopy and CT enteroclysis discover small bowel tumors more frequently in patients with vague abdominal symptoms and obscure gastrointestinal bleeding. In close collaboration with regional gastroenterologists, Mercy’s surgical oncology team established a referral center for these uncommon tumors. A prompt work-up and treatment at earlier stages may lead to better treatment results and longer patient survival from these rare but complex cancers.
Colon and rectal cancers are among the most common malignancies both in men and women. Substantial progress in treatments of these tumors has been made in the last decade. A combination of surgery, chemotherapy and radiation is tailored to the particular patient in order to maximize the treatment effect and minimize side effects whenever possible. Thus, a combination of radiation and chemotherapy given before surgery frequently allows the surgeon to perform sphincter-preserving rectal resections for advanced rectal cancer, sparing the patient from a permanent colostomy (a bag). Mercy’s surgical oncologists work closely with the multi-disciplinary cancer team to achieve the best results for each patient.
Colon and rectal cancers frequently spread to the liver. Resection of the tumor, when possible, is the optimal treatment for these tumors. See liver tumors.
Some cancers of colon and rectum run in families. These familial tumor syndromes may also manifest as cancers in other organs such as the uterus, ovaries, and prostate. Mercy’s Center for Prevention and Research provides a full-time medical geneticist, who works in concert with the physicians of Surgical Oncology to help diagnose familial syndromes and select the best treatment and surveillance/screening plan for the patient and his or her family. With knowledge about the particular tumor syndrome it is possible to intervene before the cancer develops.
Palliative Surgery can be performed in the case of an advanced, late-stage gastrointestinal cancer diagnosis. Palliative surgery is performed to relieve symptoms and reduce pain in cases where the tumor has already spread extensively and is difficult to remove or if the patient is too ill to tolerate more aggressive surgery. Palliative surgery may effectively relieve unbearable symptoms such as pain, intestinal or bile duct obstruction by creating a bypass around the tumor. Performing these operations laparoscopically makes the recovery faster and the patients may resume their treatments sooner or simply spend their valuable time among the relatives and friends outside the hospital.
Other clinical conditions managed by Surgical Oncology at Mercy:
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