Gastrointestinal Cancer Program

Gastrointestinal Cancer Program

Members of Our Team

Darius Desai, MD 
St. Luke's Cancer Care Associates

Roderick Quiros, MD 
St. Luke's Cancer Care Associates

S. Asim Ali, MD 
St. Luke's Hematology Oncology Specialists

 

Grace Fan, MD

Grace Fan, MD 
Advanced Radiation
Oncology Associates

Daniel Eyvazzadeh, MD

Daniel Eyvazzadeh, MD 
Eyvazzadeh & Reilly
Colon & Rectal Center

Anna Niewiarowska, MD

Anna Niewiarowska, MD 
VITA Medical
Associates, PC

Tests

Sentinel Lymph Node Biopsy (SLNB) is a nuclear medicine and surgical procedure that involves injecting dye around a tumor to identify a single lymph node at risk for the spread of cancer. St. Luke's surgical oncologists perform SLNB for colon and gastric cancers.

P.E.T./CT is a powerful combination of the Positron Emission Tomography (P.E.T.) and Computed Tomography (CT) technologies used for the diagnosis and treatment of cancer. In one exam using one system, P.E.T./CT produces images of the patient's anatomy, while looking at chemical and physiological changes in the body.

Magnetic Resonance Imaging (MRI) has proven useful in determining if tissue is cancerous or non-cancerous. MRI also may be used to plan surgery or help establish the order that treatments are given.

Interventional Radiology procedures, such as CT scan-guided biopsy and the insertion of hepatic stents (a mold insert that keeps a liver implant in place), are minimally invasive methods of diagnosing tumors.

Endoscopy is a small camera-system that is inserted through the esophagus to look at the interior of the gastrointestinal system.

Anorectal Manometry can be used to evaluate rectal function prior to surgery, helping to maximize gastrointestinal function and avoid colostomies.

Rectal Ultrasound is the standard for assessing rectal tumors to determine if radiation or chemotherapy is needed before surgery.

Octeoscans are nuclear medicine tests to detect some gastrointestinal tumors, including pancreatic and liver tumors.

Endoscopic Ultrasound uses an endoscope for visualizing the digestive tract in combination with ultrasound to record live images of what is seen on the endoscope. Biopsies may also be done with endoscopic ultrasound before surgery.

Treatments & Procedures

The treatment of gastrointestinal cancer depends on several factors, including the area of the tumor, the size of the tumor and the patient's age and health. Treatments include:

Surgical removal of solid gastrointestinal tumors: Surgery offers the best chance for a cure for solid gastrointestinal tumors and may be combined with other treatments including radiation and chemotherapy.

Photodynamic Therapy (PDT) is a procedure that treats or relieves the symptoms of esophageal cancer with a photosensitizing drug and a special laser light. PDT appears to shrink or destroy tumors by damaging blood vessels in the tumor, preventing the cancer from receiving necessary nutrients. PDT also may activate the immune system to attack the tumor cells.

The Whipple Procedure, also called pancreaticduodenectomy, is a surgical procedure for pancreatic cancer that generally offers the best chance for a cure. The procedure involves the removal of the gallbladder, common bile duct, part of the duodenum (a part of the small intestine), head of the pancreas and associated lymph nodes. In some cases, a portion of the stomach and the entire duodenum may be removed.

Colonic stenting is performed to open an obstruction in the colon from a tumor. This procedure allows for a full evaluation of the patient and preparation of the colon, which may prevent the need for colostomies in certain situations. The procedure also is performed to improve the quality of life for those who are not candidates for surgery.

Laparoscopic surgery is available to selected colon cancer, pancreas cancer patients; it diminishes recovery time without reducing the cure rate for colon and rectal cancers.

Laparoscopic liver resections may benefit patients with localized tumors. Tumors can originate in the liver itself or can present as metastatic disease.

Total mesenteric excisional surgery is the state-of-the-art treatment for rectal cancer. Mesenteric excision, with or without radiation therapy, allow the patient to have optional rectal function while maximizing the cure rate and dramatically reducing pelvic recurrences of rectal cancer.

Radiofrequency ablation/Microwave ablation is a treatment where a probe is placed into a liver tumor during surgery and microwaves heat the tumor to kill it. This procedure has the advantage of killing the tumor cells while limiting injury to the normal liver tissue.

Hepatic pumps allow for chemotherapy to be given directly to the liver through the hepatic artery. This requires the placement of a catheter into the main artery of the liver.

Chemotherapy is used to treat some gastrointestinal cancers after surgery. Occasionally, chemotherapy may be given before surgery. Chemotherapy drugs are most often given orally or through a needle in a vein and travel through the bloodstream to kill cancer cells throughout the body. Newer delivery methods target the tumor and include:

Intraperitoneal Hyperthermic Chemotherapy (IPHC) is an abdominal cancer treatment that combines heat and chemotherapy administered during surgery. The treatment may be used for select patients whose cancer has spread to the abdominal cavity from primary colon, appendix, gastric and ovarian tumors.

Radiation Therapy is used before or after surgery for certain gastrointestinal cancers. Radiation also may be used to control the disease and relieve the pain and discomfort of cancer that has spread or re-grown.

Sir-Spheres (selected internal radiation therapy) may be appropriate for patients with primary colorectal cancer that has spread to the liver and has failed to respond to chemotherapy. SIR-Spheres are microscopic, radioactive beads that help destroy tumors and are inserted directly into the liver artery that supplies the tumor using X-ray guidance.

Image-guided radiation therapy (IGRT) makes the tracking and targeting of tumors with radiation more accurate, as it addresses the problem of the patient's internal movement of critical structures and disease. IGRT is a robotically controlled “arm” that allows the radiation oncologist to counteract the patient's internal body movements and pinpoint the tumor site on a daily basis. This results in better outcomes as less healthy tissue is exposed to radiation and higher doses of radiation can be given to the tumor.

Interventional Radiology procedures include:

 - Chemoembolization allows for chemotherapy to be injected directly into the liver and the blood supply of the tumor. This often helps control the disabling symptoms that the tumor may be causing.
 - Alcohol injections are performed by a radiologist and can be used to kill cells in tumors that are inoperable.
 - TheraSphere is an FDA-approved outpatient treatment for inoperable liver cancer; it uses radioactive microscopic glass beads inserted directly into the liver's blood supply. The beads lodge inside the liver tumor and deliver high doses of radiation.

Why Choose St. Luke's

St. Luke's GI Cancer Program offers patients the best chance for success against their disease. Patients benefit from one-stop appointments with a core group of GI cancer experts who work together on a case-by-case basis to develop the most appropriate treatment plan.

St. Luke's treats the full spectrum of digestive cancers. Gastrointestinal cancers we treat include: