Inova’s gastrointestinal cancer program specializes in the treatment of gastric, esophageal, pancreatic, liver, gallbladder, and intestinal cancers. Care is provided in a multidisciplinary clinic, meaning that multiple physicians are able to better coordinate care. Patients are seen by both a surgical oncologist and a medical oncologist at the same time in the same place.
Our Commitment to Innovation
Because our physicians are actively involved in cancer research, they are helping to develop new treatments to improve patient care in the future. Equally important, they are knowledgeable and skilled in incorporating new treatment options that may benefit patients today who are dealing with challenging cancers.
An example of the innovation put forth from Inova Gastrointestinal Multidisciplinary Clinic is the combination cytoreductive surgery/HIPEC treatment for patients with difficult-to-treat abdominal cavity cancers.
What to Expect
- The physicians screen every referral in advance; if additional critical studies are needed prior to the multidisciplinary consultation, they will be arranged by our team
- All patients are discussed in a multidisciplinary tumor conference the morning prior to their visit with a review of all pertinent radiologic studies and biopsy results (if applicable)
- The patients are seen by both the medical oncologist and the surgical oncologist on the same day and in the same office setting
- The recommendations are communicated to the referring physicians and further steps in care are facilitated by our patient care coordinator
Facts About Gastrointestinal Cancers
Esophageal cancer is cancer that develops in the esophagus, the muscular 10- to 13-inch tube that connects the throat to the stomach.
The esophagus is located just behind the trachea and allows food to enter the stomach for digestion. The wall of the esophagus is made up of several layers and cancers generally start from the inner layer and grow out.
Often there are no symptoms in the early stages of esophageal cancer. Symptoms do not appear until the disease is more advanced. The following are the most common symptoms of esophageal cancer. However, each individual may experience symptoms differently. Symptoms may include:
- Difficult or painful swallowing, known as dysphagia, is the most common symptom of esophageal cancer. Dysphagia gives a sensation of having food lodged in the chest.
- Pain in the throat or back, behind the breastbone or between the shoulder blades
- Severe weight loss due to the unintentional lack of not getting enough food
- Hoarseness or chronic cough that does not go away within two weeks
- Blood in stool or black-looking stools
What is liver cancer?
Liver cancer is cancer that starts in your liver. This is also called primary liver cancer. Primary liver cancer is not the same as cancer that started somewhere else in the body and then has spread (metastasized) to the liver. Cancer that starts in another organ, such as the colon, breast, or lung, and then spreads to the liver is called secondary liver cancer. Secondary liver cancer is more common in the U.S. than primary liver cancer. Cancer that has spread to the liver from somewhere else is treated like the original cancer. For instance, lung cancer that has spread to the liver is treated like lung cancer.
What types of cancer start in the liver?
The main types of primary liver cancer include:
Hepatocellular carcinoma. This is the most common liver cancer. It’s also called hepatoma. About 4 out of every 5 primary liver cancers are of this type. This type of cancer starts in the main liver cells called hepatocytes.
Intrahepatic cholangiocarcinoma. About 10–20% of all liver cancers are cholangiocarcinomas. These cancers start in the bile ducts. These are small tubes where bile leaves the liver and goes into the gallbladder and intestines during digestion. This type of cancer can also start in the bile ducts outside the liver.
Hepatoblastoma. This is a rare liver cancer often found in children.
Angiosarcoma. This is another uncommon form of liver cancer. It starts in blood vessels inside the liver.
Several types of non-cancerous (benign) tumors can also form in the liver. These include hemangiomas, hepatic adenomas, and focal nodular hyperplasia. These tumors don’t spread to other parts of the body. But they can still cause problems if they grow large enough.
Pancreatic cancer is the fourth most common cause of cancer deaths in men and women in the United States. It is a disease in which cancer cells are found in the tissue of the pancreas.
The following are the other most common symptoms of pancreatic cancer. However, each individual may experience symptoms differently. Symptoms may include:
- Pain in the upper abdomen or upper back
- Loss of appetite
- Weight loss
- Jaundice (yellow skin and eyes, and dark urine)
- Extreme tiredness
The symptoms of pancreatic cancer may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
Gallbladder cancer is often hard to find. That’s partly due to where the gallbladder is in the body and because many people don’t have symptoms in the early stages of the disease (when the cancer is small and hasn't spread).
In many cases, gallbladder cancer is found by chance when surgery is done to remove the gallbladder to treat a problem like gallstone. This surgery is called a laparoscopic cholecystectomy. A laparoscope is a thin, lighted tube that lets a healthcare provider see your gallbladder and nearby organs. The healthcare provider makes a small cut just above your belly button to insert the tube. Tools are then passed through other cuts in the skin to take out the gallbladder. A pathologist checks the gallbladder when it’s taken out with surgery. A pathologist specializes in looking at cells under a microscope to check for problems, including cancer.
Liver function. These are blood tests that help show how well the liver is working. They can help diagnose liver and bile duct diseases. The gallbladder is part of the liver and bile duct system. Gallbladder cancer can affect liver function. The most common liver function tests are:
Alanine aminotransferase (ALT)
Aspartate aminotransferase (AST)
Alkaline phosphatase (AP)
Gamma glutamyl transpeptidase (GGT)
Prothrombin time (PT)
Tumor markers. This is another type of blood test. These tests look for increases in certain substances called tumor markers. Some cancers make these substances. If you have gallbladder cancer, two markers may be increased. They are carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9). If your tumor markers are high, it may mean that you have cancer or you may have another disease. A normal level of tumor markers doesn’t always mean there is no cancer. Your healthcare provider may repeat this test during your treatment to see how your treatment is working.