Diagnosis & Treatment Gastrointestinal Cancer
How Is Gastrointestinal Cancer Diagnosed?Diagnosis
Health care experts at NewYork-Presbyterian can perform a wide range of procedures to confirm a diagnosis of GI cancers. Methods include:
- Colonoscopy. A doctor views the inside of your colon in search of abnormalities using a camera attached to a flexible tube inserted into the rectum.
- Upper Endoscopy. A small tube with a camera mounted on the end is inserted through the mouth to allow a doctor to view your esophagus, stomach, and the top part of your small intestine.
- Laparoscopy. This minimally invasive procedure involves making a small incision in the abdominal area, allowing a camera to be passed into the body to detect tumors or other abnormalities.
- Imaging tests. Doctors can perform high-resolution computed tomography (CT or CAT) scanning and positron emission tomography (PET) scanning to determine if GI tumors are present.
- Biopsies. A biopsy involves taking a tissue sample of the targeted area within the digestive tract to determine if cancerous cells are present.
- Blood tests. Blood tests can be conducted to detect the presence of chemical abnormalities. A blood test cannot be conclusive in the diagnosis of GI cancer, but it can help determine the extent to which the cancer may be progressing.
Some GI cancers, such as colorectal cancer and Barrett’s esophagus, can be found in their earliest or even precancerous stages through various screening techniques. NewYork-Presbyterian offers screening tests, as well as genetic counseling for people whose family medical history suggests they have an increased risk of GI cancer. Our physicians and genetic counselors can assess your risk and help you make an informed decision about reducing your risk and that of your family members.
How We Treat Gastrointestinal CancerTreatments
At NewYork-Presbyterian, we offer the latest technologies and treatments to care for your gastrointestinal cancer. Your personalized team of specialists will determine the treatment options that will be most effective for you based on the type and stage of GI cancer.
Treatment options for gastrointestinal cancer include:
- Invasive and reconstructive digestive tract surgery. Surgery may be required to remove part or all of an organ to rid the body of cancerous cells.
- Chemotherapy. GI cancer cells are killed by drugs injected into the bloodstream or taken orally. Chemotherapy is often used to shrink tumors in the digestive tract before surgery or to kill any remaining cancerous cells after a tumor has been removed.
- Radiation therapy. High-energy rays kill cancer cells. Like chemotherapy, this can be useful in shrinking tumors before surgery or killing cancer cells that were left behind after surgery.
- Minimally Invasive New Technologies (MINT). This type of intestinal surgery can be done completely internally, with no exterior incisions and an improved healing time.
- Hepatectomy. This surgical procedure involves removing part or all of the liver to rid the body of cancer. The liver can regenerate if only part is removed, while removing the entire organ requires a liver transplant. Our academic medical centers were the first in New York City to perform both left and right fully robotic hepatectomies using advanced instruments.
- Combined endoscopic-laparoscopic surgery. Our surgeons pioneered combined endoscopic-laparoscopic surgery (CELS) to remove complex or hard-to-reach polyps in the colon.
- Heated intraperitoneal chemotherapy. An advanced technique requiring the collaboration of surgeons and oncologists, heated chemotherapy drugs are applied after all visible tumors are removed from the abdominal cavity to destroy any remaining cancer cells.
- Intraoperative radiation therapy. This treatment applies radiation to the cancerous area during surgery, leaving the surrounding healthy tissue unaffected. NewYork-Presbyterian is one of the few centers with intraoperative radiation therapy (IORT) capability to target advanced colorectal tumors.
- Continent ileostomy procedures. An ileostomy involves removing the ileum, the segment of the small intestine that connects to the large intestine. In a continent ileostomy, surgeons use a part of the small intestine to create an internal pouch that collects food waste. We are one among only a handful of centers worldwide able to perform continent ileostomy procedures to avoid an external ostomy appliance.
NewYork-Presbyterian attracts nationally recognized gastroenterologists, surgical oncologists, medical oncologists, radiation oncologists, interventional radiologists, genetic specialists, and researchers. Your customized team has extraordinary compassion and experience in caring for people with digestive cancers.
Our health care professionals treat GI cancer differently, providing treatment not only for GI cancer, but for the whole body. Our nutritionists, social workers, rehabilitation therapists, palliative care experts, and others will help you and your loved ones address the effects of cancer and its treatment — physical, emotional, and spiritual. Surgical and nonsurgical treatment options can cause side effects that NewYork-Presbyterian medical experts can also treat.
Minimally invasive and reconstructive surgery
We use minimally invasive surgical approaches whenever appropriate — including laparoscopic surgery and robotic surgery — resulting in smaller incisions, a shorter hospital stay, and a faster recovery. If you need a more extensive operation, our surgeons have the expertise to perform those procedures. We also offer reconstruction when appropriate, such as creating a J-pouch in patients with colorectal cancer who undergo removal of the large intestine.
We are developing and testing the next wave of minimally invasive surgical procedures, including endoscopic techniques performed entirely inside the digestive tract and requiring no external incisions.
Advanced interventional techniques
Interventional radiologists specialize in minimally invasive, targeted treatments. They use image guidance to perform procedures that would otherwise be unavailable or require open surgery. Interventional radiology offers care with less risk, less pain, and less recovery time compared with traditional treatments.
At NewYork-Presbyterian, our interventional radiologists and interventional endoscopists perform thousands of procedures each year. We have all of the necessary imaging and procedural facilities to offer the most comprehensive, cutting-edge interventional oncology care. Examples of interventional approaches for digestive cancers include:
- Interventional biopsy to retrieve tissue for analysis without surgery
- Embolization to block flow in blood vessels feeding a tumor, such as liver tumors
- Ablation to destroy a tumor with radio waves, light-sensitive drugs, or extreme temperatures
- Interventional endoscopy to relieve obstructions, remove superficial tumors, and insert stents in a blocked bile duct or an esophagus narrowed by cancer
You may receive chemotherapy alone to treat your gastrointestinal cancer or in combination with other therapies, such as radiation and surgery. We give intravenous chemotherapies in our warm, supportive infusion centers, where we can monitor your side effects and address your comfort.
- Presurgical chemotherapy. Some patients receive chemotherapy before surgery to shrink the tumor. Your doctor will let you know if this is an option for you.
- Chemotherapy after surgery. Many patients with digestive cancers receive anticancer drugs after surgery to kill any remaining cancer cells. You may receive one drug or a combination of medications.
- Targeted therapies. We treat some digestive cancers with targeted therapies, which work by shutting down certain proteins that cancer cells need to grow. Examples include trastuzumab for some stomach cancers, cetuximab, and bevacizumab for colorectal cancer, sorafenib for liver cancer, and erlotinib for pancreatic cancer.
- Immunotherapy. These treatments harness the power of the immune system to fight cancer. Many types of immunotherapy drugs used to treat other cancers are now being evaluated in clinical trials for patients with digestive cancers, including colon, pancreas, stomach, and liver cancers.
- Heated intraperitoneal chemotherapy. This special technique combines chemotherapy and surgery in one procedure and is used primarily to destroy any unseen cancerous tissue in the abdomen after all visible tumors have been removed.
- Chemotherapy. The correct application of chemotherapy around the time of surgery and for advanced disease can dramatically improve a patient’s life, reduce symptoms, and improve the quality of life. Our world-class medical oncologists are well-versed in standard and investigational chemotherapy approaches.
Precise radiation therapy
NewYork-Presbyterian’s radiation oncologists use 3D imagery to deliver radiation to digestive cancer cells while reducing radiation exposure to nearby healthy tissue. This approach now allows us to treat tumors that may have been too close to vital organs to safely treat in the past.
Our radiation therapy units feature the latest highly precise radiation delivery equipment. We offer external beam radiation therapy (such as intensity-modulated radiation, 3D conformal radiation, and stereotactic body radiotherapy) and brachytherapy (the implantation of radioactive seeds within or next to a tumor).
As active members of the international cancer research community and national cooperative cancer networks, our oncologists design, conduct, and lead clinical trials of promising treatments for digestive cancers, including metastatic disease. You may have the opportunity to receive an innovative therapy by participating in one of these pivotal studies.
Trust NewYork-Presbyterian for Gastrointestinal Cancer Treatment
NewYork-Presbyterian doctors offer a full range of treatment options to provide patients with the best opportunities for treatment and recovery based on the type and stage of GI cancer. Our team of dedicated cancer professionals provides care at every step.
Schedule an appointment with one of our health care experts today.