GI Cancer Program

At Western Connecticut Health Network, we understand how overwhelming it feels to face a diagnosis of gastrointestinal cancer. Our dedicated cancer specialists provide the expertise, guidance and personalized support you need.

Our physicians have trained at some of the country’s most prestigious medical programs. Their training, along with decades of clinical experience, brings expertise directly to you, right here in our community.

Our team of specialists treats all types of GI cancers including:
  • Colon-rectal
  • Hepatic, pancreatic and biliary
  • Upper GI: Esophagus, gastric and small intestinal cancer
  • Neuroendocrine tumors such as carcinoid
  • Pre-cancerous lesions

Other reasons to choose WCHN include:

  • Our staff includes fellowship trained oncologic surgeons specializing in colon-rectal, hepatobiliary, pancreatic, esophageal and other gastrointestinal surgeries, dedicated diagnostic and interventional gastroenterologists and radiologists, medical oncologists, radiation oncologists, and pathologists.
  • Our comprehensive multidisciplinary program offers risk assessment, screening, diagnosis, treatment, education and support, genetics, research and clinical trials and wellness.
  • Our multidisciplinary care team of experts meets regularly to discuss every patient’s care and develop an individualized and comprehensive treatment plan offering hope and options.
  • Oncology nurse navigators assist you with education and support.
  • We offer advanced, minimally invasive surgical and diagnostic techniques, such as the laparoscopic Whipple procedure for pancreatic cancer.
  • We use innovative treatments and technology to bring you evidence-based therapies for the best possible outcome or cure.
  • Our comprehensive clinical research program offers opportunities to participate in trials investigating novel therapies.
  • Our genetics program tests for DNA mutations to catch cancer risk factors earlier, potentially leading to greater screening rates and cures now and for future generations.

If you are at average risk for colorectal cancer, it’s recommended to have routine colonoscopies beginning at age 50. A colonoscopy is the most effective way to screen for, prevent and diagnose colon cancer in its early stages. Colon cancer is highly treatable when found early. People at higher risk, including those with a family or personal history of colorectal cancer, may need to begin screening earlier and have colonoscopies more often.

Risk factors for colorectal cancer include:

  • A personal history of colorectal cancer or adenomatous polyps
  • A personal history of inflammatory bowel disease (i.e. ulcerative colitis or Crohn's disease)
  • A strong family history of colorectal cancer or polyps
  • A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC)*

Click here to calculate your risk of colon cancer, courtesy of the National Cancer Institute.

Our cancer specialists have training and expertise in the use of advanced diagnostic techniques. We offer a variety of sophisticated gastrointestinal cancer diagnostic tests, such as:

  • Colonoscopy: To examine the colon and rectum for polyps, which are removed and then tested by a pathologist for the presence of cancer or pre-cancerous cells
  • CT scan: To visualize organs within the chest, abdomen or pelvis though cross-sectional imaging of the body using x-rays and a computer
  • Endoscopic Ultrasound(EUS): A specialized endoscope that incorporates a high-frequency ultrasound probe into a video endoscope, providing images of the both the lining of the gastrointestinal tract and the surrounding structures, particularly the pancreas, bile ducts and lymph nodes
  • Endoscopic Retrograde Cholangiopancreatography (ERCP)
  • Spyglass Direct Visualization System: A type of technology that provides highly detailed images used during ERCP, helping to detect cancers without the need for a biopsy
  • MRI: A type of imaging that uses a powerful magnet to provide detailed images
  • PET/CT scan: A form of 3-D imaging that provides more definitive information about cancerous tumors and other lesions located throughout the body
  • Specific tumor markers: A biomarker found in the blood, urine, or body tissues that can be elevated in cancer, including CA-19-9 for pancreatic cancer and CEA for colon cancer
  • Upper endoscopy: A technology that allows examination of the esophagus and stomach, under anesthesia, using a tiny camera that is passed down the throat

Pathology

Our board certified pathologists and cytopathologists are specialists in the critical evaluation of and diagnosis of diseases. They work closely with the medical and surgical team in the diagnosis of cancer. Our accredited laboratory is committed to the latest and most trusted methods of testing to guarantee the accuracy and quality of each analysis for a cancer diagnosis in the shortest time possible.

Our Western Connecticut Health Network physicians personalize your cancer treatment based on your specific diagnosis. Factors include the type and stage of your cancer, along with your own treatment goals and lifestyle.

Each patient diagnosed with GI cancer benefits from a review at our multidisciplinary (full team) case conferences (GI tumor board) to arrive at a personalized treatment plan.

Factors evaluated include the stage of your cancer, pathological and molecular profiling and patient general health and treatment goals. This plan is then discussed with you. Together, you and your doctor will arrive at a treatment decision that is right for you. It may include one or a combination of several of the following types of treatment:

  • Surgery
  • Systemic therapy (chemotherapy, including targeted therapy)
  • Radiation therapy
  • Palliative care
  • Clinical trials

Your doctor may recommend one or a combination of several treatment modalities, including:

  • Cryotherapy: Uses ultra-cold nitrogen gas to destroy cancerous or precancerous tissue in the esophagus and stomach
  • Halo/radiofrequency ablation for Barrett’s esophagus: Stenting for malignant obstructions and other conditions of the gastrointestinal tract
  • Stent placement: Endoscopically or via ERCP

Minimally Invasive Surgical Techniques

Our WCHN surgeons use minimally invasive and robotic approaches for complex surgical treatment for benign and malignant diseases, such as colorectal, gastric, liver, pancreas, gallbladder and bile duct cancers.

The advantages of smaller incision surgeries are less pain, shorter hospital stay, and a reduction in post-operative complications, such as wound infection and quicker healing leading to an overall faster recovery. We are proud to offer advanced technology and surgical techniques, including:

  • TEMS (Transanal Endoscopic Microsurgery): A minimally invasive surgery for rectal cancer
  • Cutting-edge surgeries: For esophageal cancer and for Barrett’s esophagus, a condition that often leads to cancer

Specific Hepatobiliary (HPB) surgeries

  • Whipple Procedure: The Whipple procedure, also called pancreatoduodenectomy, is the most common operation to remove pancreatic cancers. This procedure may also be used to treat some benign pancreatic lesions, and cysts and cancers in the bile duct and beginning part of the small intestine (duodenum). This surgery can be done using a minimally invasive approach, laparoscopically or robotically.
  • Gastrectomy: A gastrectomy is the surgical removal of all or part of the stomach to remove a malignant tumor.
  • Liver resection: Liver resection is the surgical removal of part of the liver for some types of liver cancer and for certain cases of metastatic colorectal cancer.
  • Distal Pancreatectomy: This is a surgical procedure to remove the tail and body of your pancreas, most commonly to remove a tumor.
  • Endoscopic Ampullectomy: This procedure is a minimally invasive way to treat superficial lesions of the biliary tract.

Systemic Therapy

The treatment of gastrointestinal cancers is now individually tailored to a patient’s cancer and also to the medical health of the patient. The different types of drug treatments are listed below.

Chemotherapy - Chemotherapy drugs are used to fight and kill cancer cells. Chemotherapy may be used alone or in combination with other treatments such as surgery and radiation. Chemotherapy is associated with side effects but there are many medications today to help to reduce these and most people manage well. Chemotherapy is sometimes given by intravenous infusion (an IV, through a vein in your arm or port) or it may be taken orally as a pill. Most patients have a series of treatments over several weeks or months, often including drug-free periods to allow your body to recover. Chemotherapy can be used in several ways:

  • To decrease the risk of spread of cancer
  • Prior to surgery, to shrink a tumor so it is easier to remove
  • After surgery, to ensure that no cancer cells remain after the tumor has been removed
  • As a palliative therapy, to reduce pain and other symptoms of advanced cancer
  • As maintenance therapy

Hyperthermic intraperitoneal chemotherapy (HIPEC) - This advanced treatment combines the surgical removal of most visible abdominal tumors with heated, cancer-fighting drugs that are delivered directly into the abdominal cavity.

Used primarily to treat advanced-stage abdominal cancers, HIPEC is an especially powerful treatment for several reasons. First, cancer cells are more vulnerable to heat than healthy cells. Second, because the chemotherapy is largely isolated to the abdomen, a more potent dose can be delivered. This maximizes the power of the drug while minimizing the toxicity and side effects typically associated with intravenous chemotherapy.

HIPEC is delivered as the second phase of a surgical procedure. During the first phase, your surgical oncologist explores the abdominal cavity to find and remove as much of the cancer as possible. Next, your surgeon administers a heated chemotherapy solution that is circulated throughout the abdomen to kill off any remaining cancer cells. Click here for more detailed information on chemotherapy.

Targeted Therapies - Targeted therapies work differently from standard chemotherapy. They are typically oral medications (in pill form) that work by “targeting” specific DNA abnormalities within the cancer cells. The target is chosen after a thorough analysis of a patient’s tumor specimen. Herceptin, which targets HER2, was one of the first targeted therapies. These are truly personalized cancer medicines. Click here for more information on targeted therapies

Radiation Therapy

Radiation therapy, the precise and controlled use of radiation to kill cancer cells, can provide effective treatment for cancer. Here at WCHN, our highly skilled radiation oncologists use advanced technology that adapts to your breathing cycle. This ensures accuracy and protects nearby tissue as high doses of radiation therapy are delivered to your cancer. Our techniques include external beam radiation. External beam radiation delivers a beam of high-energy x-rays to destroy cancer cells. External beam radiation gets its name from the fact that the beams come from an external source (a machine called a linear accelerator) and are aimed at the site of the tumor.

We offer several types of external beam radiation:

  • Image-guided radiotherapy (IGRT)
  • Intensity-modulated radiation therapy (IMRT)
  • 3D conformal radiation therapy
  • Volumetric modulated arc therapy (VMAT)

Specialized Treatments Delivered by Interventional Radiologists

Radiofrequency Ablation - Radiofrequency ablation for cancer is a minimally invasive procedure that uses electrical energy and heat to destroy cancer cells. This procedure is an option for patients when surgery isn’t possible, for people with just a few small tumors, or for those with health problems that make surgery risky.

Chemoembolization - Chemoembolization, a minimally invasive treatment for liver cancer or metastasis, can be used when the tumor is too large for radiofrequency ablation (RFA), when the tumor is in a location that cannot be treated with RFA, or in combination with RFA or other treatments. Chemoembolization delivers a high dose of cancer-killing drug (chemotherapy) directly to the organ, while depriving the tumor of its blood supply by blocking, or embolizing, the arteries feeding the tumor.

Sir-Spheres -Y-90 (Ytrium-90 radio embolization) - SIR-Spheres®Y-90 resin microspheres, also known as selective internal radiation therapy (SIRT), delivers internal radiation to liver tumors.Designed specifically to work with the liver’s unique blood supply, millions of tiny spheres are sent directly to the tumors while sparing healthy liver tissue. The treatment requires a small incision in the groin and is administered via a very small, flexible tube (microcatheter) into the liver.

Clinical Trials

Clinical trials are research studies that evaluate the safety and effectiveness of new methods or drugs to treat cancer or procedures to diagnosis or screen for cancer. Participation is always voluntary. WCHN’s research program is part of a premier regional cancer network that includes Danbury, New Milford and Norwalk Hospitals. Clinical trials at WCHN come from a wide variety of sources, including the National Cancer Institute (NCI), pharmaceutical companies, nearby university cancer centers, as well as well as those developed at the WCHN. Our goal is to offer you the most promising emerging treatments available.

We offer many supportive services to help with the questions and concerns that may arise during treatment, and beyond, in your life as a survivor of cancer.

Navigation - Cancer treatment can be complex, but we’re here to help. To ensure that your needs are met, we’ll connect you to a special team of navigators focused on helping you through your treatment experience. Though our entire staff is available for questions and guidance, we also have dedicated navigators with specific areas of specialization.

Oncology Nurse Navigator - Our nurse navigators will meet with you to provide information and emotional support, help you understand treatment options or assist with scheduling and coordination of your medical tests or appointments.

Oncology Financial Navigators - We offer financial counseling for all patients (insured and uninsured). Their role is to provide information on treatment costs and insurance benefits and help connect you to resources that may help cover or subsidize costs for treatment and cancer medications.

Integrative Medicine - We offer a wide array of complementary programs to promote healing and relaxation, help reduce unpleasant side effects and contribute to overall well-being. We believe in holistic cancer treatment, using complementary therapies such as aromatherapy, acupuncture, massage, and reflexology.

Nutritional Counseling - Our dietitian can provide support and guidance on nutrition during treatment and in managing sensory changes in taste along other side effects that alter nutritional intake.

Support Groups - We offer an ongoing calendar of community support groups and educational programs for you and family members, with programs for people who are newly diagnosed, in treatment and living as survivors of cancer. Danbury Hospital works collaboratively with Ann’s Place (link here to events), a cancer community support center that offers support groups, classes, and social support services to those who need additional assistance.

Spiritual Care - With sensitivity to every patient’s beliefs, needs and desires, our specially trained oncology chaplains are available for supportive listening, patient advocacy and counseling for you and your family members.

Palliative Care - The Western Connecticut Health Network is the first in the state to have offered a JCAHO-accredited palliative care program at Danbury Hospital. Pain and other symptoms are not only uncomfortable, but also can present a barrier to treatment. That’s why symptom management is a key part of our palliative care program. Please make sure to communicate with us about what pain you or your loved one may be feeling; we have many therapies and treatments to offer.

Physical Therapy/Rehabilitation - Our occupational therapists have expertise in treating lymphedema and other complications from axillary surgery. With the goal of helping every patient achieve as close to normal function as possible, we offer the full array of rehabilitation.

To find more information on the team or to speak with a cancer specialist, call:

  • 860-210-5300: WCHN The Diebold Family Cancer Center at New Milford Hospital
  • 203-852-2148: WCHN Whittingham Cancer Center at Norwalk Hospital

For additional resources, please visit:

Our expert cancer treatment professionals – physician specialists, nurses, care coordinators and the many other caregivers you’ll meet during the course of treatment – are highly trained and fully dedicated to providing excellent treatment in a warm and personalized manner.

Multidisciplinary Care Physician Team