This article was written by Dr. Irada Ibrahim-zada, Surgical Oncologist at St. Elizabeth Physicians. She sees patients in Edgewood, Ky.
Q: What does a surgical oncologist do? When should people seek help from one?
A: A surgical oncologist specializes in treating various cancers by surgically removing a tumor and nearby tissue. I specialize in surgical oncology of the abdomen. My focus is on cancers of the pancreas, liver, stomach, metastatic colon and appendiceal cancer. I also treat sarcomas, as well as neuroendocrine tumors and adrenal masses.
As surgical oncologists, we use conventional open surgery and minimally invasive (robotic and laparoscopic surgery) to perform surgeries. We perform chemotherapy (HIPEC — hyperthermic intraperitoneal chemotherapy) for peritoneal cancers, which develop in the abdomen’s thin lining and include either primary or stage 4 cancers. We also perform Whipple surgery for pancreatic cancers and liver resections for one, two, or multiple liver masses.
Q: What’s something surprising about surgical oncology that people might not know?
A: We offer hope for a cure for some lethal cancers if patients come to us at the right time. Certain metastatic cancers of the liver and stage 4 peritoneal cancer can still be treated with surgery and have better long-term outcomes. Contrary to the belief, resecting the tumor does not spread the disease. Instead, it improves a patient’s chances of survival. We offer surgery in combination with other treatment modalities, such as radiation, chemotherapy, and immunotherapy to cure the patients.
Q: What is St. Elizabeth doing in surgical oncology that is innovative, unique, or leading edge?
A: Here at St. Elizabeth, we offer state-of-the-art facilities under one roof to provide comprehensive assessment and evaluation from a multidisciplinary team that includes surgical oncologists, medical oncologists, geneticists, gastroenterologists, interventional radiologists, radiation oncologists, and dieticians.
Patients receive outstanding support from nurse navigators who help to coordinate their treatment plan and navigate their medical care. We use robotic and open equipment to perform many cancer surgeries, including robotic HIPEC, liver, stomach, and pancreas surgeries.
Patients have access to their medical team around the clock. The cancer center and the hospital are located on the same campus and offer patients direct access. There, we implement all the latest technologies to perform liver, pancreas, stomach, colon, appendix, and peritoneal cancer surgeries. In addition, we offer both radical resection of the liver, pancreas, stomach, adrenal gland, and colon, as well as interventional radiology therapies with organ-sparing techniques when appropriate.
We offer conventional liver resections and liver-directed therapies, including:
- TACE: A minimally invasive procedure that restricts a tumor’s blood supply
- Y90: A targeted radiation treatment
- RFA: A minimally invasive procedure that uses electrical energy and heat to kill cancer cells
- MWA: A minimally invasive treatment that uses ultrasound, CT, or MRI to direct microwaves to heat and destroy a tumor
- Portal vein embolization: A procedure that prompts liver tissue growth before resection
Our center also offers tumor resections with vascular reconstructions if there is an invasion into the critical vascular structures.
Q: What is currently on the horizon for surgical oncology? What changes might we expect in the next few years?
A: We continue to expand our interests and collaborate with other centers across the United States. We have many ongoing clinical trials in hepatopancreatobiliary (liver, bile duct, gallbladder, and pancreatic) and gastrointestinal cancers for stage 2, 3, and 4 patients. We also have phase 1 trials focused on the safety and efficacy of the new chemotherapeutic agents and immunotherapeutic agents.
We offer genetic screening for all our patients regardless of age and diagnosis. At the same time, we provide genotype screening of the cancer tissue to tailor our treatments. There is a tight collaboration between all the teams, and we aim to offer consultations and workup within a week of a new diagnosis. We anticipate continuing to develop ongoing trials and minimally invasive approaches to the surgery and increasing our collaboration with international surgical oncology societies.
Q: Does St. Elizabeth offer screenings for early detection of illness in surgical oncology?
A: The current guidelines in the United States do not recommend routine screening for pancreas, liver, or stomach cancers. Patients with liver cirrhosis or hepatitis B and C are eligible for a screening program for liver cancers. We also offer surveillance for patients with pancreatic cysts to monitor for any cancer development.
We continue to advocate for the nationwide implementation of the screening guidelines for other cancers. However, we work closely with primary care providers to identify patients who potentially benefit from the screening imaging to rule out those cancers.
Q: From your perspective as a surgical oncologist, what should people be aware of to prevent disease or catch it early?
A: Many liver and pancreas cancers are silent in the early stages. That makes them hard to detect. However, a new diagnosis of diabetes later in your life should prompt increased vigilance as it might be an early presentation of pancreas cancer. Smoking cessation, as well as a healthy and active living style, will help to decrease the risk of the development of those cancers. At the same time, the following recommendations for routine endoscopy and colonoscopy can detect stomach and colon cancers early and help to cure them.
Learn more about world-class cancer care at St. Elizabeth.
