Pancreatic, Liver, and Bile Duct Cancers

We offer a range of surgical approaches including minimally invasive laparoscopic and robotically-assisted surgery. These result in less bleeding, fewer complications and quicker recovery, meaning you get back to your regular activities a lot faster.

High-powered energy beams, such as X-rays, are used to kill cancer cells directly. We also have expertise in brachytherapy, which is high-dose radiation therapy delivered precisely to the tumor bed. This approach spares healthy tissue and minimizes the after effects of the radiation.

Intravenous and/or oral medication that attacks and kills cancer cells in the body. Many patients maintain normal activities during treatments.

Therapy focused on blocking the growth and spread of cancer cells by targeting the specific genes, proteins, or tissue affected by cancer.

Intravenous medication that stimulates your immune system, by helping it recognize and destroy cancer cells.

Dignity Health offers the most advanced procedures in colorectal cancer surgery. Our team of oncology experts are sensitive to your urgent needs and have compassion and humankindness. Our specialists work side-by-side to carefully review complex cases and develop personalized treatment plans.

Our skilled surgeons use minimally invasive surgical procedures to reduce risk and optimize outcomes. We invest in advanced imaging technologies and radiation therapies to target tumors with greater precision.

You should choose Dignity Health because we’ve built a reputation for innovative therapies and surgical techniques that minimize the need for temporary or permanent colostomies. Our holistic approach is evident in services designed to treat the whole person—mind, body, and spirit.

Services provided by the Gastrointestinal (GI) Program at Dignity Health – Cancer Institute at St. Joseph’s Hospital and Medical Center includes individualized, patient-focused screening/early detection, diagnosis, and multi-disciplinary treatment of malignant and high-risk diseases of the lower (colon, rectum, and anus) and upper gastrointestinal tracts (esophagus, liver, pancreas, gallbladder, stomach, and small bowel). Therapeutic treatment options may entail implementation of the latest proven strategies incorporating surgery, chemotherapy, radiotherapy, and/or any combination of the above.  In addition, symptom management and survivorship services are also available.

Our evidence-based collaborative team approach to treating patients with cancer, which incorporates the various disciplines of surgery, medical oncology, radiation oncology, radiology, pathology, supportive care/pain management, nursing, rehabilitation services, nutrition, and social work is a unique distinguishing strength; and one that makes the patient the focal point and recipient of the best in comprehensive and compassionate care.

Understanding more about these cancers can help you better understand the treatment that may be selected for you or your loved one, based on genetic profile, lifestyle, and individual circumstances. For more information about scheduling an appointment at Dignity Health – Cancer Institute at St. Joseph’s, please call (602) 406-8222.

Gallbladder cancer is difficult to diagnose in the early stages because there are few signs or symptoms. Gallbladder cancer may be found when the gallbladder is checked for gallstones or removed. Symptoms of this cancer may include:

• jaundice (yellowing of the skin and whites of the eyes)

• pain above the stomach

• fever

• nausea and vomiting

• bloating

• lumps in the abdomen

For more information specifically about gallbladder cancer, visit this page from the National Cancer Institute: cancer.gov/types/gallbladder. The National Cancer Institute estimates that nearly 11,000 Americans are diagnosed every year with this type of cancer. For information about treatments for gallbladder cancer, visit cancer.gov/types/gallbladder/patient/gallbladder-treatment-pdq.

Liver cancer is cancer that begins in the liver. Cancer that spreads, or metastasizes, from another organ to the liver, is not considered liver cancer. That is considered cancer affecting the location where it began. As many as 36,000 Americans are diagnosed every year with primary liver cancer, according to the National Cancer Institute. The majority are age 64 and over; liver cancer is rare in children and teenagers.

Symptoms of primary liver cancer, according to the American Cancer Society, include

• weight loss without trying

• loss of appetite

• feeling very full after a small meal

• nausea or vomiting

• an enlarged liver, felt as a mass under the ribs on the right side

• an enlarged spleen, felt as a mass under the ribs on the left side

• pain in the abdomen or near the right shoulder blade

• swelling or fluid build-up in the abdomen

• itching

• yellowing of the skin and eyes (jaundice)

For more information specifically about primary liver cancer, visit this page from the National Cancer Institute: cancer.gov/types/liver. For information about survival rates for liver cancer, visit cancer.gov/statfacts/html/livibd.html.

Pancreatic cancer typically does not secrete hormones and doesn’t cause obvious signs or symptoms. This makes it hard to diagnose early. For the majority of patients with the most common kind of pancreatic cancer - called exocrine pancreatic cancer—current treatments do not cure the cancer. As many as 49,000 Americans are diagnosed every year with pancreatic cancer, according to the National Cancer Institute.

Symptoms of pancreatic cancer, according to the American Cancer Society, can include:

• yellowing of the eyes or skin

• nausea and vomiting

• itchy skin, palms, and soles of feet

• lack of appetite

• abdominal or back pain

• an enlarged gallbladder that can sometimes be felt by a doctor as a large lump under the right ribcage during a physical exam

• pale, floating stools. This symptom can be an early clue and is often overlooked.

• sudden, unexplained weight loss.

• uneven texture of the fatty tissue beneath the skin

For more information specifically about pancreatic cancer, visit this page from the National Cancer Institute: cancer.gov/types/pancreatic. For information about survival rates for pancreatic cancer, visit seer.cancer.gov/statfacts/html/pancreas.html.

Small intestine cancer is a relatively uncommon cancer, accounting for less than 1 percent of all new cancers diagnosed in the U.S. in a single calendar year. It occurs in the long, coiled tube that connects the stomach to the large intestine. The small intestine, or small bowel, receives food from the stomach, helps break it down, and absorbs nutrients that are used by the body. The three parts of the small intestine are the duodenum, jejunum, and ileum. The jejunum is located between the duodenum and the ileum. The duodenum connects to the stomach, and the ileum connects to the colon.

Small intestine cancer often starts in the duodenum. The most common type of small intestine cancer is adenocarcinoma. The most common type of small intestine cancer is adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). Symptoms of small intestine cancer, according to the American Cancer Society, include:

• pain in the belly

• weight loss without trying

• weakness and fatigue

• low red blood cell counts (anemia)

For more information specifically about small intestine cancer, visit this page from the National Cancer Institute: cancer.gov/types/small-intestine. About 9,400 Americans are diagnosed every year with small intestine cancer, according to the National Cancer Institute. For information about survival rates for colorectal cancer, visit seer.cancer.gov/statfacts/html/smint.html.

Stomach cancer (gastric cancer) forms in the lining of the stomach. The stomach is in the upper abdomen and helps digest food. Almost all gastric cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Infection with bacteria called H. pylori is a common cause of gastric cancer. Gastric cancer is often diagnosed at an advanced stage because there are no early signs or symptoms. Symptoms, though uncommon, of stomach cancer, according to the American Cancer Society, can include:

• poor appetite

• weight loss without trying

• belly pain

• vague discomfort in the abdomen, usually above the navel

• a sense of fullness in the upper abdomen after eating a small meal

• heartburn or indigestion

• nausea

• vomiting , with or without blood

• swelling or fluid build-up in the abdomen

• low red blood cell count (anemia)

For more information specifically about stomach cancer, visit this page from the National Cancer Institute: cancer.gov/types/stomach. About 24,600 Americans are diagnosed with stomach cancer every year, according to the National Cancer Institute. For information about survival rates for stomach cancer, visit seer.cancer.gov/statfacts/html/stomach.html.

Treatment you may receive

There are three ways to treat gastrointestinal cancers: surgery, radiation, and medications. Your oncologist at the Dignity Health – Cancer Institute at St. Joseph’s will help you understand which treatment is most appropriate for you.

Questions to ask your oncologist

1. What is my diagnosis and prognosis?

2. What is your experience in treating the cancer I have?

3. How will you determine the best treatment for me?

4. How long does each treatment option typically last, both individually and as a series of treatments?

5. How will you know if the treatment is making progress?

For more information about various types of cancer, cancer staging and treatment options, click on this link from the National Comprehensive Cancer Network (NCCN): NCCN Guidelines for Patients® - nccn.org/patients/default.aspx.

For more information about scheduling an appointment at the Dignity Health – Cancer Institute at St. Joseph’s, please call (602) 406-8222.

You can minimize your risk of developing gastrointestinal cancer through these five steps:

• If you are 50 or older, get a screening colonoscopy to rule out cancer or have precancerous polyps removed

• Maintain a normal body weight and exercise regularly

• Treat H Pylori infections promptly

• Avoid using tobacco products

• Limit alcohol consumption