GI Cancer Care at Northwestern Medicine Regional Medical Group

A Collaborative Approach to Care.

If you have gastrointestinal (GI) cancer – including cancer of the liver, bile duct, gallbladder, pancreas, stomach, esophagus, colon, appendix or rectum, you’ll find comfort in knowing that the multidisciplinary GI cancer team at Northwestern Medicine Regional Medical Group (NMRMG) has the latest diagnostic and treatment technology – delivered by compassionate and expert caregivers. In addition our dedicated GI nurse navigator will be there to answer questions and guide you during your entire treatment.

At Northwestern Medicine Regional Medical Group, our goal is to provide the best level of care possible to preserve the highest level of function and quality of life. We accomplish this by giving you personalized treatment using state of the art technology, national protocol standards and clinical trials. Our specialized cancer team includes:

• Fellowship trained GI surgical oncologists
• Specialized GI medical oncologists
• Specialized GI radiation oncologists
• Dedicated GI radiologists
• Dedicated GI pathologists
• Fellowship trained interventional gastroenterologist
• Fellowship trained interventional radiologist
• Dedicated nurse navigator

Liver and Pancreas

Tumors evaluated and treated by our team include:

• Hepatocellular carcinoma (primary liver cancer)
• Cholangiocarcinoma (bile duct cancer)
• Gallbladder cancers
• Metastatic colorectal cancer to the liver
• Selected non-colorectal metastatic cancer to the liver
• Pancreatic neuroendocrine tumors
• Pancreatic adenocarcinoma
• Pancreatic cystic disease (mucinous cystic neoplasms, intraductal papillary mucinous neoplasms)
• Neuroendocrine tumors

Our expert fellowship trained surgical oncologists use comprehensive surgical techniques with a dedicated operating team to remove tumors of the liver and pancreas. Intraoperative ultrasound is routinely utilized to guide the identification and accurate removal of tumors of the liver.

Patients with liver tumors are discussed in the multi-disciplinary cancer care conference to determine which treatments would be best for each patient. In addition to conventional therapies (surgery, chemotherapy and radiation), our specialists also use molecularly targeted therapy and liver-directed therapy for select patients.

The treatments include regional therapy to a portion of the liver with radioembolization (Y-90/SIRT), trans-arterial chemoembolization (TACE), and bland embolization. Local therapy also includes stereotactic radiation, microwave and radiofrequency ablation strategies.

For advanced bilateral liver tumors, we offer two-staged liver surgery with portal vein embolization to help preserve healthy liver function. This treatment will expand the number of patients that may be candidates for curative surgery for metastatic (stage 4) colon and rectal cancers.

Patients with pancreas tumors are extensively evaluated for tumor type, appropriateness of undergoing surgery and stage of disease. Endoscopic ultrasound is performed when indicated to assist in the diagnosis. We utilize specialized CT scanning for the pancreas to closely evaluate surrounding structures. Our surgical oncologists routinely perform complex pancreas surgery including pancreaticoduodenectomy (Whipple procedure) as well as other pancreas resections. For locally advanced pancreatic tumors, portal vein/superior mesenteric vein resections with vascular reconstruction are performed when necessary to completely remove these tumors. Often pancreas cancer is treated first with chemotherapy and radiation followed by surgery in order to give you the best chance for complete cancer removal.

For patients with pancreatic cysts or selected pancreatic neuroendocrine tumors, we offer techniques to preserve pancreas function for these often benign or low-grade tumors.

When appropriate, liver and pancreatic resection may be performed with minimally-invasive techniques to minimize pain, reduce length of hospital stay and improve recovery. Some pancreas tumors are low risk and immediate treatment may not be necessary. For these patients we have surveillance programs to monitor these tumors.

Esophagus and Stomach Cancer

The treatment of stomach cancer often starts with chemotherapy followed by surgery. Esophageal cancer treatment may start with combined chemotherapy and radiation followed by surgery. Our GI team follows national protocols when treating patients with stomach and esophagus cancers. Our fellowship trained gastroenterologists perform endoscopic ultrasound which offers a more precise evaluation of the cancer so that the multi-disciplinary team can recommend the best treatment for you. This treatment may or may not include surgery.

If you do need surgery the surgical oncologist routinely completes a comprehensive lymph node dissection to accurately determine the cancer stage. Our expert fellowship trained surgical oncologists use comprehensive surgical techniques with a dedicated operating team to remove tumors of the esophagus and stomach.

Our stomach and esophagus cancer team includes registered dieticians who will work with you to create a comprehensive nutritional plan for you to follow throughout your treatment.

Colon and rectal cancer

A team approach is absolutely essential in the treatment of colon and rectal cancer. Successful surgery for colon and rectal surgery is of the utmost importance in increasing your recurrence and chance of survival. Our surgeons utilize minimally invasive techniques when possible. Patients with rectal cancer will be offered a rectal ultrasound, CT scans and possibly PET scans. Patients may receive surgery alone, or chemotherapy and radiation followed by surgery. Based on discussion in our multi-disciplinary cancer care conference, a team will decide if surgery alone or chemotherapy and radiation followed by surgery is indicated for rectal cancer. With colon and rectal surgery, the team will discuss your tumor type and whether any chemotherapy is necessary.

Peritoneal Surface Malignancy (HIPEC)

There are certain types of abdominal cancers that spread along the surface of the abdominal cavity. These tumors can be removed with a procedure known as cytoreduction or debulking. During this operation, the tumors on the lining of the abdomen (peritoneal surface) or organs are removed. Depending on the amount of cancer present, this procedure usually requires the removal of abdominal organs covered with these tumors that cannot be spared. After removing all visible cancer, the abdomen is filled with heated chemotherapy, known as HIPEC (hyperthermic intraperitoneal chemotherapy) that is circulated on a pump to eliminate any microscopic tumor cells that are not visible. This approach has been demonstrated as an effective treatment for several types of cancers listed below.

• psuedomyxoma peritonei
• mucinous appendix cancer
• colorectal cancer
• abdominal mesothelioma

The fellowship-trained surgical oncologists and medical oncologists at Northwestern Medicine Central DuPage Hospital have expertise in these treating these cancers. Our comprehensive cancer team including, gastroenterologists, GI navigator, dieticians and counselors will help guide you through the entire treatment process.

Clinical Trials

Find out if there is a clinical trial for your type of gastrointestinal cancer currently enrolling patients through Northwestern Medicine Central DuPage Hospital or Northwestern Medicine Delnor Hospital. Your doctor and our research team can tell you if you are eligible and answer any questions you may have. See the cancer clinical trials list.

Learn more about the benefits and guidelines for participating in a clinical trial from the National Cancer Institute**.

Know what questions to ask** when evaluating a clinical study at ClinicalTrials.gov**, a service of the U.S. National Institutes of Health.

**By clicking on these websites, you are leaving the Northwestern Medicine website. These websites are independent resources. Northwestern Medicine does not operate or control the content of these websites.

Learn More

The care team partners with your referring physician to ensure coordinated care from diagnosis through survivorship. To make an appointment with a GI cancer specialist, please call 630.352.5450 (Warrenville) or 630.232.0610 (Delnor campus). TTY 711.