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Each year, nearly 300,000 people in the United States are diagnosed with a type of gastrointestinal cancer. Many of these cancers are too complex or difficult to be treated with just one type of treatment. The Center for Gastrointestinal Cancers at Smilow Cancer Hospital and Yale Cancer Center provides patients with gastrointestinal cancers a comprehensive, multidisciplinary approach to the treatment of complex disease. As experts in the treatment of cancers of the esophagus, stomach, liver, pancreas, colon, bile ducts, rectum, and anus, we collaborate with diagnostic and interventional radiologists, gastroenterologists, and pathologists to provide the most up-to-date and effective treatments available. Our advanced diagnostic imaging services, including Endoscopic Retrograde Cholangiopancreatography (ERCP), MRI/MRCP (ERCP in conjunction with MRI), high-resolution CT scans, Endoscopic ultrasound (EUS), and EUS-guided fine needle aspiration, allow for patients to be comprehensively evaluated at the onset of their diagnosis. Surgical Oncology Surgery is commonly used to effectively manage certain types of gastrointestinal cancers, including malignant and premalignant tumors in the stomach, liver, bile ducts, pancreas, small intestine, and colorectum. Our team of surgeons incorporate a variety of state-of-the-art surgical techniques into procedures when necessary. These include: Laparoscopic and robotic surgery for stomach, small bowel, and colorectal tumors, as well as for primary and metastatic liver tumors and biliary tumors Cytoreduction and heated intraperitoneal chemotherapy Pancreatectomy (Whipple procedure, distal pancreatectomy, total pancreatectomy, central pancreatectomy, pancreas preserving enucleation) Medical Oncology In addition to chemotherapy, our medical oncology experts provide innovative nonsurgical treatment options including: Targeted Therapy, in which a special type of chemotherapy targets the changes in cancer cells that help them grow, divide, and spread Immunotherapy, which uses a patient’s own immune system to find and destroy cancer cells Yale Cancer Center emphasizes the importance of clinical trials for all stages of disease. Many of these drugs are exploring new types of therapy and new combinations of therapies, and many of our studies are available as part of our network of Care Centers. We perform state-of-the-art genomic profiling and laboratory explorations to determine the biologic weaknesses of the tumors and to develop better therapies for patients. Radiation Oncology Patients who need radiation oncology to treat their gastrointestinal cancers can feel confident that they are receiving the highest quality care from the most experienced team of radiation oncologists in Connecticut. We offer innovative therapies including: Three-dimensional Conformal Radiation: This technique may be used to target radiation to tumors by matching their particular shapes. Four-dimensional (4-D) CT simulation makes CT scans f

Located at the Digestive Health Center at 8 Devine Street, the Gastrointestinal (GI) & Pancreatic Cancer Prevention Program is an interdisciplinary group of specialists who work together with the goal of providing patients with a personalized cancer risk assessment and taking steps to prevent the development of cancer. It includes the Lynch Syndrome and Polyposis and Hereditary Gastric Cancer Clinics, directed by Xavier Llor, MD, and the Pancreatic Cancer Early Detection Clinic (PCDC) , directed by James Farrell, MD. Our clinical team is committed to providing a comprehensive plan to help assist patients with risk assessment for gastrointestinal cancers, surveillance, surgical decision-making, and follow-up care. Patients with an identified familial or hereditary cancer risk will receive personalized recommendations for cancer risk management based on their own personal risk assessment. Individuals not suspected of having a genetic predisposition also receive personalized information on how to lower their cancer risk. These interventions can have a huge impact on a person’s life by allowing them to better manage their health and reduce their risk of ever developing cancer.

Yale Cancer Center is Connecticut's only cancer center designated as a Comprehensive Cancer Center by the National Cancer Institute—and one of only 57 in the nation. The significance of this designation has profound implications for those who choose Smilow Cancer Hospital as the place where they will be cared for and receive treatment for their cancer. National Cancer Institute cancer centers are national leaders in cancer research, prevention, detection, and treatment. This provides patients at Smilow Cancer Hospital with novel treatment options and expert care.

At Yale Medicine, we specialize in a full range of digestive health care, from advanced endoscopy and colon cancer genetics to managing such conditions as inflammatory bowel disease and liver cancer. We treat complex gastrointestinal motility disorders, provide care for rare diseases, and support patients through liver transplants. Our dedicated team is committed to offering personalized and effective treatments for all aspects of gastrointestinal health. Specialized care is offered in the following areas: Advanced endoscopy: Specialized procedure using an endoscope to diagnose or treat complex issues in the digestive system. Colon cancer genetics: Study of genes that affect the risk of developing colon cancer. Gastrointestinal motility: The movement of food through the digestive tract. Inflammatory Bowel Disease (IBD): Chronic inflammation of the digestive tract. Liver cancer Liver transplant Lysosomal disease: A group of rare inherited metabolic disorders that result when lysosomes in cells cannot breakdown waste properly. Viral hepatitis: Liver inflammation caused by a virus, such as hepatitis A, B, or C, which can lead to liver damage.

The Center for Thoracic Cancers at Smilow Cancer Hospital consists of a multidisciplinary team of experts dedicated to providing evaluation of and treatment for patients with a thoracic malignancy, including lung cancer, esophageal cancer, thymoma, or chest wall tumors. Patients in Connecticut and beyond have access to nationally recognized expert clinicians, who provide an organized, collaborative approach to cancer care, as well as the latest technologies and treatments. Our team consists of a collaboration of specialty physicians, including medical oncology, radiation oncology, thoracic surgery, pulmonary medicine, digestive diseases, pathology, diagnostic imaging, and nursing. In addition to our expert clinicians, patients also receive comprehensive care to help with the physical, emotional, and psychological issues that are part of confronting cancer. Patients also benefit from the attention of the team's care coordinators, who make management of even the most detailed multidisciplinary treatment plan less complicated. Our team is active in clinical research, and focuses on developing advances to care in areas of thoracic oncology where the standard treatment needs improvement and where the optimal treatment approach remains unclear. To provide the best care, most of our patients are enrolled in a clinical trial where they can receive innovative therapy for their advanced disease, including immunotherapy, which was first used in clinical trials at Smilow Cancer Hospital. The Center for Thoracic Cancers offers second opinions that are easy, convenient, and all done remotely. Call (203) 200-LUNG for more information and learn how to schedule a second opinion appointment with one of our providers. Medical Oncology Our medical oncologists are nationally recognized for their leadership and expertise in lung cancer treatment and research, and are dedicated to offering personalized treatment options. Biomarker testing is often performed on the tumor to look for specific mutations that can be targeted by medication. There are currently FDA-approved lung cancer treatments for tumors showing abnormalities in EGFR, KRAS, ALK, ROS1, BRAF V600E, MET, RET , and NTRK genes. Recent studies conducted at Yale have led to FDA approval of drugs for the treatment of lung cancer, such as the immunotherapy drug Tecentriq (atezolizumab), which has been proven to improve patient survival for newly diagnosed NSCLC. This drug is designed to block PD-L1, a protein that was discovered by scientists at Yale and that has been instrumental in improving survival for lung cancer patients. Another FDA-approved drug, osimertinib, which stemmed from Yale Cancer Center and Smilow Cancer Hospital researchers, was approved for the treatment of adults with early-stage NSCLC with EGFR gene mutations. Surgery Many patients in need of surgery are referred for a minimally invasive surgery known as a video-assisted thoracoscopi

The Sarcoma Program at Smilow Cancer Hospital consists of a multidisciplinary team of physicians who diagnose, treat, and provide expert care for patients with both soft tissue sarcomas and sarcomas of the bone, or osteosarcoma. Our team includes orthopedic physicians, dermatologists, diagnostic radiologists, medical oncologists, pediatric oncologists, radiation oncologists, and pathologists, all with specific expertise in the treatment and care of patients with sarcoma. For diagnosis, our physicians employ state-of-the-art methods including CT scanning, which is excellent at seeing both bone and soft tissues; MRI, which has the ability to “view” the tissue in and around bone with exquisite detail; PET scanning that is able to look at the cancer’s biological activity at the cellular level; bone scans that use a very small amount of radioactive material to check for cancer cells within the bone; and X-ray. Bone scans can also be performed to check for cancer cells in the bone. Surgery Surgery is often a key treatment for patients with sarcomas of the bone. Upon consultation to determine a treatment plan designed to meet the individual needs of the patient, the following types of surgery may be considered: Wide local excision: Removal of the cancer and some healthy tissue around it. Limb-sparing surgery: Removal of the tumor in an arm or leg without amputation, preserving the use and appearance of the limb. The tumor is removed—and tissue and bone that are removed may be replaced with a graft using tissue and bone taken from another part of the patient’s body, or with an implant. Most patients with osteosarcoma can be treated with this type of surgery. Amputation: In some instances, it is not possible to remove the entire tumor in limb-sparing surgery, and therefore amputation may be considered to remove part or all of an arm or leg. The patient may be fitted with a prosthesis after amputation. Radiation Some patients who are undergoing surgery may have radiation therapy first to shrink a tumor to improve the success of the surgery. Radiation therapy is also often used after surgery to try to eliminate any remaining cancerous cells. Therapeutic Options Following successful surgery to remove the sarcoma, patients are also given chemotherapy to kill any remaining cancer cells. For soft tissue sarcomas, chemotherapy may be used before or after surgery and radiation. There are several approved chemotherapy options for patients and their oncologists to consider. Additionally, clinical trials offering the latest treatment combinations and new therapies are available for our patients through Yale Cancer Center, a comprehensive cancer center designated by the National Cancer Institute. Smilow Cancer Hospital and Yale Cancer Center are also members of the Sarcoma Alliance for Research through Collaboration (SARC). SARC is a collaboration of distinguished research institutions throughout the country that work together to design and evaluate clinica

We understand that a cancer diagnosis can be life-altering, bringing with it a wave of concerns and emotions that can feel overwhelming. At Yale Medicine, you can trust in our dedicated surgical oncology team to provide not only compassionate care but also the information you need to make empowered decisions about your health. An integral part of our approach is to give you detailed answers by thoroughly explaining your treatment options and what you can expect before, during, and after surgery. For every surgery, we focus on giving you the most successful outcome, resulting in the least pain, scarring, and recovery time. Our expert surgeons are leaders in minimally invasive procedures, even for many complex cases that would otherwise require traditional open surgery. We treat the following cancers and cysts: Breast cancer Gastrointestinal cancers, including gastric bile duct, gallbladder, liver, colon, stomach, pancreas, and colorectal cancers Intra-abdominal cancers Melanoma Sarcoma Noncancerous and cancerous conditions affecting the pancreas, bile duct, and small intestines

The Oligometastatic Cancer Program at Smilow Cancer Hospital consists of a multidisciplinary team of nationally recognized physicians and clinicians who are experts in providing care for patients with oligometastatic cancer. Oligometastatic cancer is a concept in oncology that describes a state of cancer progression in which the cancer has spread, but only to a few specific areas. Unlike widespread metastatic disease, where cancer has spread extensively to distant organs, oligometastasis involves a more localized and contained pattern of metastatic spread. Effectively, oligometastatic cancer represents a middle ground between localized cancer (cancer of one area) and widespread metastatic cancer. The clinical significance of identifying patients with oligometastatic cancer lies in its potential for more targeted and aggressive treatment approaches. Unlike widespread metastatic disease, where the primary goal may be palliative or to control symptoms, oligometastatic cancer offers patients an opportunity for interventions that can lead to a cure. This identification has been facilitated by advancements in imaging technologies, particularly the use of positron emission tomography (PET) scans. These sophisticated imaging techniques enable our clinicians to detect and visualize small numbers of metastatic sites that might be overlooked by conventional imaging methods. Here at Smilow Cancer Hospital, our multidisciplinary teams treat oligometastatic disease using the following treatment types: Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Hepatic Artery Infusion (HAI) The concept of oligometastatic cancer has gained increasing attention in the field of oncology, leading to clinical trials and extensive research aimed at refining its definition, understanding its behavior, and determining optimal treatment strategies. It is important to note that all cancer types are different and do not show an oligometastatic pattern, and the relevance of this concept varies across different tumor types. The management of oligometastatic cancer requires a personalized and multidisciplinary approach, considering factors such as the primary tumor type, the location of metastases, overall patient health, and treatment goals. Our team of clinicians collaborates directly with patients to identify the presence of oligometastatic disease, establish a tailored treatment plan, and enhance outcomes for patients in this unique stage of cancer progression. For gastrointestinal oncology-related appointments, view the profile of Kiran Turaga, MD, MPH . For gynecologic oncology-related appointments, visit the profile of Elena Ratner, MD, MBA .

The Department of Therapeutic Radiology works closely with the Yale Cancer Center to comprehensively evaluate and treat patients in need of any form of radiation therapy. We are widely known for our innovative approach to treatment, and have extensive experience in the following specialized areas: Breast cancer radiotherapy Central nervous system radiotherapy Gastrointestinal radiotherapy Head and neck radiotherapy Pediatric radiotherapy Prostate and genitourinary cancer radiotherapy Spine radiosurgery Stereotactic body radiotherapy (SBRT) and Gamma Knife® radiosurgery Thoracic radiotherapy Total skin electron beam therapy (TSEBT) Our primary goal is to ensure our patients receive the right amount of radiation at the tumor site, with as little impact as possible on the surrounding healthy tissue. Our treatment planning program, also known as medical dosimetry, is focused on just that, providing a highly individualized external or internal radiation treatment course for each patient. Site of the only Gamma Knife® center in Connecticut One of the largest U.S. centers for stereotactic body radiotherapy (SBRT) First program in Connecticut to incorporate SpaceOAR hydrogel technology in prostate radiotherapy First and only program in New England to combine SpaceOAR technology with Calypso radiofrequency tracing for precision prostate surgery

Covering every aspect of health care for adults, Internal Medicine is the largest department in the Yale School of Medicine, and the largest clinical service at Yale New Haven Hospital. We provide comprehensive and specialized services in all areas in a variety of outpatient settings as well as the Veterans Affairs (VA) Connecticut Health Care System campus in West Haven. Our culture of collaboration and research gives patients access to expert opinions from nearly 1,000 doctors, as well as opportunities to get tomorrow’s health care today through more than 100 clinical trials. Most importantly, we attend to our diverse community of patients with compassionate, thorough care. Specialized care is offered in the following areas: Allergy & clinical immunology Cardiovascular medicine Digestive diseases Endocrinology General internal medicine Geriatrics Hematology Infectious diseases Medical oncology Occupational health & environmental medicine Nephrology Pulmonology, critical care & sleep medicine Rheumatology International reputation for work in understanding function, independence, and quality of life in older persons Key research breakthroughs of the past decade that include the development of a protective Lyme bacillus disease vaccine, exploration of the underlying causes of allergic disease, and the discovery of novel inherited immunological diseases Largest interventional cardiology program in Connecticut Major referral center for patients with type 1 and type 2 diabetes, as well as other metabolic conditions Nationally ranked program in kidney diseases and the largest kidney transplant program in New England, with multidisciplinary care clinics One of the largest peripheral vascular programs in the country, with leadership and participation in multiple new percutaneous device trials Once of only a few motility centers in Connecticut to provide all motility procedures and services Unique medical forensic exams for individuals with claims of torture who are seeking asylum in the U.S.

Our program was formed in 2013 to address the clinical issues and concerns faced by patients and their families with pancreatic disease, such as pancreatic cancer, pancreatic cysts, and pancreatitis. We provide the latest treatments in collaboration with other Yale programs such as the Yale Cancer Center. Our team comprises doctors from several fields to provide patients with the most comprehensive care, including advanced endoscopy, gastroenterology, surgery, medical oncology, radiation oncology, pathology, and genetics. Our nurses and advanced practice nurses are also highly experienced in pancreatic diseases. It is important to us that we educate our patients about pancreatic disease and its related procedures and treatments. We believe this empowers patients and family members to take an active role in their health care decisions, which can lead to an improved quality of life. We specialize in treating the following conditions: Pancreatic cancer Pancreatic cysts Chronic pancreatitis Acute pancreatitis We also offer the following services: Endoscopic ultrasound Endoscopic retrograde cholangiopancreatography Medical oncology Radiation oncology Pancreas surgery

The Center for Breast Cancer at Smilow Cancer Hospital and Yale Cancer Center provides coordinated, state-of-the-art care for patients with benign and malignant diseases of the breast. For patients diagnosed with breast cancer , we offer dedicated care, innovative treatment options, and cutting-edge research. A great deal of progress in the detection and treatment of breast cancer has been made in recent years, and our physicians are on the leading edge of finding even better solutions. Women with a diagnosis of breast cancer are cared for by a multidisciplinary team of physician specialists, including radiologists, breast surgeons, medical oncologists, radiation oncologists, pathologists, and plastic surgeons. From the tranquility of the building, to our complementary therapy services, to the most sophisticated personalized therapies and equipment available, Yale is committed to tailoring treatment to our patients to ensure they have the best experiences possible during their time in our care. Breast Surgery Although many general surgeons perform breast surgery, dedicated breast surgeons have the experience and knowledge to handle difficult or unusual cases, and are generally more likely to understand the complexities of breast diagnosis and treatment. The surgeons at the Center for Breast Cancer at Smilow Cancer Hospital and Yale Cancer Center perform breast surgery exclusively, and are nationally known as leaders in their field. Yale surgeons were among the first to perform a lumpectomy instead of a mastectomy, and were instrumental in the development of noninvasive procedures like sentinel lymph node biopsy, intraoperative guidance by ultrasound, and advanced oncoplastic procedures. Our surgeons are experienced in cutting-edge techniques, such as skin-sparing and nipple-sparing mastectomy, and often work hand-in-hand with our plastic surgeons to offer women a variety of options for breast reconstruction. Medical Oncology Many patients with breast cancer also need medical therapy, such as chemotherapy and/or endocrine therapy. Our team of experts utilizes both standard chemotherapies and novel targeted therapies to attack the cancer precisely while minimizing harm to normal tissues. Our medical oncologists are nationally recognized for their contributions to breast cancer research. For example, investigators at Yale helped to elucidate the biology of a cellular receptor called HER2. As a result, our medical oncologists have been successful in developing treatment strategies for HER2-positive breast cancer, and have extended this expertise to provide effective therapies for triple-negative/basal-like and hormone receptor-positive breast cancer. They continue to study new treatments, and patients at Smilow Cancer Hospital have the opportunity to receive such novel therapies through clinical trials, many of which are not available elsewhere in Connecticut. New and complicated patient cases are discussed weekly by the entire team so that