Digestive Cancer Program at Providence Cancer Institute of Orange County
At the Providence Cancer Institute of Orange County, our dedicated team specialize in treating digestive cancer, or gastrointestinal cancer. These cancers form in the organs of the gastrointestinal (GI) tract – more commonly known as the digestive tract – which starts at the esophagus and ends at the anus. The digestive tract includes the stomach, esophagus, small and large intestine, pancreas, liver and more.
Digestive Cancer Program at Providence Cancer Institute of Orange County
At the Providence Cancer Institute of Orange County, our dedicated team specialize in treating digestive cancer, or gastrointestinal cancer. These cancers form in the organs of the gastrointestinal (GI) tract – more commonly known as the digestive tract – which starts at the esophagus and ends at the anus. The digestive tract includes the stomach, esophagus, small and large intestine, pancreas, liver and more.
Our Approach to Digestive Cancer Care
At the Providence Cancer Institute of Orange County, our GI specialists include gastroenterologists, colorectal surgeons, radiation oncologists, medical oncologists, genetic counselors, pathologists and endoscopy technicians. They collaborate with you and take a multidisciplinary, personalized approach to treating your cancer. Additionally, our oncology nurse navigators are always available to answer your questions and support you before, during and after treatment.
Together, we’re committed to improving outcomes for patients with gastrointestinal cancer.
Digestive Cancer Conditions We Treat
We provide comprehensive care for gastrointestinal cancer and related conditions, including:
- Ampullary cancer
- Anal cancer
- Bile duct cancer
- Colon cancer
- Duodenal Cancer
- Esophageal cancer
- Gallbladder cancer
- Liver cancer
- Neuroendocrine cancer
- Pancreatic cancer
- Rectal cancer
- Small intestine cancer
- Stomach cancer
Meet Our Expert Cancer Team
At the Providence Orange County Cancer Institute, our multi-disciplinary team is committed to providing expert care to every patient. We work together to deliver a personalized approach to prevention and treatment, supporting you at every stage. With our collaborative expertise, you receive dedicated guidance and compassionate support throughout your journey.
Comprehensive Testing and Diagnostics
Our care team uses many tools to provide a diagnosis and learn which therapies will work best to treat your cancer type based on your individual needs.
An abdominal ultrasound, also known as an abdominal sonogram, is a diagnostic imaging technique that uses high-frequency sound waves to create an image of your internal organs. Your care team can use this imaging to detect, diagnose and treat conditions that affect the abdominal region.
Advanced endoscopy refers to specialized endoscopic techniques and procedures that extend beyond traditional endoscopy, offering enhanced diagnostic capabilities and therapeutic interventions. It utilizes technologies like endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), and capsule endoscopy to perform complex evaluations and treatments, such as staging cancers, removing challenging polyps, or managing bile and pancreatic duct disorders.
A biopsy involves taking a small tissue sample to determine whether cancer cells are present. It’s a common and reliable diagnostic method used to determine the presence of cancer cells.
Commercial clinical trials represent research studies sponsored by the pharmaceutical industry. These trials may include new non-FDA approved drugs, FDA approved drugs being used in a non-FDA approved cancer, or in a new novel combination. These trials are often used to obtain FDA approval for the new treatment.
Endoscopy uses a thin, flexible tube with a light and a camera to look inside your digestive tract. Upper endoscopy allows your doctor to view the esophagus, stomach, and the first part of the small intestine. Lower endoscopy, also known as a colonoscopy, examines the colon and rectum. These procedures help detect polyps, abnormal tissue, or cancerous growths early, often before symptoms appear.
An endoscopic ultrasound (EUS) is a non-invasive diagnostic procedure that helps us inspect and diagnose conditions within the gastrointestinal tract, as well as nearby organs. Like an endoscopy, EUS involves an endoscope – a thin tube with a camera on the end inserted into the mouth or rectum – along with an ultrasound transducer.
The ultrasound transducer uses soundwaves so that your care team can view organs like the pancreas, which is often hard to see because of its position in the body. This imaging helps evaluate the size and status of growths, like tumors or cysts.
Genetic tests, also known as genetic screenings, DNA tests or chromosomal tests, can help determine your risk of developing certain cancers, especially if you have a family history of cancer. We offer treatment, management and prevention plans that are personalized to your unique genetic profile.
Genomic tumor profiling for lung cancer is a type of molecular testing that looks for specific genetic changes or mutations, common in cancer tumors. Identifying a specific mutation can tell us more about your cancer and help us target your treatment based on what we know about that mutation.
A PET scan is a nuclear imaging procedure that uses a combination of computer technology and a radioactive imaging agent called a tracer to produce clear, high-resolution images of the body and its various functions in real-time and in 3D. They allow doctors to evaluate a wide range of conditions – including brain disorders such as Alzheimer’s disease and a variety of cancers – and provide more accurate diagnoses, targeted treatments and better outcomes for our patients.
Services and Treatments
Each treatment plan is unique, personalized to your cancer type and individual needs. Your care team collaborates with you and discusses your treatment plan in detail, which may include a combination of therapies.
Medical oncology uses systemic therapies that travel through the bloodstream to treat cancer that has spread to other areas of the body or has a high risk of spreading. Sophisticated genetic analysis allows some of these therapies to target specific DNA mutations that cause cancer cells to develop and grow.
Chemotherapy is the systemic use of cytotoxic chemicals to kill cancer cells. Today there are many medications (e.g., biological medications, immune treatments, targeted therapies) that do not fit the classic definition of chemotherapy yet are often included in this category.
Chemotherapy (including antibody-drug conjugates) is a specific form of chemotherapy in which the drug is combined with an antibody that carries the chemotherapy to the specific targeted cancer cell. This concentrates the drug in the cancer cells – where it does the greatest good while minimizing the effect on normal cells.
Chemoradiotherapy combines the use of chemotherapy and radiation at the same time. When given together, the two treatments are more effective than when given in sequence. This approach is often used when a cancer is advanced but has not spread to distant parts of the body and therefore may respond to more intense therapy.
Immunotherapy boosts or restores the body’s natural defenses. Cellular therapies, stem cell transplants and biologic therapies use your own cells to fight disease and support recovery.
Molecularly targeted therapy uses drugs – including oral and intravenous (IV) biologics – to target specific molecules that allow cancer to grow. This therapy enables personalized treatment for patients, especially those who carry certain genetic mutations or abnormalities.
Somatostatin analogues are man-made synthetic compounds that inhibit the excessive production of naturally occurring hormones that overproduce in some neuroendocrine cancers. This therapy helps control symptoms of carcinoid syndrome, such as diarrhea, flushing, pain, palpations, wheezing and hypertension. The treatment may also cause shrinkage in some tumors.
Surgical therapies involve an operation or procedure to remove cancer from the body. Surgery may be the main treatment for some invasive cancers, but it’s only one part of the entire treatment plan.
Abdominoperineal resection is surgical removal of the anus, rectum and part of the colon through an incision in the abdomen.
Appendectomy is surgical removal of the appendix.
Bile duct excision and reconstruction is a surgical procedure involving the removal (excision) of part or all of the bile duct, often due to conditions such as tumors, strictures, or injury. Following the excision, reconstruction is performed to restore the continuity of the bile flow from the liver to the small intestine, often using techniques such as direct anastomosis or employing a segment of the intestine to replace or bypass the removed bile duct portion. This procedure aims to alleviate symptoms, prevent complications like jaundice, and ensure proper digestion.
Coloanal anastomosis using total mesorectal excision is surgery to attach the colon to the anus.
Distal gastrectomy is surgical removal of cancer in the lower part of the stomach. Part of the small intestines may also be removed.
Duodenal resection is a surgical procedure that involves the removal of part or all of the duodenum, which is the first section of the small intestine immediately following the stomach. This procedure may be performed to treat conditions such as tumors, severe ulcers, or other obstructions in the duodenum. Depending on the extent of the disease and resection, it may be necessary to reconnect the remaining portions of the digestive tract to ensure normal digestive function.
Endoscopic ultrasound staging combines endoscopy and ultrasound to evaluate growths or other abnormalities in the gastrointestinal tract, including the esophagus.
Laparoscopic gallbladder surgery is a video-camera assisted procedure to remove the gallbladder.
Open gallbladder surgery is a traditional approach to removing the gallbladder.
Subtotal or total gastrectomy is surgical removal of all or part of the stomach.
Irreversible electroporation (IRE) of the pancreas is a procedure that uses electrical currents to treat pancreatic tumors.
Laparoscopic and open ablation refer to surgical procedures where radiation, chemicals, or microwave and laser technologies are used to destroy cancer cells.
The procedures may be done using a laparoscope that’s inserted through a small incision or traditional open surgery.
Open liver resection (partial, hemi and extended) is a surgical procedure to remove a tumor from the liver through an incision in the abdomen. The diseased part of the liver is also removed.
Laparoscopic liver resection (partial, hemi and extended) is a surgical procedure in which up to half of the liver is removed through a laparoscope, leaving the remainder of the organ in place.
Laparoscopic and open ablation refers to surgical procedures in which radiation, chemicals, or microwave or laser technologies are used to destroy cancer cells. The procedures may be done using a laparoscope inserted through a small incision, or in a traditional open manner.
Open esophageal surgery is a procedure to remove esophageal tissue and reconstruct the organ with tissue from the stomach or intestines.
Open radical cystectomy is surgical removal of the bladder, lymph nodes and other organs in the pelvic area.
Laparoscopic pancreatectomy & Open pancreatectomy is surgical removal of or part of the pancreas and possibly the spleen.
Laparoscopic pancreatectomy & Open pancreatectomy is surgical removal of or part of the pancreas and possibly the spleen.
Laparoscopic pancreatectomy & Open pancreatectomy is surgical removal of or part of the pancreas and possibly the spleen.
Regional nodal dissection, also referred to as regional lymphadenectomy, is the surgical removal of lymph nodes near a tumor. The nodes are then checked for the presence of cancer cells.
Neuroendocrine resection is surgical removal of glands, organs and tissues related to the neuroendocrine system.
Robotic abdominal perineal resection is an advanced, video camera-assisted surgery to remove the rectum, anus and parts of the lower intestines.
Robotic-assisted surgery is a new way of performing minimally invasive procedures, incorporating techniques that allow a surgeon to operate through several small incisions, or ports, about the size of a dime. Robotic-assisted surgery uses technology proven to effectively treat a wide range of conditions with less pain, faster recovery and reduced risk of complications following surgery.
Transanal endoscopic microsurgery is surgery performed through the anus and rectum to remove polyps and early-stage cancers.
Transanal excision is a surgical treatment for colorectal cancer that allows a surgeon to remove tumors and some surrounding tissue, leaving the anus and sphincter in place.
Transanal minimally invasive surgery is a video camera-assisted procedure to remove polyps and other growths from the rectum.
Whipple procedure is surgery to remove cancerous tumors; and to examine blood vessels and surrounding tissue to detect the spread of cancer cells. It is one of the most effective treatments for pancreatic and neuroendocrine cancers and offers a good chance for full recovery.
Radiation is effective in killing cancer cells and shrinking tumors. It can be used alone or in combination with other cancer treatments.
IGRT delivers high-dose radiation, guided by imaging, directly to tumors. It provides precise and accurate cancer treatment while preserving healthy tissue and potentially keeping the side effects that you experience to a minimum.
IMRT and VMAT are advanced types of radiation therapies:
- IMRT uses advanced technology to manipulate the radiation beams to conform to the shape of a tumor.
- VMAT is a subtype of IMRT in which the machine actively delivers radiation beams while moving in an arc around the patient.
The arc-based therapy provided via VMAT delivers high doses of radiation to more focused areas, reducing side effects, toxicity and harm to vital organs and the overall treatment time.
Learn more about intensity-modulated radiation therapy (IMRT)
Radiopharmaceuticals (Lu-177) is a radioisotope that is combined with a delivery molecule to specifically target a type of cancer cell in some neuroendocrine tumors and prostate cancers. This radiopharmaceutical compound simulates the action of a naturally occurring substance and binds to cancer cells. This interaction slows the growth of cancer cells, working to destroy them using a radioactive particle inside the cell to damage the cancer cells’ DNA.
The elegance of this therapy lies in its ability to bind the medication directly to cancer cells and to apply radiation from inside the cancer cell – thus delivering a potent dose that doesn’t penetrate very far, potentially sparing the surrounding healthy cells.
Radiopharmaceuticals (Y-90) is a group of treatments delivered by a catheter and consisting of millions of microscopic, radioactive microspheres that are infused into the arteries that feed the tumor. Y-90 microspheres are delivered into the arteries and can be used to treat cancer that has spread, or metastasized, to the liver. These particles become embedded into the cancer cells and deliver the radiation directly to the cancer site. Two commonly used agents are Theraspheres and Sir Spheres.
The advantage of this treatment is that the radiation penetrates only a short distance, so the risk to the organ is very low while the dose the cancer experiences is very high.
This procedure is one of several new ways to deliver radiation therapy directly into the tumor site. It requires a sophisticated facility and equipment, along with highly specialized physicians. It is available at some Providence locations.
Both SABR and SBRT deliver high-dose radiation to a specific area with very precise targeting through special immobilization and imaging techniques. These therapies can include stereotactic radiosurgery (SRS) systems like CyberKnife, which delivers precisely targeted radiation using a robotic delivery system with sub-millimeter accuracy. SABR and SBRT are often outpatient procedures, so you could go home the same day.
SGRT/SIGRT uses real-time beam guidance and surface-recognition technology to target tumors, reducing side effects and harm to vital organs. This therapy can be used in conjunction with IMRT and VMAT to help guide your positioning during treatment and account for any involuntary movement, making it less invasive and potentially more comfortable for you.
3DCRT uses 3D planning and CT imaging to better target tumors and cancerous areas and improve the outcome of radiation treatment. It also limits the damage to healthy tissue, potentially decreasing risks like infection and minimizing side effects.
Learn more about three-dimensional conformal radiation therapy (3DCRT)
Additional therapies may also be part of the treatment plan for a small number of patients.
Histotripsy is a revolutionary treatment for both cancerous and non-cancerous liver tumors, as well as metastatic cancer that has spread to the liver. This FDA-approved procedure uses high-energy ultrasound waves that convert to sonic beams and destroy liver tumors – without a single incision or needle.
Histotripsy has shown a 95.5% success rate in clinical trials, and multiple tumors can be treated in a single therapy session. It can be used to effectively treat liver tumors in patients who aren’t candidates for open surgery or have been told their liver tumor is inoperable.
Interventional radiology is a minimally invasive procedure guided by radiologic imaging. It may be used to implant a port, or vascular access device, to obtain diagnostic material, remove fluid from the chest or abdomen or deliver treatment locally.
Duodenal resection is a surgical procedure that involves the removal of part or all of the duodenum, which is the first section of the small intestine immediately following the stomach. This procedure may be performed to treat conditions such as tumors, severe ulcers, or other obstructions in the duodenum. Depending on the extent of the disease and resection, it may be necessary to reconnect the remaining portions of the digestive tract to ensure normal digestive function.
TACE is a minimally invasive procedure – primarily used to treat liver cancer – that uses imaging guidance to directly deliver chemotherapy drugs to a tumor via embolic agents. The embolic agents are injected into the blood vessel feeding the tumor, which cuts off the blood supply and keeps the chemotherapy drugs within the tumor.
This procedure helps patients with advanced stages of cancer or those who aren’t good candidates for surgery.
Histotripsy: A Breakthrough Liver Cancer Therapy
Histotripsy is a revolutionary treatment for both cancerous and non-cancerous liver tumors, as well as metastatic cancer that has spread to the liver. This FDA-approved procedure uses high-energy ultrasound waves that convert to sonic beams and destroy liver tumors – without a single incision or needle.
Patient Resources & Support
Get a second opinion from our world-class cancer experts, so that you can make important decisions about your treatment plan and move forward with confidence. Our web page will walk you through the next steps and let you know how to prepare for your appointment.
Are you looking for a clinical trial, either for yourself or a patient? Currently, Providence Cancer Institute of Orange County is involved in over 100 ongoing clinical trials.
We offer comprehensive support services – including oncology nurse navigators, transportation services and financial counseling – to help you and your loved ones throughout your cancer journey.
Frequently Asked Questions
Your doctor may refer you for different imaging and testing of your body tissue so that we can make a cancer diagnosis. Scans and pathology tests also help us look for changes, or mutations, in your cancer, which can tell us how to treat your specific cancer type.
It can take one to two weeks to receive pathology results, but these results are important for getting you the targeted treatment that serves you best.
Cancers often require a combination of approaches to achieve the best outcome, so it’s likely your care plan could include more than one type of treatment.
Chemotherapy, radiation therapy, molecularly targeted therapy or cellular therapy may be needed to target cancer cells throughout the body, reduce the risk of recurrence or improve the overall effectiveness of your treatment.
Not always. A colostomy bag is a pouch that collects fecal waste through an opening in your abdomen called a stoma. The need for a colostomy bag depends on many factors, including tumor size and the type and stage of your cancer.
We use advanced surgical and imaging techniques to help us precisely detect your cancer and provide highly personalized treatment plans that are as minimally invasive as possible.
When a colostomy bag is required, our care teams are here to provide comfort, education, instruction and support.
Yes, our support services at Providence Cancer Institute of Orange County include financial navigation to help ease your way through financial concerns and barriers.
Our staff can help you:
- Evaluate insurance health plans to ensure the right choices are made for your care
- Leverage available programs and services, such as co-pay assistance and patient assistance programs to help reduce financial barriers
- Optimize external assistance programs, such as patient financial support programs
Your oncology nurse navigator can refer you to a social worker, who can connect you with financial support as needed.
An oncology nurse navigator is a nurse or registered clinician who personally guides you from diagnosis through survivorship. They are your advocate, here to provide support and reassurance tailored to your needs – whether that's occasional conversations or daily check-ins.
Your navigator can coordinate your appointments, speak directly with your primary care physician, provide support to lower your stress, talk to your loved ones and help you access all the resources that you need.
Many people assume that if you’re joining a clinical trial, other treatment options have failed, but that’s not always the case. Your care team may know of clinical trials that offer promising, innovative therapy options that are best suited to treat your cancer type. Your participation in a clinical trial also offers a way to help others by advancing cancer research. If you’re curious, you don’t need to wait. Ask your care team as many questions as you need to, as soon as you’d like.
We’re proud to offer a variety of clinical trials with the most advanced types of therapies.
Not necessarily. Palliative care isn’t just hospice care. Palliative care offers additional support alongside your treatment, and it can start as soon as you’re diagnosed. It helps you define treatment goals, manage symptoms and improve your overall quality of life.
With palliative care, you get support managing pain, symptoms and side effects from your cancer treatment. Your palliative care team also helps you deal with physical and emotional stress, spiritual needs and more.
You have the option to incorporate palliative care into your treatment plan right from the start, which can help keep you comfortable and receive the extra support that you need.