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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on April 1, 2021.

Gastroenterology

Gastroenterology is a branch of medicine focused on gastrointestinal diseases, such as Crohn's disease, irritable bowel syndrome and pancreatitis. Gastroenterologists are trained to diagnose and treat a broad spectrum of disorders that affect the digestive tract, from the mouth to the anus. The gastroenterology team at Cancer Treatment Centers of America® (CTCA) specializes in diagnosing and treating stomach, gallbladder, large and small intestine

What procedures are performed by gastroenterologists?

Gastroenterologists use a number of tests, screens and procedures to diagnose and stage cancer. Colonoscopies are often used to determine the cause of constipation and abdominal pain, to look for signs of colorectal cancer, such as polyps or tumors, and to take tissue samples for biopsies. CTCA® gastroenterologists also use endoscopic ultrasounds (EUS) to stage and diagnose cancers that affect the biliary tract, colon, rectum, esophagus, pancreas and stomach. For some patients, another form of endoscopy, endoscopic retrograde cholangiopancreatography (ERCP), may be used to explore pancreatic bile ducts, relieve obstructions, insert stents in narrow ducts or take samples for a biopsy.

Once a gastric cancer has been diagnosed, some of the procedures that may be performed by CTCA® gastroenterologists include:

Fiducial markers: Fiducial markers are placed inside a tumor before radiation therapy. Using these markers allows for more precise targeting of tumors and helps reduce harm to healthy tissue.

Jejunostomy tube (J-tube): This feeding tube is inserted through the abdomen and into the second part of the small intestine, known as the jejunum. Patients who receive a feeding tube may be having difficulty digesting food or may inhale food into their lungs.

Esophagogastroduodenoscopy (EGD): Commonly called an upper endoscopy, this procedure is used both to diagnose and treat conditions of the upper gastrointestinal tract. The doctor views the lining of the esophagus, stomach and beginning of the small intestine using real-time images from a camera attached to a thin, flexible tube called an endoscope. An EGD may be used to treat cancer of the esophagus, stomach and small intestine.

Nd: YAG laser: The Nd: YAG (neodymium: yttrium-aluminum-garnet) laser shrinks or destroys tumors and/or helps relieve symptoms in difficult-to-reach areas of the body, such as the lungs, esophagus or colon.

A high-power laser beam burns, or “vaporizes,” the tumor. The cancer is evaporated, and the vapor is suctioned out through an endoscope or bronchoscope.

The Nd: YAG laser is often used to treat large, obstructive masses that causes symptoms such as bleeding or obstruction but cannot be removed surgically. For example, the laser may be used to remove an obstruction in the esophageal tract to relieve swallowing difficulties, or in the airways to improve breathing.

Needle-based ablation: Needle-based ablation is a localized cancer treatment that uses high-energy radio waves or microwaves to heat and destroy cancerous cells.

Using a CT scan for guidance, a thin probe is temporarily inserted into a tumor through a tiny incision in the skin. The probe releases heat and destroys cancer cells. This procedure may be used to treat tumors when surgery is not an option or to relieve other symptoms related to cancer treatment.

How do gastroenterologists work with other medical specialists to treat cancer?

Gastroenterologists do not perform surgery. But they partner closely with surgical oncologists to develop a high-quality, individualized care plan that prepares the patient for tumor removal or surgical resection, as well as other treatments and recovery. With expertise in internal medicine, hepatology and the digestive system, CTCA board-certified gastroenterologists are familiar with common side effects for gastroenterology patients. They also frequently consult registered dietitians and other members of the care team to help patients manage those side effects so they can be strong and well enough to continue with their treatment.