The Gastrointestinal Cancer Center at Orlando Health UF Health Cancer Center offers a range of treatments. Your team of doctors will recommend a combination of therapies that will give you the most benefits based on your diagnosis, the stage and your personal preferences.
Our expert surgeons are experts in a variety of oncology techniques, including minimally invasive surgeries and traditional open surgeries. Minimally invasive surgeries, some with robotic assistance, require smaller incisions and patients experience shorter recovery times.
Doctors at Orlando Health are recognized as an epicenter for da Vinci® robotic colorectal surgery, Orlando Health is visited by doctors from across the country to receive training from our skilled surgeons in colon and rectal surgery.
For most patients with colon cancer, no matter the stage, surgery to remove the tumor is a key element of treatment depending on the stage of the cancer and location. Your surgeon may perform one of these procedures:
• Local excision: If your cancer is in an early stage, your doctor may be able to avoid cutting through the abdominal wall and instead insert a tube into the rectum up to the colon to cut out the cancer.
• Resection of the colon with anastomosis: This procedure removes the part of the colon with the cancer and a margin of healthy tissue, along with its lymph nodes, then rejoins the pieces of the colon.
• Resection of the colon with colostomy: If after removing the cancer the surgeon cannot reconnect the two pieces of the colon, an opening is made outside the body for waste to pass through.
In cases where the cancer has spread from the colon and rectum to other parts of the body, the highly trained team of surgeons, radiation oncologists, and radiologists, in our Metastatic Colorectal Cancer Program will determine if they can pursue other local measures. If so, they can use any of the many procedures designed to remove or kill these masses including:
• Radiofrequency ablation: a probe with tiny electrodes, placed into the tumor.
• Microwave ablation: microwaves are created from a needle, placed in the tumor.
• Surgical resection: a procedure to remove a tumor and normal tissue around it.
• Cryosurgery: an instrument that freezes the cancer cells.
After surgery, your team of physicians will discuss with you whether radiation or chemotherapy is needed to eliminate any remaining cancer cells. Radiation uses high-energy x-rays to kill or stop the growth of cancer cells. Radiation therapy can be performed with an external machine or internally with a radioactive substance sealed in needles, seeds, wires or catheters targeting the cancer. Chemotherapy uses medicines to kill the dividing cancer cells and may be injected directly into the blood supply of these metastases liver lesions.
If your cancer already has spread within the abdominal cavity, you may be a candidate for Cytroreductive Surgery and Hyperthermic Interperitoneal Chemotherapy (HIPEC). This two-step procedure involves surgery to remove all visible tumor followed by heated chemotherapy drugs that are placed in the abdomen. The patient lies on a cooling blanket to keep body temperature at a safe level, and surgeons rock the patient during the procedure. Afterward, the chemotherapy is removed from the body.
HIPEC has several advantages over traditional chemotherapy:
• Direct placement of the agent means the drug is better able to access cancer cells at this concentration.
• Depending on tumor type the patient may only need a single dose that is administered in the operating room.
• Because most of the drug stays in the abdomen, typically chemotherapy side effects can be avoided.
Difficult to detect in their early stages because symptoms often don’t develop until the disease has progressed, pancreatic cancer depend on a combination of surgery, chemotherapy and radiation therapy to treat the different stages. Treatments are named according to surgical involvement:
• Resectable: Surgery is the main treatment, although chemotherapy and radiation could be used before or after.
• Borderline resectable: Chemotherapy and radiation are used first and then possibly followed by surgery.
• Unresectable: Chemotherapy and possibly radiation are done without surgery.
• Metastatic: Chemotherapy is the primary treatment.
The Gastrointestinal Cancer Center at Orlando Health UF Health Cancer Center also is a leader in using neoadjuvant therapy for pancreatic cancer. In cases where the cancer is borderline resectable, the use of chemotherapy before surgery has been found to increase survival rates.
In addition, clinical trials may offer pancreatic cancer patients additional treatment options. These studies test the most innovative therapies, and trials may accept patients before, during or after cancer treatment.
We offer many treatments for liver cancer, and your team of doctors will recommend a combination of therapies that best suit your diagnosis and personal preferences.
Surgery, called hepatectomy, to remove the tumor or tumors can be an option for patients with early-stage cancer who have otherwise healthy livers. This option is more viable when the tumors are small and do not affect nearby blood vessels. Patients with early-stage cancer whose livers are not healthy may be candidates for liver transplant surgery.
When a liver tumor(s) cannot be removed safely by surgery but the cancer has not spread to other parts of the body, treatment options usually focus on reducing symptoms and extending life expectancy, rather than curing the disease. These treatments include:
• Intraarterial chemotherapy is the use of strong medicines to kill the dividing cancer cells.
• Radiation therapy can be done externally with a machine targeting the cancer cells with high-energy x-rays to kill them or internally with a radioactive substance sealed in needles, seeds, wires or catheters to target the cancer.
• Ablation uses a probe with tiny electrodes to target the tumors.
• Embolization is a procedure that injects substances to stop blood flow to cancer cells in the liver.
• Targeted therapy uses chemotherapy drugs designed to work in different ways than traditional chemotherapy while still covering the whole body.
• Immunotherapy is the use of medicines that help a patient’s own immune system identify and destroy cancer cells.
Secondary liver cancer is far more common than primary liver cancer. That means the cancer is the result of metastasis of cancer from another part of the body to the liver. When that happens, the Gastrointestinal Cancer Center at Orlando Health UF Health Cancer Center uses highly specialized therapies to fight the disease. Among them:
• Staged liver surgery for bilobar disease involves performing surgery on tumors in both lobes of the liver during separate operations.
• Yttrium 90 Spheres are a type of Selective Internal Radiation Therapy (SIRT) that is administered through a catheter in the artery that supplies blood to the tumor. These beads contain radiation and travel through the bloodstream to the liver where they become lodged in the tumor and kill the cancer cells. This therapy delivers a dose of internal radiation up to 40 times higher than traditional external therapy and protects healthy tissues.
• Chemoembolization is a procedure that delivers a highly concentrated dose of chemotherapy medicine through a catheter in the blood vessel at the location of the tumor. A blood vessel occluding agent also is used to starve the tumor’s blood supply. This two-pronged approach is often successful in stopping tumor growth or even shrinking a tumor.
• Clinical trials explore the most innovative therapies, giving patients new options for treatment.
Although stomach cancer is becoming rarer in the United States, when is does occur, it typically is not diagnosed until it reaches an advanced stage. Because of this, stomach cancer usually is difficult to treat and requires aggressive procedures.
Surgery is used to treat all stages of stomach cancer, if possible. Several different operations can help patients with stomach cancer:
• A subtotal gastrectomy removes the part of the stomach with cancer as well as nearby lymph nodes, and other tissues and parts of organs near the tumor.
• A total gastrectomy takes out the entire stomach as well as nearby lymph nodes and parts of the esophagus, small intestine and other tissues.
• A gastrojejunostomy is a procedure to connect a small tube to the stomach and small intestine with an end outside the body for feeding and administering medications. This surgery is performed when the diseased stomach cannot be removed.
Your team of physicians will discuss with you whether radiation or chemotherapy is needed to shrink the tumors before surgery or to eliminate any remaining cancer cells afterward. Radiation uses high-energy x-rays to kill or stop the growth of cancer cells. Radiation therapy can be performed with an external machine or internally with a radioactive substance sealed in needles, seeds, wires or catheters targeting the cancer. Chemotherapy uses medicines to kill the dividing cancer cells.
The Gastrointestinal Cancer Center at Orlando Health UF Health Cancer Center also uses highly specialized therapies to fight stomach cancer. Among them is Cytroreductive Surgery and Hyperthermic Interperitoneal Chemotherapy (HIPEC). This two-step procedure involves surgery to remove the tumor followed by heated chemotherapy drugs that are placed in the abdomen. The patient lies on a cooling blanket to keep body temperature at a safe level, and surgeons rock the patient during the procedure. Afterward, the chemotherapy is removed from the body.
HIPEC has several advantages over traditional chemotherapy:
• Direct placement of cisplatin means the drug is better able to target cancer cells and can be given at a higher dose.
• The patient only needs a single dose that is administered in the operating room.
• Because most of the drug stays in the abdomen, there is no increase in side effects or complications.
Another specialized treatment is molecular profiling. This therapy uses different technologies to determine specifics about the genetic makeup of your cancer, such as protein expression and DNA mutations, and then uses that information to halt the tumor.