Curbside Consultation in Gi Cancer for the Gastroenterologist: 49 Clinical Questions

Description

Are you looking for concise, practical answers to questions that are often left unanswered by traditional cancer references that are not designed for gastroenterologists? Are you seeking brief, evidence-based advice for complicated cases or patients with complications that need management? Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions provides quick and direct answers to the thorny questions commonly posed during a “curbside consultation” between colleagues.

Dr. Douglas G. Adler has designed this unique reference, which offers expert advice, preferences, and opinions on tough clinical questions commonly associated with GI cancer. The unique Q&A format provides quick access to current information related to GI cancer with the simplicity of a conversation between two colleagues. Numerous images, diagrams, and references are included to enhance the text and to illustrate the treatment of GI cancer patients.

Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions provides information basic enough for residents while also incorporating expert advice that even high-volume clinicians will appreciate. Gastroenterologists, fellows and residents in training, surgical attendings, and surgical residents will benefit from the user-friendly and casual format and the expert advice contained within.

Some of the questions that are answered:

• An 81-year-old man is found to have unresectable esophageal cancer and malignant dysphagia. Should he have a stent? A nasogastric feeding tube? A PEG tube?
• How is tumor-related bleeding from gastric cancers best approached?
• Do patients with pancreatic cancer and jaundice need to have an ERCP preoperatively?
• What is the role of ERCP and EUS in patients with suspected cholangiocarcinoma?
• Why are rectal cancers so different from colon cancers with regards to medical and surgical management?

Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions illustrates how patients at different points in their treatment may go back and forth between specialists to receive coordination of care, and incorporates input from gastroenterologists, surgeons, radiologists, and oncologists. While providing up-to-date information, this book will help gastroenterologists to manage complex cancer-related issues and guide physicians through the maze of cancer-related treatments available.

Ideal for practicing gastroenterologists, gastroenterology fellows, surgeons, oncologists, residents, and medical students, Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions is sure to benefit anyone caring for patients with gastrointestinal cancers.

Contents

Section I: Esophagus

• Question 1: What Are the Risk Factors for the Development of Esophageal Cancer?
  Kevin D. Halsey, MD and Bruce D. Greenwald, MD
• Question 2: Do All Patients With Esophageal Cancer Require Surgery or Can Some Be Managed With Nonsurgical (Endoscopic, Oncologic, Etc) Methods Alone?
  Robin B. Mendelsohn, MD and Christopher J. DiMaio, MD
• Question 3: What Options Exist for Enteral Feeding in Preoperative Patients With Esophageal Cancer Who Have Dysphagia?
  Vivek Kaul, MD, FACG
• Question 4: An 81-Year-Old Man Is Found to Have Unresectable Esophageal Cancer and Malignant Dysphagia. Should He Have a Stent? A Nasogastric Feeding Tube? A Percutaneous Endoscopic Gastrostomy Tube?
  Katarina B. Greer, MD, MS and Ashley L. Faulx, MD, FASGE
• Question 5: How Should Malignant Tracheoesophageal Fistulae Be Managed in Patients With Esophageal Cancer?
  Ananya Das, MD, FACG, FASGE
• Question 6: A 55-Year-Old Man Undergoes an Esophagectomy for Esophageal Cancer. Two Years Later, He Develops Dysphagia and a Contrast Study Discloses a Narrowing at His Anastomosis. How Should This Be Investigated and Treated?
  Michael Walker, MD and John Fang, MD

Section II: Gastric

• Question 7: What Are The Known Risk Factors For the Development of Gastric Cancer?
  Selvi Thirumurthi, MD, MS
• Question 8: What Is the Relationship Between Helicobacter pylori and the Development of Gastric Cancer and Lymphoma? Do All Patients With Helicobacter pylori-Related Gastric Malignancies Need Surgery?
  Scott Pollack, MD and Virendra Joshi, MD, AGAF
• Question 9: What Options Exist for Patients With Gastric Outlet Obstruction From Gastric Cancer?
  Andrew Singleton, MD and Robert E. Glasgow, MD
• Question 10: What Is the Role of Endoscopic Ultrasound in Staging Gastric Cancers?
  Jeffrey L. Tokar, MD
• Question 11: How Is Tumor-Related Bleeding From Gastric Cancers Best Approached?
  Jeffrey L. Tokar, MD
• Question 12: What Is Linitis Plastica and How Does Its Development Affect the Management and Prognosis of Patients With Gastric Cancer?
  Caroline R. Tadros, MD
• Question 13: A 42-Year-Old Woman Has an Esophagogastroduodenoscopy for Dyspepsia. A 2-cm Submucosal Lesion in the Proximal Stomach Is Seen. How Should This Lesion Be Further Evaluated and Treated?
  Robert C. Wrona, MD and Robert E. Glasgow, MD

Section III: Pancreatic

• Question 14: A 54-Year-Old Woman Has Weight Loss and Back Pain. An Ultrasound Is Suggestive of a Solid Mass in Her Pancreas. How Should Her Evaluation Best Proceed With Regards to Diagnosis and Staging?
  Randall K. Pearson, MD
• Question 15: Do Patients With Pancreatic Cancer and Jaundice Need to Have an Endoscopic Retrograde Cholangiopancreatography Preoperatively?
  Todd H. Baron, MD
• Question 16: A 43-Year-Old Woman Has Syncope Due to Hypoglycemia. An Insulinoma Is Suspected. Computed Tomography and Magnetic Resonance Imaging of Her Abdomen Are Negative. How Should This Patient Be Further Evaluated?
  Sergey V. Kantsevoy, MD, PhD
• Question 17: How Should a Cystic Pancreatic Lesion Be Evaluated Prior to Treatment? Which Cystic Lesions in the Pancreas Require Resection and Which Can Be Followed Conservatively?
  Randall K. Pearson, MD
• Question 18: What Is the Role of Metal Biliary Stents in Patients With Unresectable Pancreatic Cancer and Jaundice?
  Sergey V. Kantsevoy, MD, PhD
• Question 19: Should Patients With a Strong Family History of Pancreatic Cancer Be Screened for the Disease, and if so, How?
  David Chu, MD and Douglas G. Adler, MD, FACG, AGAF, FASGE
• Question 20: A 78-Year-Old Woman With Pancreatic Cancer and Severe Pain Is Referred to You for Evaluation. What Is the Role of Celiac Plexus Neurolysis to Control Pain in These Patients?
  Nikhil Banerjee, MD and Douglas G. Adler, MD, FACG, AGAF, FASGE
• Question 21: A 70-Year-Old Man With Pancreatic and Liver Cancers Develops Gastric Outlet Obstruction Due to a Mass Compressing the Mass Proximal Duodenum. What Treatment Options Exist for This Situation?
  Todd H. Baron, MD
• Question 22: A 67-Year-Old Man With Pancreatic Adenocarcinoma Undergoes Endoscopic Ultrasound, Which Reveals Malignant Adenopathy and Superior Mesenteric and Portal Vein Involvement. What Treatment Options Exist for This Patient?
  Sean J. Mulvihill, MD
• Question 23: A 68-Year-Old Man Develops Painless Jaundice. Endoscopic Retrograde Cholangiopancreatography Demonstrates a Large Ampullary Mass. Biopsies Demonstrate Adenocarcinoma. How Should This Patient Be Managed?
  Shyam J. Thakkar, MD and Douglas Pleskow, MD, AGAF, FASGE

Section IV: Biliary

• Question 24: A 24-Year-Old Female Is Found to Have Primary Sclerosing Cholangitis. What Is Her Risk of Developing Cholangiocarcinoma?
  James D. Morris, MD and Virendra Joshi, MD, AGAF
• Question 25: What Is the Role of Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound in Patients With Suspected Cholangiocarcinoma?
  Rabi Kundu, MD, FRCS and Douglas Pleskow, MD, AGAF, FASGE
• Question 26: Which Patients With Cholangiocarcinoma Are Candidates For Surgical Resection? Is Liver Transplant an Option for Patients With Cholangiocarcinoma?
  William R. Hutson, MD
• Question 27: What Oncologic Treatment Options Exist for Patients With Cholangiocarcinoma Who Are Not Considered Surgical Candidates?
  Kimberly Jones, MD
• Question 28: Should Patients With Unresectable Cholangiocarcinoma and Jaundice Be Managed Via Endoscopy With Stents, Interventional Radiologists With Drains, or Both?
  Allene Salcedo Burdette, MD
• Question 29: What Is the Role of Photodynamic Therapy and Brachytherapy in Patients With Cholangiocarcinoma?
  Ananya Das, MD, FACG, FASGE

Section V: Hepatic

• Question 30: What Are the Risk Factors for the Development of Heptaocellular Cancer?
  Ravinder R. Kurella, MD and William M. Tierney, MD
• Question 31: A 55-Year-Old Man is Newly Diagnosed With Cirrhosis From Hepatitis C. What Is the Best Imaging Modality and Treatment Strategy to Screen Him for Hepatocellular Carcinoma?
  William R. Hutson, MD
• Question 32: Which Patients With Hepatocellular Cancer Are Candidates for Liver Transplantation or Surgical Resection?
  Colin T. Swales, MD and Fredric D. Gordon, MD
• Question 33: In Nonsurgical Patients With Hepatocellular Cancer, What Treatment Options Exist, and How Effective Are They?
  Allene Salcedo Burdette, MD
• Question 34: A 67-Year-Old Female With Cirrhosis Develops Hepatocellular Cancer. Shortly After Diagnosis, She Becomes Jaundiced. How Do You Determine if the Jaundice Is Due to Cirrhosis, Biliary Obstruction, or Both?
  Darryn Potosky, MD and Eric Goldberg, MD
• Question 35: A 55-Year-Old Cirrhotic Man Is Found to Have a 1.5-cm Liver Lesion and an Elevated Alpha-Fetoprotein. Is a Biopsy or Other Testing Required to Confirm a Diagnosis of Hepatocellular Carcinoma? What Other Evaluation Is Warranted?
  Fredric D. Gordon, MD

Section VI: Small Bowel and Colon

• Question 36: What Diseases Increase the Risk of Developing Small Bowel Carcinoma?
  Caroline R. Tadros, MD
• Question 37: What Are the Current Guidelines for Screening for Colorectal Cancer?
  Harshinie C. Amaratunge, MD and Waqar A. Qureshi, MD
• Question 38: What Are the Risk Factors for Colorectal Cancer?
  Devina Bhasin, MD and Ashley L. Faulx, MD, FASGE
• Question 39: What Surgical Options Are Available for Patients With Colon Cancer, Including Those Who Present With Acute Obstruction?
  Clifford S. Cho, MD, FACS
• Question 40: How Should Patients With a Solitary Liver Metastasis From Colon Cancer Be Evaluated and Treated?
  Clifford S. Cho, MD, FACS
• Question 41: What Patients With Colorectal Cancer Should Be Considered for a Colonic Stent?
  Jeffrey Laczek, MD and Peter Darwin, MD
• Question 42: What Is the Best Surveillance Regimen for Patients Following Colon Cancer Resection?
  David Chu, MD and Douglas G. Adler, MD, FACG, AGAF, FASGE
• Question 43: A 78-Year-Old Man With Metastatic Colon Cancer Had a Colonic Stent Placed 16 Months Ago. He Has Developed Recurrent Obstruction at the Site of the Tumor. How Should This Patient Be Evaluated and Managed?
  Waqar A. Qureshi, MD and Yasser H. Shaib, MD, MPH, FASGE

Section VII: Rectum and Anus

• Question 44: A 55-Year-Old Man Presents With Rectal Bleeding. A Digital Rectal Exam Reveals a Firm 1-cm Perianal Lesion. Biopsy of This Lesion Is Consistent With Squamous Cell Carcinoma. How Do You Manage This Patient?
  Selvi Thirumurthi, MD, MS
• Question 45: Why Are Rectal Cancers so Different From Colon Cancers With Regard to Medical and Surgical Management?
  Kimberly Jones, MD
• Question 46: What Is the Role of Endorectal Ultrasound in Patients With Rectal Cancer? Do All Patients With Rectal Cancer Need to Have an Endorectal Ultrasound?
  Leyla J. Ghazi, MD and David A. Schwartz, MD
• Question 47: Which Patients With Rectal Cancer Should Undergo Neoadjuvant Therapy and Which Patients Can Proceed Directly to Surgery?
  Ryan C. Van Woerkom, MD and Douglas G. Adler, MD, FACG, AGAF, FASGE
• Question 48: How Should Patients Be Followed After Successful Treatment for Rectal Cancer?
  Brad Shepherd, MD; David A. Schwartz, MD; and Paul E. Wise, MD
• Question 49: How Low in the Rectum Can a Colonic Stent Be Safely Placed? What Happens if the Stent Is Deployed Too Far Distally?
  Vivek Kaul, MD, FACG

Financial Disclosures
Index

About the Editor

Douglas G. Adler, MD, FACG, AGAF, FASGE received his medical degree from Cornell University Medical College. He completed his residency in internal medicine at Beth Israel Deaconess Medical Center/Harvard Medical School. Dr. Adler completed both a general GI fellowship and a therapeutic endoscopy/ERCP fellowship at Mayo Clinic in Rochester, Minnesota. He then returned to the Beth Israel Deaconess Medical Center for a fellowship in endoscopic ultrasound (EUS).

Dr. Adler is currently an Associate Professor of Medicine and Director of Therapeutic Endoscopy at the University of Utah School of Medicine in Salt Lake City, Utah. Working mostly out of the School of Medicine’s Huntsman Cancer Institute, Dr. Adler’s clinical, educational, and research efforts focus on the diagnosis and management of patients with gastrointestinal cancers, with an emphasis on therapeutic endoscopy. He is the author of more than 150 scientific publications and book chapters.