Esophageal and Gastric Cancer Center of Excellence

Transformative esophageal and gastric care

At AHN, our patients have access to the most up-to-date, comprehensive, and multidisciplinary care for esophageal and gastric cancers at all stages. Our team has extensive experience in the diagnosis, treatment, and aftercare of esophageal and gastric cancers. We offer a variety of services to support nutrition, mental health, and physical rehabilitation.

Our experts are highly trained in the management of all esophageal and gastric diseases at all stages. We treat all cancers and pre-cancerous changes of the esophagus including Barrett’s esophagus.

Precision diagnosis

For patients with esophageal and stomach cancer, precise staging and diagnosis is critical for the individualization of care. Our state-of-the-art evaluations include:

• Esophagogastroduodenoscopy (EGD/upper endoscopy) with biopsy: A procedure with a long flexible tube that allows a doctor to see the inside of the esophagus and stomach and obtain samples of tissue to obtain an accurate diagnosis. Learn more about EGD procedures.
• Endoscopic ultrasound (EUS): A special endoscopy that uses ultrasound to evaluate the esophagus and stomach to measure a tumor and associated lymph nodes.
• Barium swallow study: A radiology study using X-ray with swallowed contrast to evaluate the esophagus and stomach. Learn more about barium swallow studies.
• CT scan with PET: A radiology study to evaluate the location and potential spread of tumor throughout the body.
• Laparoscopic evaluations: Can be used to evaluate the extent of the disease and develop a proper treatment plan. 

Treatment options

We provide dedicated individualized care for our patients. Our care is centered on the unique needs of each patient in order to provide the best experience and outcomes.

Chemotherapy

Chemotherapy uses specialized drugs to kill cancer cells. These drugs target rapidly dividing cells, which is a characteristic of cancer cells. However, they can also affect healthy cells that divide quickly, such as those in the bone marrow, hair follicles, and digestive tract, leading to side effects.

Chemotherapy, along with radiation therapy, can be given before surgery to shrink the tumor, after surgery to kill remaining cancer cells or as palliative care for those with advanced cancer cases. Combination chemotherapy is when two or more chemotherapy drugs are used together to increase their effectiveness.

Your AHN oncology team will provide you with medications and other strategies to manage the side effects of chemotherapy. Common side effects of chemotherapy include:

• Nausea and vomiting
• Fatigue
• Hair loss
• Mouth sores
• Diarrhea
• Increased risk of infection (due to low white blood cell count)
• Anemia (low red blood cell count)
• Peripheral neuropathy (numbness and tingling in the hands and feet)

Radiation therapy

The use of high energy (radiation) in a focused manner to treat cancer cells. It can be used by itself or in combination with chemotherapy. It can be delivered externally (from a machine outside the body) or internally (by placing radioactive material directly into or near the tumor). 

Radiation therapy may be used before surgery to shrink the tumor, rarely used after surgery to kill remaining cancer cells or as palliative care for those with advanced cancer cases. It could also be used as the primary treatment for patients who are not able to undergo surgery due to medical reasons or if the cancer is too advanced to be surgically removed. It's usually combined with chemotherapy.

Radiation therapy also affects normal cells in the treatment area, which can lead to side effects including:

• Fatigue
• Skin irritation (redness, dryness, itching)
• Difficulty swallowing (esophagitis)
• Nausea and vomiting
• Loss of appetite
• Diarrhea
• Late side effects:
  • Esophageal stricture (narrowing of the esophagus)
  • Lung damage (pneumonitis, fibrosis)
  • Heart damage (pericarditis, cardiomyopathy)
  • Spinal cord damage (rare)

Your AHN oncologist and care team will monitor your progress and response to treatment. If adjustments need to be made, those will be considered.

Immunotherapy

Immunotherapy helps your own immune system recognize and attack cancer cells. It works by blocking certain proteins that prevent the immune system from attacking cancer cells.

Immunotherapy is typically used for advanced esophageal and gastric cancers that have spread to other parts of the body or that have recurred after initial treatment. It can be used post operatively to help reduce the risk of relapse. It may be used as a first-line treatment in combination with chemotherapy or as a second-line treatment after chemotherapy has stopped working.

The side effects of immunotherapy can sometimes be serious and require treatment with steroids or other medications. Your AHN oncology team will closely monitor you for side effects and provide appropriate treatment. Common side effects of immunotherapy include:

• Fatigue
• Skin rash
• Diarrhea
• Cough
• Shortness of breath
• Hormone problems (e.g., thyroid problems)
• Inflammation of various organs (e.g., lungs, liver, intestines)

Surgery

Our highly trained surgeons provide the most advanced minimally invasive endoscopic and surgical procedures to treat esophageal cancer. Treatment of esophageal and gastric cancer requires a team approach involving surgeons, oncologists, radiation oncologists, gastroenterologists, and other specialists. Nutritional support is also crucial before and after surgery to maintain strength and promote healing. Our surgical approaches include:

• Esophagectomy: An esophagectomy is the primary surgical procedure for esophageal cancer, which involves removing all or part of the esophagus.
• Gastrectomy: In a gastrectomy, the surgeon removes all (a total gastrectomy) or part (partial gastrectomy) of your stomach. The surgeon then reconnects your digestive system so you can continue to eat and digest food.
• A combination of both approaches may be used depending on the tumor location.

Expert treatments and therapies

AHN offers coordinated care that includes individualized chemotherapy, radiotherapy, immunotherapy as well as more unique therapies including:

• Brachytherapy
• Photodynamic therapy
• Esophageal stenting
• Endoscopic removal of tumors
• Minimally invasive surgery

Further care includes placement of feeding tubes to support nutrition and special catheters to help deliver treatments. 

Patient Care Fund

The Esophageal and Gastric Institute recognizes that patients may need financial support along their treatment pathway. We are developing a fund to support all our patients. Please consider donation to assist patients with their care. 

Esophageal and gastric cancer specialists

AHN’s team of esophageal and gastric cancer specialists include doctors who are nationally renowned experts in esophageal motility disorders, diseases and surgical treatments. Whether you are facing an esophageal cancer diagnosis or struggling with swallowing difficulties, our doctors will provide comprehensive and compassionate care that is specific to your needs.

Chairperson

Foregut Surgeons

Stomach Cancer Surgeons

Specialty Leads

How to get care

If you want to be tested for or have been diagnosed with esophageal or gastric cancer, we’re here to help.

For surgery or other appointments call:

• 412-359-4373 to schedule an appointment with one of our surgeons.
• (412) DOCTORS 412-362-8677 to schedule an appointment with one of our oncologists or to obtain an imaging study.

What to expect from your first appointment

At your first appointment, you will meet multiple members of our care team. Collectively, we will work to review your diagnosis and plan of care. If you have imaging or imaging from another hospital, please send in this information prior to your appointment or bring it with you. Through the course of your appointment, we will work together to understand who you are as a patient and how we can best develop a plan of care that fits your individual needs.

Leaders in esophageal and gastric cancer research

AHN researchers are continually investigating novel and effective ways to treat esophageal and upper GI cancers.

What is a clinical trial?

Clinical trials are studies that try to answer questions about new ways to treat cancer with medications, radiation, or surgical techniques. Previous trials have shown how new methods of treatment improve survival and quality of life and reduce the risk of cancer returning.

You participate in a clinical trial only if you volunteer to do so and meet criteria for inclusion in the study, and you can stop participating in a trial at any time.

Who can join a clinical trial?

Clinical trials often have criteria in place to help determine a patient’s eligibility to participate. The treatment team and the researchers can review these criteria to help determine eligibility for a clinical trial. 

Currently active esophageal and upper GI cancer clinical trials

Find currently active trials if you would like to participate in cutting-edge investigations into the most advanced treatments for esophageal cancer.

Refer your patient to an AHN specialist

Medical professionals who work outside of the Allegheny Health Network, can refer their patients for care by calling:

• 412-359-4373 to schedule an appointment with one of our surgeons.
• (412) DOCTORS 412-362-8677 to schedule an appointment with one of our oncologists or to obtain an imaging study.

For more information about referring your patient to an AHN specialist, read the Independent Physician Referral FAQs.