Why is a gastroenterologist on the cancer care team
BBreast cancer patients often have a number of questions and concerns during the treatment process. Should I have a breast reconstruction? What do I do about hair loss once I start chemotherapy? Should I have a genetic test? An additional question you may have when meeting with your treatment team is: Why do you need to see a gastroenterologist who specializes in stomach problems? The short answer: Breast cancer patients, such as those with cancer of the lung, skin, bone, and other areas of the body that do not include the gastrointestinal tract, often experience side effects that affect the gastrointestinal (GI) tract and treatment for these conditions. It could be the key to your healing. Then there is the help that gastroenterologists provide to diagnose and classify a variety of diseases. “We do a lot of consultations with the breast cancer team,” says Jeffrey Weber, MD, a gastroenterologist at our hospital near Phoenix. “And often the patient thinks, ‘” What is the relationship of gastrointestinal diseases with breast cancer? “
What do gastroenterologists do?
Gastroenterologists are trained to treat diseases of the digestive system, including the esophagus, stomach, small intestine, colon, gallbladder, rectum, bile ducts, liver, and all the organs involved in digesting food and processing waste. But in treating cancer, these doctors do much more than that. Gastroenterologists can help medical oncologists diagnose and stage tumors or look for metastatic disease. Using a colonoscopy or endoscopy, they can help surgical oncologists identify tumors during surgery. They can also help cancer patients cope with a range of illnesses and treatment side effects, many of which are related to the digestive system, such as vomiting, diarrhea, constipation, and weight loss. Tawfiq Kashamy, MD, medical director of Interventional Gastroenterology, Endoscopy and Innovation at our hospital near Phoenix says:
“A gastroenterologist with experience in cancer care works with the oncology team to manage symptoms and improve quality of life and nutrition. All of this helps patients better tolerate cancer treatment.” – Tawfiq Qeshami, MD, gastroenterologist and advanced endoscopy
When does a gastroenterologist intervene?
For example, suppose that a patient’s lung cancer has spread and the tumor is blocking the bile duct, causing jaundice or yellowing of the skin caused by a buildup of waste products in the blood. A gastroenterologist can treat the condition by inserting tubes called stents, which allow fluid to flow through the body’s channels and blood vessels. Or suppose a patient loses weight after persistent bouts of nausea and vomiting due to treatment or a tumor blocking the gut. A gastroenterologist can work with a dietitian to develop a nutrition plan to help a patient return to eating and prevent malnutrition, a leading cause of death from cancer. A gastroenterologist can also use cryotherapy to remove blockages caused by esophageal tumors that can prevent patients from eating or swallowing.
Gastroenterologists also play an important role in cancer prevention, as well as in diagnosing and staging gastrointestinal cancers. And its role continues to evolve, according to John M. Carrithers, MD, of the University of Michigan. A gastroenterologist may once have been called upon to diagnose and treat a condition associated with the digestive system. But as cancer care has advanced and patients’ needs have become more complex, the gastroenterologist has emerged as a major player offering a wide range of skills and expertise. “The gastroenterologist is evolving from a pure diagnostician to a surgeon. Immunologist, chemotherapy, and palliative care physician,” he wrote in an article published in PubMed Central . “This transformation allows the gastroenterologist to be an even more important part of the ongoing care of cancer patients.”