nterventional program specialist, chief of medicine and director of Gastroenterology and Endoscopy, City of Hope, Phoenix, and the founder and chair of the 

Endoscopic Oncology special interest group

To register for City of Hope's Advances and Innovations in Endoscopic Oncology and Multidisciplinary Gastrointestinal Cancer Care, please 

In this second episode of OncChats: Understanding Endoscopy in the Realm of GI Cancers, Madappa Kundranda, MD, PhD, of Banner MD Anderson Cancer Center, and Toufic A. Kachaamy, MD, of City of Hope, explain the evolution of minimally invasive surgery and the emergence of interventional radiology in gastrointestinal cancer.

: Dr Kachaamy, as an experienced interventional endoscopist, what are you seeing as a trend in procedures that help a patient with this multidisciplinary care?

: Excellent question. In general, with surgery, especially complex surgery, we are becoming much better in GI malignancies. Surgeries are becoming mostly minimally invasive, where patients can recover much faster and get back to either their cancer treatment or their normal life and have a faster recovery. But the trend, however, is to try to preserve the organ. What do I mean by that? The trend is to try to manage patients in a nonoperative way because GI cancer surgery often leaves patients with some long-term symptoms that significantly affect their quality of life [QOL]. For example, if we look at colorectal cancer and sphincter-sparing surgery, half of the patients 10 years after their original treatment, including surgery, will have some symptom and have problems having normal bowel movements; [this will be] significant enough to affect their QOL. If we move to esophageal cancer, for example, [it’s] the same thing. Half of [patients with] esophageal cancer after esophagectomy have some form of symptoms related to either sleeping or eating that significantly affects their QOL.

This has opened the field for a relatively new discipline called interventional oncology, which is a form of minimally invasive procedures for organ-sparing, and at the same time, managing cancer. What can you tell us as an experienced GI oncologist about this field of interventional oncology?

: Oncology, over the past several decades, has become more complex. Forgone, are the traditional modalities of treatment, including medical oncology, surgical oncology, and radiation oncology. This can be even more evident in managing these complex gastrointestinal malignancies. Interventional oncology involves modalities of treatment including interventional endoscopy, interventional radiology, and interventional neurology, to name a few. In my opinion, with interventional endoscopy, this is an integral part of the diagnosis and management of gastrointestinal malignancies.

Check back on Wednesday for the next episode in this series.

Videos

In this second episode of OncChats: Understanding Endoscopy in the Realm of GI Cancers, Madappa Kundranda, MD, PhD, and Toufic A. Kachaamy, MD, explain the evolution of minimally invasive surgery and the emergence of interventional radiology in gastrointestinal cancer.

Understanding Endoscopy in the Realm of GI Cancers: Interventional Oncology 

In this first episode of OncChats: Understanding Endoscopy in the Realm of GI Cancers, Madappa Kundranda, MD, PhD, and Toufic A. Kachaamy, MD, discuss the importance of endoscopic oncology as it relates to rising cancer incidence and multidisciplinary care in gastrointestinal cancer.

: Hello, my name is Toufic Kachaamy. I’m a gastroenterologist. I am [also] the chief of Medicine and the director of Gastroenterology at Cancer Treatment Centers of America in Phoenix. We’re part of City of Hope now. I’m joined today by Dr Madappa Kundranda, the Division Chief of Cancer Medicine at Banner MD Anderson in Phoenix, and the co-program director for the GI Oncology Cancer Program. At the 2023 Gastrointestinal Cancers Symposium, [we announced] a new video blog series on endoscopic oncology. Dr. Kundranda, can you start by telling us why this topic is relevant to the complex multidisciplinary care for GI cancer in today’s world.

: Thank you, Dr Kachaamy, for the kind introduction. Let me start by providing some background first, in cancer, and then endoscopy, as it pertains to cancer care. The numbers are alarming with regards to cancer surpassing cardiovascular disease as the number 1 cause of death in many countries. At this point in time, we are diagnosing cancers at a much younger age in these patients. Most cancers aren’t hereditary; however, sadly, it’s becoming a family disease. What do I mean by that? It’s not uncommon to see a parent being affected by cancer. In addition to them caring for their cancer, they’re also taking care of their children and their parents, so they are sandwiched within this generation. Amid all this, this cancer diagnosis becomes such a critical part, and therefore, this use of multidisciplinary care is important.

However, the good news is that [we have seen] more patients [with cancer] have been cured in the past decade than ever before. Furthermore, patients are living much longer, even if they’re not cured of the disease, with a good quality of life. These emerging technologies, some of which [were presented] at this year’s ASCO GI, give us hope. However, we still have a long way to go with regard to treatment modalities.

Check back on Friday for the next episode in this series.

In this first episode of OncChats: Understanding Endoscopy in the Realm of GI Cancers, Madappa Kundranda, MD, PhD, and Toufic A. Kachaamy, MD, discuss the importance of endoscopic oncology as it relates to rising cancer incidence and multidisciplinary care in gastrointestinal cancer. 

Toufic A. Kachaamy, MD

Articles

Understanding Endoscopy in the Realm of GI Cancers: Interventional Oncology

Understanding Endoscopy in the Realm of GI Cancers: Multidisciplinary Care