OUR AREA OF PRACTICE
Gastroesophageal Junction (GEJ)
Adenocarcinomas that start at the area where the esophagus joins the stomach (the GE junction, which includes about the first 2 inches (5 cm) of the stomach), tend to behave like cancers in the esophagus and are treated like them, as well.
Stomach cancers, or gastric cancers, tend to develop slowly over many years. Before a true cancer develops, pre-cancerous changes often occur in the inner lining (mucosa) of the stomach. These early changes rarely cause symptoms and therefore often go undetected. Gastric cancer almost always is an adenocarcinoma.
Head and Neck
Head and neck cancer arises in the epithelium of the paranasal sinuses, nasopharynx, oropharynx, oral cavity, hypopharynx and larynx. Risk factors include the use of tobacco and alcohol, as well as viral infections, namely human papillomavirus (HPV) infection (primarily in oropharyngeal cancers), and Epstein-Barr virus (EBV) infection (in nasopharyngeal cancers).
Over the past 30 years, there has been a drop in the incidence of head and neck cancers caused by tobacco and alcohol, and a rise in the incidence of head and neck cancers caused by HPV; up to 70% of tumors of the oropharynx are predicted to be due to HPV-16/18 infection.
Ovarian cancer begins in the ovaries, which are made up of 3 main kinds of cells. Each type of cell can develop into a different type of tumor:
- The most common type, epithelial tumors, develops from the cells that cover the outer surface of the ovary.
- Germ cell tumors develop from the cells that produce the eggs.
- Stromal tumors develop from tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.
Ovarian, fallopian tube, or primary peritoneal cancer have a lot in common and are treated following similar approaches. Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States and the country’s fifth most common cause of cancer mortality in women. This cancer mainly develops in older women.
Hepatocellular carcinoma makes up 80% of all cases of liver cancer. Liver cancer incidence rates are about three times higher in men than in women. Approximately 40% of hepatocellular carcinoma is diagnosed at an early stage and may be amenable to surgery (resection or liver transplantation) and/or locoregional procedures (radiofrequency ablation or embolization). With early diagnoses, the five-year survival rate is 29%, but decreases to 10% for regional and 3% for distant stages of the disease. Overall, the five-year survival rate for liver cancer remains low at approximately 16% and has not improved significantly over the past four decades.
Myxoid/Round Cell Liposarcoma (MRCLS)
Soft tissue sarcomas can develop from soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. There are approximately 50 types of soft tissue sarcomas including liposarcoma which is a malignant tumor of fat tissue. Myxoid/round cell liposarcoma (MRCLS) is a type of liposarcoma that is predominantly found in the limbs. One-third of MRCLS cases will become metastatic with tumors spreading to unusual bone and soft tissue locations. MRCLS commonly presents at an age ranging from 35-55 years and has a poor prognosis because they recur locally and tend to metastasize quickly and widely.
Melanoma is a cancer that begins in specific skin cells called melanocytes. Because most of these cells still make melanin, melanoma tumors are often brown or black. But some melanomas do not make melanin and can appear pink, tan, or even white. Melanoma most often starts on the chest or back in men and on the legs of women. Although melanoma is much less common than basal cell and squamous cell skin cancers, it is far more dangerous and is likely to spread to other parts of the body if it is not caught early. The rates of melanoma have been rising for the last 30 years.
Urothelial carcinoma, also known as transitional cell carcinoma (TCC), is the most common type of bladder cancer. These cancers start in the urothelial cells that line the inside of the bladder. Urothelial cells also line other parts of the urinary tract, such as the part of the kidney that connects to the ureter (called the renal pelvis), the ureters, and the urethra. Patients with bladder cancer sometimes have other tumors in these places.
Soft tissue sarcomas can develop from soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. There are approximately 50 types of soft tissue sarcomas, including synovial sarcoma, a cancer of the connective tissue around joints. The most common locations are the hip, knee, ankle, and shoulder. Synovial sarcoma accounts for approximately 6% to 10% of all soft tissue sarcomas. Approximately one-third of synovial sarcomas occur in childhood and the peak incidence is in the third decade of life.
Cancer of the esophagus starts in the inner layer (the mucosa) and grows outward (through the submucosa and the muscle layer). Since two types of cells can line the esophagus, there are two main types of esophageal cancer, squamous cell carcinoma and adenocarcinoma. Esophageal cancer is more common among men than among women.