City of Hope's Gastrointestinal Oncology Program takes an aggressive, multidisciplinary approach to fight cancers of the digestive system.
Our renowned team of gastroenterologists, medical oncologists, radiation oncologists, surgical oncologists and researchers combine the latest, most promising treatments with some of the world's most sophisticated technologies to give patients the best care possible.
Listen as Joseph Kim, MD, Head, Upper GI Surgery
Director, Surgical Oncology Training Program, comes on the show to discuss Upper GI cancers and how the latest treatments and innovations are being used at City of Hope to give you the best possible outcome.
Upper GI Cancers: Sophisticated Technologies for Life Saving Techniques
Featured Speaker:
Dr. Kim uses advanced laparoscopic and robotic techniques to perform his operations. This clinical expertise is the foundation for his translational research investigations, which incorporate his skills and knowledge as a surgical oncologist into the identification and development of novel targets and therapies for gastrointestinal cancers.
Joseph Kim, M.D.
Joseph Kim, M.D., is a surgical oncology expert in the surgical treatment of liver, pancreas, and stomach cancers.Dr. Kim uses advanced laparoscopic and robotic techniques to perform his operations. This clinical expertise is the foundation for his translational research investigations, which incorporate his skills and knowledge as a surgical oncologist into the identification and development of novel targets and therapies for gastrointestinal cancers.
Transcription:
Upper GI Cancers: Sophisticated Technologies for Life Saving Techniques
Melanie Cole (Host): City of Hope’s gastrointestinal oncology program takes an aggressive multidisciplinary approach to fighting cancers of the digestive system. My guest today is Dr. Joseph Kim. He’s the head of Upper GI Surgery and the director of Surgical Oncology Training Program at City of Hope. Welcome to the show, Dr. Kim. Tell us about the types of upper GI cancers.
Dr. Joseph Kim (Guest): Well, thank you for having me on the program. It's a pleasure to be here. When we talk about upper GI cancers, I think most commonly we’re referring to esophageal cancers and stomach cancers. So those are the two primary upper GI cancers that we’ll be speaking about.
Melanie: Are there certain races that are at higher risk for upper GI cancers?
Dr. Kim: Certainly. With regards to gastric cancer, there are select racial groups that are at very high risk for developing gastric cancer. It's very important for us here at City of Hope because we live in Southern California, and the racial groups that are at highest risk for developing gastric cancer are Asians and some groups of people from South America. So we see very high numbers of gastric cancers here because of our population in Southern California.
Melanie: Dr. Kim, what are some symptoms that someone might experience that would even send them to see you to check for esophageal or stomach cancers?
Dr. Kim: Well, unfortunately some of those symptoms are very non-specific. So people may have some difficulty swallowing. They may have some very non-specific abdominal complaints, a little bit of indigestion, some stomach discomfort. These of course can mimic normal conditions, problems that we may have after having normal meals, so it sometimes can be very difficult to diagnose these cancers.
Melanie: How are they diagnosed?
Dr. Kim: Well, typically, when people have persistent symptoms, they’ll go to their physician’s office, and the physician will order an upper endoscopy. So that’s the most common way that we will diagnose these cancers, with a camera that’s placed down into the esophagus or into the stomach.
Melanie: If somebody gets this diagnosis, it could be very, very scary. So tell us about some of the newer treatments at City of Hope used in treating these upper GI cancers.
Dr. Kim: Well, you're exactly correct that this diagnosis can be very scary. What we have to tell our patients is that cure is still a possibility with these cancers. What's special about the way that we treat these cancers, we use of course the standardized techniques to operate and remove these cancers, but also we employ some of the newest technologies, including laparoscopy and robotics, to take care of these cancers for our patients.
Melanie: When you're using surgery, you're removing the tumor, and then generally is there radiation, chemotherapy involved? And also, Dr. Kim, people hear about these types of cancers and they think they're not going to be able to eat anymore. They’re going to be maybe a little disfigured. Tell us about some of the recovery.
Dr. Kim: Yes, that’s a great question. So, the use of additional therapies may be recommended if patients have advanced disease. But we do see patients that have very early stage disease, and surgery alone is all that’s necessary to cure our patients. Our patients that do have advanced disease, we will have to employ or incorporate chemotherapy as well as radiation therapy. Having part of your stomach or esophagus removed will be life-changing for our patients, so we’re very careful in terms of counseling and advising our patients about the cultural, societal, family changes that they will have to undergo. For some of our folks, their daily meal is more than just eating, it’s a social event, and so they do have to readjust the way that they have to do things. Some of the basic outcomes for a gastrectomy or esophagectomy is that they do have to change the amount that they can eat at any one given time.
Melanie: What is some of the current research that’s underway at City of Hope for upper GI cancers?
Dr. Kim: Well, we’re doing some basic science, laboratory-based research, but we’re also incorporating research looking at new therapies for patients with advanced disease. So although esophageal cancer and gastric cancer can still be curative, patients who have advanced disease or metastatic disease, their outcomes still are far from where they should be compared to some of the other cancers where we’ve made significant improvements. So we have laboratory basic science studies, we have new therapy studies, and we have new imaging studies that are supported by the National Institute of Health to help us diagnose and treat gastric cancers better.
Melanie: We hear about colonoscopies; you get them every three to five years, testing for colon cancers. But endoscopies do not seem to be covered on the WellCare programs. They’re usually only given when indicated. When do you recommend people have an endoscopy?
Dr. Kim: Well, patients who have symptoms should certainly have endoscopies as appropriate. Again, most of the symptoms that we have are indigestion and can be easily treated with medical therapies, so we do have to be very careful about unnecessary endoscopy. However, that being said, Asian countries where gastric cancer remains the number one or number two cancers in those countries, they have incorporated nationwide screening programs where patients will undergo screening endoscopy at age 40. So, since we have many of those patients of those racial backgrounds living in Southern California, we’re trying to initiate a program so that those patients who are at highest risk can undergo such endoscopic procedures here.
Melanie: People have heard about Barrett’s esophagus and pre-cancerous lesions that might be spotted. Tell us about this. Is this a risk? Is eating spicy food a risk and damage your esophagus, and then if you damage your esophagus, are you then predisposing yourself to cancer?
Dr. Kim: Well, the Barrett’s esophagus is a pre-neoplastic lesion and it is certainly a concern, and people who have that diagnosis have to be followed closely as that can turn into an invasive cancer. Those patients probably aren’t developing Barrett’s esophagus because of the types of foods that they eat but more so from the exposure of the esophagus to the acids and bile from the stomach. People who are at the highest risk for developing gastric cancer, there are strong feelings that diet does play a role—not so much spicy foods but probably the salted, the fermented foods that are prevalent to any Asian and South American cultures. So I think those are some of the important risk factors. As well as the bacteria that can live in the stomach, the bacteria known as H. pylori, is a risk factor for gastric cancer.
Melanie: Dr. Kim, in just the last minute or two that we have left, tell listeners why a patient should go to City of Hope for treatment of their upper GI cancers.
Dr. Kim: Patients who may have an esophageal or gastric cancer should seek treatment at a hospital that takes care of those patients frequently. Because we are situated here in Southern California and we see a large number of patients with gastric and esophageal cancers, we have the experts not only for surgery but also for radiation therapy and medical oncology that can provide comprehensive care for patients with gastric cancer. Because these cancers can be relatively rare depending on the location where you live or the office that you go to, you certainly don't want to have a physician who has very little experience in treating those cancers. So our multidisciplinary care and our advance surgical techniques are really what set us apart from other places that may not take care of these cancers frequently.
Melanie: Thank you so much, Dr. Joseph Kin. You’re listening to City of Hope Radio. For more information, you can go to cityofhope.org. This is Melanie Cole. Thanks so much for listening.
Upper GI Cancers: Sophisticated Technologies for Life Saving Techniques
Melanie Cole (Host): City of Hope’s gastrointestinal oncology program takes an aggressive multidisciplinary approach to fighting cancers of the digestive system. My guest today is Dr. Joseph Kim. He’s the head of Upper GI Surgery and the director of Surgical Oncology Training Program at City of Hope. Welcome to the show, Dr. Kim. Tell us about the types of upper GI cancers.
Dr. Joseph Kim (Guest): Well, thank you for having me on the program. It's a pleasure to be here. When we talk about upper GI cancers, I think most commonly we’re referring to esophageal cancers and stomach cancers. So those are the two primary upper GI cancers that we’ll be speaking about.
Melanie: Are there certain races that are at higher risk for upper GI cancers?
Dr. Kim: Certainly. With regards to gastric cancer, there are select racial groups that are at very high risk for developing gastric cancer. It's very important for us here at City of Hope because we live in Southern California, and the racial groups that are at highest risk for developing gastric cancer are Asians and some groups of people from South America. So we see very high numbers of gastric cancers here because of our population in Southern California.
Melanie: Dr. Kim, what are some symptoms that someone might experience that would even send them to see you to check for esophageal or stomach cancers?
Dr. Kim: Well, unfortunately some of those symptoms are very non-specific. So people may have some difficulty swallowing. They may have some very non-specific abdominal complaints, a little bit of indigestion, some stomach discomfort. These of course can mimic normal conditions, problems that we may have after having normal meals, so it sometimes can be very difficult to diagnose these cancers.
Melanie: How are they diagnosed?
Dr. Kim: Well, typically, when people have persistent symptoms, they’ll go to their physician’s office, and the physician will order an upper endoscopy. So that’s the most common way that we will diagnose these cancers, with a camera that’s placed down into the esophagus or into the stomach.
Melanie: If somebody gets this diagnosis, it could be very, very scary. So tell us about some of the newer treatments at City of Hope used in treating these upper GI cancers.
Dr. Kim: Well, you're exactly correct that this diagnosis can be very scary. What we have to tell our patients is that cure is still a possibility with these cancers. What's special about the way that we treat these cancers, we use of course the standardized techniques to operate and remove these cancers, but also we employ some of the newest technologies, including laparoscopy and robotics, to take care of these cancers for our patients.
Melanie: When you're using surgery, you're removing the tumor, and then generally is there radiation, chemotherapy involved? And also, Dr. Kim, people hear about these types of cancers and they think they're not going to be able to eat anymore. They’re going to be maybe a little disfigured. Tell us about some of the recovery.
Dr. Kim: Yes, that’s a great question. So, the use of additional therapies may be recommended if patients have advanced disease. But we do see patients that have very early stage disease, and surgery alone is all that’s necessary to cure our patients. Our patients that do have advanced disease, we will have to employ or incorporate chemotherapy as well as radiation therapy. Having part of your stomach or esophagus removed will be life-changing for our patients, so we’re very careful in terms of counseling and advising our patients about the cultural, societal, family changes that they will have to undergo. For some of our folks, their daily meal is more than just eating, it’s a social event, and so they do have to readjust the way that they have to do things. Some of the basic outcomes for a gastrectomy or esophagectomy is that they do have to change the amount that they can eat at any one given time.
Melanie: What is some of the current research that’s underway at City of Hope for upper GI cancers?
Dr. Kim: Well, we’re doing some basic science, laboratory-based research, but we’re also incorporating research looking at new therapies for patients with advanced disease. So although esophageal cancer and gastric cancer can still be curative, patients who have advanced disease or metastatic disease, their outcomes still are far from where they should be compared to some of the other cancers where we’ve made significant improvements. So we have laboratory basic science studies, we have new therapy studies, and we have new imaging studies that are supported by the National Institute of Health to help us diagnose and treat gastric cancers better.
Melanie: We hear about colonoscopies; you get them every three to five years, testing for colon cancers. But endoscopies do not seem to be covered on the WellCare programs. They’re usually only given when indicated. When do you recommend people have an endoscopy?
Dr. Kim: Well, patients who have symptoms should certainly have endoscopies as appropriate. Again, most of the symptoms that we have are indigestion and can be easily treated with medical therapies, so we do have to be very careful about unnecessary endoscopy. However, that being said, Asian countries where gastric cancer remains the number one or number two cancers in those countries, they have incorporated nationwide screening programs where patients will undergo screening endoscopy at age 40. So, since we have many of those patients of those racial backgrounds living in Southern California, we’re trying to initiate a program so that those patients who are at highest risk can undergo such endoscopic procedures here.
Melanie: People have heard about Barrett’s esophagus and pre-cancerous lesions that might be spotted. Tell us about this. Is this a risk? Is eating spicy food a risk and damage your esophagus, and then if you damage your esophagus, are you then predisposing yourself to cancer?
Dr. Kim: Well, the Barrett’s esophagus is a pre-neoplastic lesion and it is certainly a concern, and people who have that diagnosis have to be followed closely as that can turn into an invasive cancer. Those patients probably aren’t developing Barrett’s esophagus because of the types of foods that they eat but more so from the exposure of the esophagus to the acids and bile from the stomach. People who are at the highest risk for developing gastric cancer, there are strong feelings that diet does play a role—not so much spicy foods but probably the salted, the fermented foods that are prevalent to any Asian and South American cultures. So I think those are some of the important risk factors. As well as the bacteria that can live in the stomach, the bacteria known as H. pylori, is a risk factor for gastric cancer.
Melanie: Dr. Kim, in just the last minute or two that we have left, tell listeners why a patient should go to City of Hope for treatment of their upper GI cancers.
Dr. Kim: Patients who may have an esophageal or gastric cancer should seek treatment at a hospital that takes care of those patients frequently. Because we are situated here in Southern California and we see a large number of patients with gastric and esophageal cancers, we have the experts not only for surgery but also for radiation therapy and medical oncology that can provide comprehensive care for patients with gastric cancer. Because these cancers can be relatively rare depending on the location where you live or the office that you go to, you certainly don't want to have a physician who has very little experience in treating those cancers. So our multidisciplinary care and our advance surgical techniques are really what set us apart from other places that may not take care of these cancers frequently.
Melanie: Thank you so much, Dr. Joseph Kin. You’re listening to City of Hope Radio. For more information, you can go to cityofhope.org. This is Melanie Cole. Thanks so much for listening.