Gastrointestinal Cancer

Our approach to gastrointestinal cancer care

At UCSF Health, we're dedicated to delivering the most effective care possible while minimizing side effects and the long-term effects of treatment. Our collaborative team of cancer specialists works with you to plan the sequence of treatments that will be most effective for your needs.

Gastrointestinal cancer diagnosis and second opinions

We use the latest tools and techniques to promptly and accurately diagnose GI cancer. Advanced biomarker testing helps us determine which therapies are most likely to be effective for the type of cancer you have, allowing us to personalize your care.

Our team includes radiologists and pathologists with specialized training in digestive system diseases. People throughout the country turn to us for first and second opinions because of our diagnostic excellence and diverse treatment options.

Active surveillance

Watch and wait, also called active surveillance, may be appropriate for some people with prostate, rectal or other GI cancers who don't need surgery immediately. In these cases, we closely monitor you to see if the cancer changes or if you develop symptoms.

We intervene with treatment only when necessary. This approach helps you delay surgery and treatment side effects for as long as possible.

Medical oncology for gastrointestinal cancer

Our medical oncologists use different types of drug therapies to treat GI cancers, including:

• Chemotherapy. These powerful drugs destroy cancer cells. Chemotherapy is a common treatment for many GI cancers. We offer advanced chemotherapy delivery methods that target certain areas of your body and allow us to use more powerful doses.

• Immunotherapy. This treatment helps your body's immune system recognize and fight cancer cells. It can be especially effective for stomach and esophageal cancer. Immunotherapy may also be an option for people with colorectal cancer who have certain biomarkers.

• Targeted therapy. The goal of targeted therapy is to disrupt the processes in cancer cells that allow them to grow and spread. It may be an option for some people with advanced GI cancers, such as stomach cancer. These drugs have fewer side effects than chemotherapy and may help people live longer and improve their quality of life.

Surgery for gastrointestinal cancer

UCSF Health is home to world-class GI cancer surgeons who are leaders in their fields. Our experts are known for their extensive surgical capabilities and high success rates. They can often treat advanced or complex cancers considered inoperable at other programs.

When appropriate, our surgeons use laparoscopic and robotic techniques, which involve smaller incisions than open surgeries. These minimally invasive procedures can reduce recovery time and the risk of certain complications.

Robotic Whipple surgery

Whipple surgery is a complex procedure for certain types of pancreatic cancer. Your surgeon removes part of your pancreas, intestine, bile ducts and gallbladder, reattaching what remains to your small intestine. UCSF Health was the first institution in the Bay Area to offer robotic Whipple surgery.

The robotic approach allows our surgeons to operate through tiny incisions with the aid of a camera and computerized controls. Our surgeons have extensive experience performing this complex procedure with excellent outcomes.

Regional GI cancer therapies

Hepatic artery infusion (HAI) pump for metastatic liver cancer

HAI pumps can treat colorectal cancers and bile duct cancers that have spread (metastasized) extensively in the liver or are difficult to remove surgically. UCSF Health was the first medical program in Northern California to offer this innovative procedure and is one of the most experienced HAI programs on the West Coast.

During this procedure, your surgeon implants a pump under your skin and inserts a tube into your hepatic artery, a blood vessel that connects to your liver. The tube delivers chemotherapy medication directly to your liver.

Our team manages the pump and refills it with medication every few weeks. HAI pumps have the potential to:

• Slow liver tumor growth

• Improve survival

• Delay or prevent recurrence (cancer coming back)

• Shrink tumors so they can be removed surgically

We offer cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) for difficult-to-treat cancers in the peritoneum (lining of your abdomen). Your surgeon removes visible tumors and then pumps heated chemotherapy into your abdominal cavity to destroy any remaining cancer cells. UCSF Health is one of the most experienced programs in the country offering HIPEC.

Embolization and ablation for gastrointestinal cancer

Our interventional radiologists offer several treatments for tumors that can't be removed with surgery, particularly for primary liver cancer or liver metastases (cancer from another area that has spread to your liver).

Chemoembolization and radioembolization involve injecting chemotherapy medication or radioactive substances into your hepatic artery, which connects to your liver. These procedures also block the artery to deprive tumors of blood, so they stop growing or shrink.

UCSF Health is among a select group of institutions offering microwave ablation for inoperable liver cancer. This treatment uses a heated probe to destroy tumors.

We may use radiation therapy before or after surgery, or in combination with medication, to treat certain types of cancer. Radiation therapy can also be palliative, meaning we use it to shrink tumors and ease symptoms for people with advanced cancers.

UCSF Health offers the most sophisticated radiation technology available, including stereotactic body radiation delivered with the CyberKnife system. We may use this nonsurgical treatment for liver or pancreatic cancer to precisely target tumors and minimize damage to healthy tissue.