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Norris Cotton Cancer Center
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Our Comprehensive Approach: Typical Patient Journeys

Your providers will tailor a screening and treatment plan specifically for you. Here are examples of common screening and treatment paths for pancreatic cancer and colorectal cancer.

Pancreatic Cancer

If you have been diagnosed with pancreatic cancer or have a mass suspected to be a cancer you can expect to follow most of these steps.

  • Imaging: You will have a CT or MRI study which shows a mass in the pancreas.
  • Information Gathering: A team of medical oncologists, radiation oncologists, surgical oncologists, nutrition specialists and palliative care physicians, called a Tumor Board, will gather and review all imaging studies, physician notes, biopsy and test results. Your CT or MRI scans will be reviewed by the physicians to gather critical information about the tumor and determine if there is any evidence of cancer spread to other organs.  
  • Biopsy: If you have already had a biopsy then the biopsy specimen will be reviewed by our pathologists to confirm the diagnosis.  If you have not had a biopsy then you will be referred to gastroenterology for an endoscopic ultrasound procedure where a needle biopsy will be performed.   There are many benign masses that can look like cancer and also there are different types of pancreas cancer with differing treatment approaches so the biopsy is a critical initial step in the Tumor Board’s evaluation.
  • Treatment Plan is determined: Treatment plans vary depending on your diagnosis and the stage of your cancer.   Once the initial information from your case is reviewed and a biopsy has been performed your case will be discussed at our weekly multidisciplinary team conference to determine how best to individualize your care and treatment planning.
    • Patients with “localized” pancreatic cancer are treated by a team of physicians in the D-H NCCC Pancreas Tumor Clinic to consider possible chemotherapy and chemoradiation therapy prior to surgery.   
    • Patients with suspected “metastatic” pancreatic cancer in which the cancer has spread beyond the region of the pancreas, are referred to the medical oncology clinic to meet with a specialized gastrointestinal oncologist and palliative care specialists to discuss treatment options that may include chemotherapy, targeted therapies, immunotherapies and clinical trials.

Pancreas Tumor Clinic

The Pancreas Tumor Clinic at Norris Cotton Cancer Center is an interdisciplinary team of gastroenterologists, medical oncologists, radiation oncologists, surgeons, radiologists, palliative care specialists, advance practice nurses, cancer research nurses and oncology dietitians designed to optimize care for patients with pancreatic cancer. These specialists meet to review each patient’s case and discuss the best treatment options. This team approach allows for rapid formation of a treatment timeline for patients, who may begin treatment in as little as one week from the time of diagnosis.

Patients meet with all providers involved in their care in efficiently coordinated visits all in one location, to gain a clear understanding of their treatment plans, and set a date for their first treatment or surgery.

You will learn about the full advantages of the Pancreas Tumor Clinic the day of your appointments.

Colon and rectal cancer

If you have been diagnosed with colon or rectal cancer, you can expect to follow most of these steps.

  • Biopsy result shows cancer: A pathologist looks at your biopsy specimen under the microscope and notifies your doctor of the results.
  • Radiologist or surgeon calls or meets with you to explain your diagnosis: If you have your biopsy during a colonoscopy, the gastroenterologist or surgeon who did the biopsy tells you the results. If you have a needle biopsy, the doctor who ordered the biopsy tells you the results. This is done at an appointment or by phone.
  • Treatment plan is determined: Treatment plans vary depending on your diagnosis and the stage of your cancer. You will meet with members of your team to determine the best treatment plan. This may include meetings with a colorectal surgeon, a medical oncologist, or both. If you have rectal cancer, you may also meet with a radiation oncologist. You will have the chance to ask questions, evaluate options and work with your team to determine the best treatment plan for you. 
  • IF APPLICABLE, surgery and recovery: Your surgeon and the surgical nurse will give you information about your surgery appointment, what to expect at the hospital and what your recovery will be like. You may be referred to a medical oncologist after your surgery, depending on the findings at the time of surgery.
  • IF APPLICABLE, chemotherapy begins: These appointments are scheduled after you meet with the medical oncologist.
  • Periodic follow-up by a surgeon or an oncologist: After you finish initial treatment, you are followed closely by the members of your care team. How often you are seen depends, in part, on your individual situation.
     

Palliative Care

Palliative Care is also available. We are dedicated to ensuring that patients experiencing a life-threatening illness are comfortable and maintain the best possible quality of life during their care. Palliative Care addresses not only physical needs, but also the spiritual and emotional well-being of patients and families.

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