The Cancer-Infectious Diseases (Cancer-ID) Program is an integrated multidisciplinary clinic that will provide supportive consultative services to people with HIV and cancer. Dedicated HIV/ID specialists from Yale Medicine will work closely with the patient’s oncology care team to manage care for patients with HIV undergoing cancer treatment. A team of providers, including surgical oncologists, medical oncologists, radiation oncologists, and pathologists, will provide consultative services for people with HIV with hematologic malignancies, gastrointestinal, genitourinary, head and neck, thoracic, dermatologic, and breast cancers, as well as those with Kaposi Sarcoma, liver, gynecologic, and neuro-oncologic malignancies. Access to a wide variety of support services and clinical trials is also available. People with HIV have higher rates of cancer incidence compared to uninfected individuals. In addition, they have worse outcomes after a diagnosis of cancer. Because the majority of cancer clinical trials do not include patients with HIV among their study population, there is little evidence-based guidance with regard to cancer care for these patients. What’s more, the patient experience may additionally suffer because this patient population includes an underserved and understudied group who are often impacted by health inequities and health disparities. With the advent of immune-based therapies and personalized approaches to cancer care, the lack of data within the HIV population to guide treatment decision-making further impacts health disparities among this underserved population. The Cancer-Infectious Diseases, or Cancer-ID program, was established in July 2022 to provide consultative care to patients with HIV who are also diagnosed with cancer. Brinda Emu, MD, serves as the director of the Cancer-ID program. She and Mark Lustberg, MD, are HIV specialists with a specific interest in cancer care and will see patients on a consultative basis. The Cancer-ID program will be located within the Yale Center for Infectious Disease, which is directed by Lydia Aoun-Barakat, MD. The program additionally has the support of Yale Cancer Center leadership. It is led by Jill Lacy, MD, and a large network of consultative affiliated oncology faculty members across all oncology disease areas, who serve as liaisons and ambassadors within the Yale Cancer Center to ensure appropriate and timely care to patients with both HIV and cancer, including access to clinical care and ancillary services. There are three main goals of the Cancer-ID program: Provide consultative care to patients with both HIV and cancer to facilitate and manage both HIV infection and cancer care throughout and beyond cancer treatment Improve the patient experience while receiving cancer care Identify and engage patients in research activities and clinical trials when appropriate The program additionally hopes to build expertise in the clinical care of cancer among people with HIV, provide ou

The Smilow Cancer Genetics & Prevention Program is a team of specialists, including physicians, geneticists, genetic counselors, genetics clinical coordinators, and advanced practice providers, who work together to provide cancer genetics education and coordination of genetic testing to inform cancer risk assessment, precision treatment for patients with cancer, and surgical management decisions. Patients seen in the Smilow Cancer Genetics & Prevention Program will typically first meet with a genetic counselor, a genetics clinical coordinator, or have a combined visit with one of our specialty providers and a genetic counselor. Genetic counselors are licensed medical professionals with advanced training in genetics who help patients understand and adapt to the medical, psychological, and familial implications of genetic contributions to diseases such as cancer. Genetics clinical coordinators are key team members who enable expedited evaluation and genetic testing for patients who meet the criteria for genetic testing as part of our novel Fast-Track Program. An initial pre-test visit in the program typically includes the following: Detailed review of a patient’s medical history and their family history of cancer Risk assessment of the chance that the cancer(s) in the family are hereditary Discussion of the risks, benefits, and limitations of genetic testing Coordination of genetic testing and detailed discussion of genetic test results Discussion of appropriate medical management recommendations, implications for family members, and support resources Coordination of cascade testing, which is genetic testing of blood relatives of individuals with genetic pathogenic variants identified Our specific goals include the following: Clinical: Provide patient-centered care and foster collaboration among health care providers Research: Advance the field of cancer genetics, risk prediction and prevention, and related treatment options Education: Provide clinical/didactic experiences for genetic counseling students, medical students, residents, fellows, and other providers Community Outreach: Promote awareness of hereditary cancer risk and provide broad-based education about cancer prevention options Who may benefit from a hereditary cancer genetics evaluation and testing? Someone with: A personal or family history of early-onset cancer (age 50 years or younger) Several family members on the same side of the family with cancer A personal or family history of breast cancer and Jewish ancestry A personal or family history of ovarian, pancreatic, triple-negative breast cancer, or metastatic prostate cancer at any age A personal or family history of multiple colon polyps A personal or family history of multiple cancer diagnoses within the same individual A personal or family history of a rare type of cancer/tumor (breast cancer in a male, medullary thyroid cancer, sebaceous carcinoma, or adenoma) A family history of a known gene pathogenic v

Each year, nearly 300,000 people in the United States are diagnosed with a type of gastrointestinal cancer. Many of these cancers are too complex or difficult to be treated with just one type of treatment. The Center for Gastrointestinal Cancers at Smilow Cancer Hospital and Yale Cancer Center provides patients with gastrointestinal cancers a comprehensive, multidisciplinary approach to the treatment of complex disease. As experts in the treatment of cancers of the esophagus, stomach, liver, pancreas, colon, bile ducts, rectum, and anus, we collaborate with diagnostic and interventional radiologists, gastroenterologists, and pathologists to provide the most up-to-date and effective treatments available. Our advanced diagnostic imaging services, including Endoscopic Retrograde Cholangiopancreatography (ERCP), MRI/MRCP (ERCP in conjunction with MRI), high-resolution CT scans, Endoscopic ultrasound (EUS), and EUS-guided fine needle aspiration, allow for patients to be comprehensively evaluated at the onset of their diagnosis. Surgical Oncology Surgery is commonly used to effectively manage certain types of gastrointestinal cancers, including malignant and premalignant tumors in the stomach, liver, bile ducts, pancreas, small intestine, and colorectum. Our team of surgeons incorporate a variety of state-of-the-art surgical techniques into procedures when necessary. These include: Laparoscopic and robotic surgery for stomach, small bowel, and colorectal tumors, as well as for primary and metastatic liver tumors and biliary tumors Cytoreduction and heated intraperitoneal chemotherapy Pancreatectomy (Whipple procedure, distal pancreatectomy, total pancreatectomy, central pancreatectomy, pancreas preserving enucleation) Medical Oncology In addition to chemotherapy, our medical oncology experts provide innovative nonsurgical treatment options including: Targeted Therapy, in which a special type of chemotherapy targets the changes in cancer cells that help them grow, divide, and spread Immunotherapy, which uses a patient’s own immune system to find and destroy cancer cells Yale Cancer Center emphasizes the importance of clinical trials for all stages of disease. Many of these drugs are exploring new types of therapy and new combinations of therapies, and many of our studies are available as part of our network of Care Centers. We perform state-of-the-art genomic profiling and laboratory explorations to determine the biologic weaknesses of the tumors and to develop better therapies for patients. Radiation Oncology Patients who need radiation oncology to treat their gastrointestinal cancers can feel confident that they are receiving the highest quality care from the most experienced team of radiation oncologists in Connecticut. We offer innovative therapies including: Three-dimensional Conformal Radiation: This technique may be used to target radiation to tumors by matching their particular shapes. Four-dimensional (4-D) CT simulation makes CT scans f