Intravesical Immunotherapy
Definition
Intravesical immunotherapy is a medical treatment that involves the administration of immunotherapeutic agents directly into the bladder to stimulate the immune system to fight against cancer cells, particularly in the case of non-muscle invasive bladder cancer. This therapy is commonly used to reduce the risk of cancer recurrence and progression.
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Head & Neck Cancers Program
The Head and Neck Cancers Program at Smilow Cancer Hospital provides total care, as well as innovative and organ-sparing treatment options to patients with cancers of the head and neck. Our team sets the tone nationally and internationally for clinical trials and state-of-the-art cancer care. By carefully balancing treatment efficacy with quality-of-life, our collaborative approach to care personalizes treatment for tumors affecting the neck, larynx (voice box), pharynx (throat), oral cavity (mouth), ear, sinuses, tonsils, and salivary glands, as well as cervical (neck) lymph nodes or neck structures. Our multidisciplinary team includes head and neck surgeons, radiation oncologists, medical oncologists, pathologists, physical therapists, speech-language pathologists, nutritionists, a smoking cessation specialist, dentists, a physical/lymphedema therapist, advanced practice nurses, and social workers. Functional outcome is an important element in deciding which treatment approach is recommended. Our program offers a promising new surgical technique, transoral robotic surgery (TORS), that can be used to remove certain throat cancers while avoiding skin and bone incisions. This approach speeds healing and shortens a patient’s hospital stay. Likewise, patients with certain laryngeal cancers, who a few years ago would have lost their vocal cords and their voices, can often be treated with less invasive surgeries. Patients who undergo these treatments maintain their ability to speak, although they may need to alter their diet or learn new swallowing techniques. At Yale, rehabilitative specialists work with patients to help them adjust to and overcome some of these swallowing impairments. In many cases, radical neck dissections have been replaced by less radical surgeries that preserve the nerves, arteries, and muscles in the neck. Patients continue to move, speak, breathe, and eat normally after less radical surgeries, without sacrificing cure rates. Additionally, in recent years, the field of reconstructive surgery has achieved many breakthroughs, yielding previously unattainable cosmetic and functional outcomes. Medical Oncology Our medical oncologists have unique expertise in head and neck cancers and dedicate their practice entirely to cancers of the head and neck. The integration of chemotherapy with radiation has become very important for patients with head and neck cancers that involve the lymph nodes or is locally extensive, and this approach can lead to organ preservation and increase the chance of cure for many patients. Breakthroughs in targeted therapy and biomarkers allow a personalized approach that can avoid the toxicities of conventional chemotherapy in some cases, and new treatments to prevent recurrence in high-risk situations are also being studied. For patients with recurrent disease, new anti-cancer drugs and immunotherapies are also available. A study led by Yale Cancer Center revealed that the checkpoint inhibitor pembroliCancer-Infectious Diseases (Cancer-ID) Program
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 ouProstate & Urologic Cancers Program
Urologic cancers include prostate, bladder, kidney, urothelial upper tract, testicular, penile, and urethral cancer. The Smilow Cancer Hospital Prostate and Urologic Cancers Program at Yale Medicine is uniquely qualified to treat these cancers. Our program utilizes the most advanced technology and techniques available to diagnose, manage, and treat urologic cancers. We are leaders in the use of MRI/US Fusion prostate biopsy (which blends MRI and ultrasound for increased accuracy), utilizing the ExactVu and Artemis systems across the region. This technology allows us to detect the cancer early and closely monitor it. When surgery is needed, our urologists provide extensive expertise in nerve-sparing laparoscopic and robotic surgery, traditional open surgery, and novel targeted or “focal“ treatments. Our patients also benefit from the expertise of a collaborative approach to cancer care, which personalizes treatment. We engage experts who specialize in medical oncology, radiation oncology, surgical oncology, pathology, and diagnostic imaging. Patients also have access to caregivers who can help with the physical, emotional, and psychological issues related to these cancers. The extended team includes health educators, social workers, dieticians, and complementary therapists. Our goal is to ensure the highest standard of care to support our patients and their families. Imaging and Interventional Radiology Our radiologists are experts in magnetic resonance imaging (MRI), ultrasound, computed tomography (CT), and fluoroscopy, and combine their clinical expertise with advances in technology including MR-US fusion for prostate imaging, as well as positron emission tomography (PET) scans and advanced nuclear medicine scans. In addition, Blue Light™ Cystoscopy, an advanced endoscopic technology, is employed to improve bladder cancer detection and reduce risk of cancer recurrence. Surgery Our experienced urologic surgeons are committed to achieving optimal cancer outcomes, emphasizing organ preservation and the safeguarding of sexual and urinary function as much as possible. Through advanced techniques including minimally invasive and robotic surgery, our urologists are able to optimize both cancer care and surgical recovery. Cryoablation (tumor freezing) may be a good option for some patients with prostate or kidney tumors. Focal therapy is also available for appropriate patients with prostate cancer, as it is able to treat the cancer without the use of radiation or surgery, preserving the prostate, as well as urinary and sexual function. Similarly, for some patients with cancers of the ureter or upper urinary tract, a laser can be used to treat the tumor and preserve kidney function. Medical Oncology Chemotherapy is an important component of cancer care for many patients, as it can delay or prevent tumors from recurring when used before surgery. It can also help patients with advanced or metastatic disease. As a major national