Departments

When caring for children with cancer, we focus on protecting normal, growing tissue while accurately targeting disease with radiation. As part of the Yale Cancer Center, our team of experts includes not just radiation oncologists, but also experts in pediatric hematology-oncology and other subspecialties such as laboratory medicine, surgery, neurosurgery, orthopaedics, pathology, and diagnostic radiology. We also have a highly trained support staff of nurses, social workers, and radiation therapists to support children and their families as they go through the treatment process. Very young children, generally those less than four years of age, are often unable to cooperate with daily external radiation treatments. Pediatric anesthesiologists assist these children with outpatient sedation or general anesthesia. This allows children to sleep through therapy, ensuring radiotherapy precision and avoiding psychological trauma.

The Endocrine Program at Smilow Cancer Hospital is one of the largest multidisciplinary endocrine programs in the country. We evaluate, diagnose, and care for patients with both cancerous and benign tumors of the thyroid, parathyroid, adrenal glands, pituitary gland, hypothalamus, and pancreas. As part of the only endocrine surgery program in Connecticut, our highly trained surgeons collaborate with specialists both at Yale and other institutions in order to provide the most comprehensive, leading-edge surgical treatment available to all of our patients. Our emphasis is on the safest and most minimally invasive surgery with the least amount of discomfort, scarring, and the fastest recovery time for every patient. The Endocrine Program is experienced in treating rare cancers, such as parathyroid carcinoma, advanced thyroid cancer, adrenal cancer, and pheochromocytoma/paragangliomas, which benefit from this multidisciplinary approach and specialized expertise. Specialized surgical expertise is essential for the management of all endocrine tumors. Some of the latest and most innovative procedures offered by our program include: Radiofrequency Ablation (RFA) is a unique, non-surgical way to treat benign thyroid lesions. Traditionally, thyroid nodules are removed surgically, which may require lifelong thyroid hormone supplementation. RFA is a safe and effective alternative to surgery that can preserve normal thyroid tissue and function and alleviate compressive symptoms. During the minimally invasive, outpatient procedure, a patient’s nodule is selectively heated and denatured using an electrode that passes through the skin. Minimally Invasive Parathyroidectomy : The removal of one or more of the parathyroid glands, which are small, pea-shaped glands located in the neck on either side of the trachea and next to the thyroid. This is performed with a focused approach, often using a gentle local anesthesia technique. This enables the patient to vocalize during surgery, ensuring the vocal cords are protected. Retroperitoneoscopic Adrenalectomy : This approach allows for direct access to the adrenal gland without the need for invasive procedures in patients deemed to have smaller tumors. This results in less scarring and pain with a quicker recovery for patients. Laparoscopic or Open Transabdominal Adrenalectomy : Based on the individual patient, and especially in the management of large adrenal tumors, either a laparoscopic or open surgical approach may be preferable. We offer several specialized approaches to enhance care in conjunction with surgery. These include: A parathyroid four-dimensional (4-D) CT Scan , an advanced imaging technique used to localize parathyroid tumors before surgery is performed Rapid PTH (parathyroid hormone) assays , which allow for real-time testing while patients are still in the operating room. Rapid PTH-assays are essential in determining if a tumor has been completely removed, or if further exploration is needed before

At Yale Medicine, our team of renowned physicians are leaders in the field of endocrinology. We specialize in understanding and treating the delicate balance of the endocrine system and the hormones that regulate essential body functions. Our physicians are also experts in the management of metabolic disease, which affects how your body processes food to create energy. We're here to provide you with advanced diagnostic and comprehensive treatment options that address these crucial hormonal and metabolic functions. Specialized care is offered in the following areas: Adrenal diseases, including adrenal masses, Cushing syndrome, hyperaldosteronism, and pheochromocytoma. Bone Center consists of a team of specialists with expertise in bone health who treat patients with bone diseases and disturbances in the metabolism of calcium and phosphorus, a mineral that helps build bones. Center for Weight Management, which offers assistance with weight and weight-related health conditions. Diabetes Center is comprised of diabetes specialists who help patients manage their diabetes and prevent long-term complications. Endocrine cancers of the thyroid and adrenal glands. Pituitary conditions and complex disorders. Thyroid diseases, including hyperthyroidism, thyroiditis, thyroid nodules, and thyroid cancer.

Our goal at the Diabetes Center is to give patients the tools necessary to successfully manage the day-to-day challenges of living with diabetes and prevent long-term diabetes complications. We provide comprehensive management and education for adults with type 1 and type 2 diabetes. We focus on lifestyle interventions and use the latest medications and technologies to improve our patients’ health. We also treat patients with: Pre-diabetes and metabolic syndrome Obesity Polycystic ovarian syndrome Lipid or cholesterol abnormalities Our nationally recognized doctors and nurse practitioners work as a team to address our patients’ needs in managing diabetes and other conditions. We understand that living with diabetes presents challenges. We focus on education and making patients their own advocates. Through the most current and state-of-the-art treatments, we will help them better manage their care. Oral Medications There are several classes of oral diabetes medications that we may prescribe if patients have type 2 diabetes. These medications differ in the way they work to reduce blood glucose levels. Frequently, oral medications from different classes are used in combination. Sulfonylureas: These drugs increase the amount of insulin produced by the pancreas. Meglitinides: These drugs rapidly increase the amount of insulin produced by the pancreas. Biguanides: Metformin is the only biguanide on the market. It is thought to work by reducing the production of glucose in the liver. Alpha-Glucosidase Inhibitors: These medications reduce the amount of glucose absorbed in the intestines. Thiazolidinediones: This agent makes the body more sensitive to insulin. Dipeptidyl Peptidase 4 inhibitors (DPP-4 inhibitors): These drugs increase the amount of insulin produced by the pancreas after a meal and reduce the amount of glucose produced by the liver. Injection Therapies There are several classes of injection therapies for diabetes. These treatments are given by an injection under the skin. The most common injection therapy is insulin, which comes in many different formulations that differ in how fast they work and how long they last. Below is a list of the different types of insulins. Technologies and Experimental Treatments Insulin Pumps: Insulin pumps were first pioneered at Yale in the 1970s. An insulin pump is an electronic, pager-sized, battery-powered device that delivers insulin continuously through a small plastic catheter under the skin. Insulin is delivered in different amounts (“basal” or “bolus” levels) during the day and controlled by the patient. While fasting, patients will administer a low level of continuous “basal” insulin to keep their blood glucose in the normal range. Prior to meals, they will determine a “bolus” of insulin based on the amount of carbohydrates in the meal. Continuous Glucose Monitoring systems (CGM): A CGM is a device that measures glucose under the skin (also known as “interstitial” glucose) every five minutes thr

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 pembroli

The Pituitary Program is a destination center for the clinical management of pituitary, parasellar, and anterior skull base disease delivering state-of-the-art, multidisciplinary care. It is the referral center for the state of Connecticut for treatment of complex pituitary and sellar-parasellar pathology using the expertise of minimally invasive endoscopic skull base surgery jointly performed by neurosurgery and ENT. Patient cases are reviewed by a multidisciplinary pituitary tumor board, with intraoperative hormone monitoring, intraoperative MRI, and whole exome sequencing of tumors for potential genomic-based diagnosis and treatment. The Yale endocrinology team and other supporting subspecialties follow each patient during the hospitalization for uninterrupted endocrine care. We aim to maximize the quality of care and the ultimate outcome of each patient. To ensure the best care possible, we co-manage the pituitary disorder with each patient’s primary care physician, and actively seek second opinions, exploring dynamic testing and pituitary hormone replacement therapy options. Yale New Haven Hospital is a regional center for pituitary surgery, and our physicians have specific expertise in treating a variety of neuroendocrine diseases, including Cushing's disease and adult growth hormone deficiency syndrome. We also evaluate and treat reproductive disorders in collaboration with the sections of Reproductive Endocrinology and Infertility. Additionally, we work closely with colleagues in neurosurgery, surgical endocrinology, therapeutic radiology, and other departments to make sure patients benefit from our patient-centered, team-based approach. Combined with first-rate technology at Yale New Haven Hospital, the Yale Cancer Center and the Department of Neurosurgery’s Gamma Knife Center, the Pituitary Program is uniquely positioned to offer every diagnostic and treatment option available, including: Dynamic pituitary magnetic resonance imaging (MRI), an enhanced diagnostic imaging technique Inferior petrosal sinus sampling to sample hormones from the veins that drain the pituitary gland 3-D conformal radiotherapy to better target tumors Intensity-modulated radiation therapy, an advanced high-precision technique Transphenoidal surgery performed through the nose and sphenoid sinus Gamma Knife surgery (stereotactic radiosurgery) performed at the Gamma Knife Center, the only dedicated Gamma Knife facility in Connecticut. At Yale New Haven Children's Hospital, our longstanding pediatric endocrinology clinic provides the same services and excellence of care that adults receive.

Cancer can have a profound impact on someone’s life. From the very beginning, most patients have many questions about the road ahead. Working in collaboration with medical and radiation oncologists at Yale Cancer Center, our world-renowned oncology surgeons are committed to providing compassionate and personalized care, offering comfort and support. We understand that the thought of undergoing surgery can be overwhelming. An integral part of our approach is to provide support, in part, through detailed answers and by thoroughly explaining treatment options and what to expect before, during, and after the surgery. Our innovative methods enable our surgeons to address even the most complex cancerous and noncancerous conditions. Our surgeons provide the most comprehensive and advanced care available, collaborating with other internationally recognized cancer care specialists at Smilow Cancer Hospital at Yale New Haven, including diagnostic and interventional radiologists, gastroenterologists, hepatologists, imaging specialists, and pathologists. Whether patients are newly diagnosed with cancer or their cancer has not responded to traditional treatment therapies, our team of surgeons and specialists will create a personalized plan based on the latest research, technologies, evidence-based medicine, and the possibility of clinical trials. During the first visit, patients will meet with a surgical oncologist, medical oncologist, and a radiation oncologist who will create a personalized treatment. Our goal is to begin treatment as soon as possible. Because our surgeons treat patients at theSmilow Cancer Hospital at Yale New Haven, patients will have access to a multitude of medical and supportive services to help improve their quality of life while living with cancer, and after. We treat the following cancers and cysts: Breast cancer Gastrointestinal cancers, including gastric bile duct, gallbladder, liver, colon, stomach, pancreas, and colorectal cancers Intra-abdominal cancers and tumors Melanoma Pancreatic cysts (noncancerous) Sarcoma Minimally invasive surgery. Our emphasis is on the most successful surgery with the least pain, scarring, and recovery time. Our highly-skilled surgeons are leaders in minimally invasive procedures, even for complex cases that would otherwise require traditional open surgery. During minimally invasive surgery, also known as laparoscopic surgery, only a few small incisions are necessary. Surgeons use small video cameras to view the affected area and use special surgical instruments to perform the surgery. Recovery time and postsurgical discomfort are significantly reduced because the incisions are smaller than with open surgery. Surgical wounds tend to heal more quickly and with less scarring. Whipple Procedure. The pancreas, which is the largest gland of the endocrine system, is difficult to treat surgically because of its position behind major organs. The Whipple procedure is an innovative approach that allows surgeons

Our program was formed in 2013 to address the clinical issues and concerns faced by patients and their families with pancreatic disease, such as pancreatic cancer, pancreatic cysts, and pancreatitis. We provide the latest treatments in collaboration with other Yale programs such as the Yale Cancer Center. Our team comprises doctors from several fields to provide patients with the most comprehensive care, including advanced endoscopy, gastroenterology, surgery, medical oncology, radiation oncology, pathology, and genetics. Our nurses and advanced practice nurses are also highly experienced in pancreatic diseases. It is important to us that we educate our patients about pancreatic disease and its related procedures and treatments. We believe this empowers patients and family members to take an active role in their health care decisions, which can lead to an improved quality of life. We specialize in treating the following conditions: Pancreatic cancer Pancreatic cysts Chronic pancreatitis Acute pancreatitis We also offer the following services: Endoscopic ultrasound Endoscopic retrograde cholangiopancreatography Medical oncology Radiation oncology Pancreas surgery

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

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

The Sarcoma Program at Smilow Cancer Hospital consists of a multidisciplinary team of physicians who diagnose, treat, and provide expert care for patients with both soft tissue sarcomas and sarcomas of the bone, or osteosarcoma. Our team includes orthopedic physicians, dermatologists, diagnostic radiologists, medical oncologists, pediatric oncologists, radiation oncologists, and pathologists, all with specific expertise in the treatment and care of patients with sarcoma. For diagnosis, our physicians employ state-of-the-art methods including CT scanning, which is excellent at seeing both bone and soft tissues; MRI, which has the ability to “view” the tissue in and around bone with exquisite detail; PET scanning that is able to look at the cancer’s biological activity at the cellular level; bone scans that use a very small amount of radioactive material to check for cancer cells within the bone; and X-ray. Bone scans can also be performed to check for cancer cells in the bone. Surgery Surgery is often a key treatment for patients with sarcomas of the bone. Upon consultation to determine a treatment plan designed to meet the individual needs of the patient, the following types of surgery may be considered: Wide local excision: Removal of the cancer and some healthy tissue around it. Limb-sparing surgery: Removal of the tumor in an arm or leg without amputation, preserving the use and appearance of the limb. The tumor is removed—and tissue and bone that are removed may be replaced with a graft using tissue and bone taken from another part of the patient’s body, or with an implant. Most patients with osteosarcoma can be treated with this type of surgery. Amputation: In some instances, it is not possible to remove the entire tumor in limb-sparing surgery, and therefore amputation may be considered to remove part or all of an arm or leg. The patient may be fitted with a prosthesis after amputation. Radiation Some patients who are undergoing surgery may have radiation therapy first to shrink a tumor to improve the success of the surgery. Radiation therapy is also often used after surgery to try to eliminate any remaining cancerous cells. Therapeutic Options Following successful surgery to remove the sarcoma, patients are also given chemotherapy to kill any remaining cancer cells. For soft tissue sarcomas, chemotherapy may be used before or after surgery and radiation. There are several approved chemotherapy options for patients and their oncologists to consider. Additionally, clinical trials offering the latest treatment combinations and new therapies are available for our patients through Yale Cancer Center, a comprehensive cancer center designated by the National Cancer Institute. Smilow Cancer Hospital and Yale Cancer Center are also members of the Sarcoma Alliance for Research through Collaboration (SARC). SARC is a collaboration of distinguished research institutions throughout the country that work together to design and evaluate clinica

We offer comprehensive leading-edge care for benign and malignant conditions of the thyroid, parathyroid, pancreas, and adrenal glands for adult patients, and for thyroid and parathyroid conditions for pediatric patients. In caring for our patients, we harness the latest in medical care and technologies, including laparoscopic and other minimally invasive surgical techniques. Our expertise ensures that, whenever possible, our patients experience shorter hospital stays and less postoperative discomfort. We understand that living with endocrine conditions presents challenges. We want to help our patients meet and overcome those challenges by exploring what their condition means in their day-to-day life. Our team includes endocrine surgeons, specialists, physician’s assistants, nurse practitioners and patient coordinators who work together to care for patients with adult benign and malignant endocrine disease, and pediatric thyroid and parathyroid disease. We collaborate with primary care providers and other specialists to optimize our patients’ health and provide them with a comprehensive network for all of their care.