Departments

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

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 incidence of liver and bile duct cancer is growing, and about 42,000 new cases are diagnosed each year in the United States. While the incidence is rising, new surgical, interventional, and medical treatments are being added to our therapeutic armamentarium and are available to our patients. After treatment, our team of hepatologists provides continued care to manage the underlying liver disease, preserve liver function, monitor for possible recurrence of cancer, and re-treat, if necessary, while our medical oncologists apply systemic cancer treatment for those in need, as well as access to innovative medications through clinical trials. The Liver Cancer Program at Smilow Cancer Hospital has assembled a dedicated group of specialists, including hepatologists, hepatobiliary and transplant surgeons, diagnostic and interventional radiologists, pathologists, medical oncologists, and nurses. The team meets weekly at a NCI-designated tumor board to discuss each patient’s diagnosis and reaches a consensus on the best personalized treatment plan. Our guiding principle is to personalize and adapt care to the changing needs of the patient. Clinical trials, using new ablation treatment, new targeted agents, and combinations of treatments to target specific intracellular mechanisms of the liver cancer, are also available for patients with advanced disease. A combination of interventional radiology and surgical techniques, including ablation therapy, liver resection, new chemotherapeutic options, and liver transplantation, are available to our patients. For some patients, these treatments can cure their disease. For patients diagnosed with early disease, liver transplantation can provide definitive cure for both the cancer and advanced liver disease that frequently accompanies a diagnosis of cancer. For patients who do not have advanced liver disease or for those who cannot receive a liver transplant, surgical resection and ablative therapies such as transarterial chemoembolization (TACE) or radiofrequency ablation (RFA) can provide excellent survival rates. TACE delivers chemotherapy through a catheter directly to the liver tumor. RFA is a common treatment method for small tumors and uses a direct current to destroy tumors. NanoKnife therapy is a state-of-the-art minimally invasive cancer treatment that applies a high voltage of electrical pulses to induce precision targeted cancer death, while minimizing surrounding tissue damage in the liver. After treatment, our onco-hepatologist team provides continued care to manage the underlying liver disease, preserve liver function, and monitor for possible recurrence of cancer and re-treat, if necessary.

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