Departments

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

Urologic diseases affect more than 20 million men, women, and children in the United States. Yale Medicine Urology, named one of the nation’s best urology programs by U.S. News & World Report, cares for adults and children with conditions that affect the bladder, kidneys, pelvic floor, penis, testicles, and urinary tract. Some urologic conditions are present at birth, and others develop over time. Whether for a routine checkup or highly specialized care, our urologists and caregivers provide the most advanced treatment, grounded in research. Our urologists are leaders in the fields of female pelvic medicine and reconstructive surgery, as well as men’s health. Our oncology team has made key research breakthroughs in the treatment of metastatic bladder cancer and kidney cancer. In addition, we offer specialized care for kidney disease, incontinence, stone disease, sexual medicine, neurogenic bladder, transgender care, and reconstructive surgery after trauma. We use the most advanced technology and procedures to give our patients the best care available. Our urologists offer Artemis MRI-ultrasound fusion for prostate biopsy, advanced imaging, laparoscopic and daVinci Si robotic surgery, Holmium Laser Enucleation of the Prostate (HoLEP), as well as UroLift and GreenLight laser procedures. Our doctors and the hospitals where we provide care rank among the best in the country. In addition to providing treatment at Yale New Haven Hospital, Smilow Cancer Hospital, Yale New Haven Children’s Hospital, Greenwich Hospital, and Lawrence + Memorial Hospital, we also have offices located in communities across Connecticut. Above all, at Yale Medicine Urology, we believe in the importance of the patient-doctor relationship. It is the cornerstone of what we do—provide compassionate, quality urologic care to every patient, every day. A multidisciplinary team of urologists, specialty-trained nurses, caregivers, and support staff will take care of patients and their families. The urologist leads the care team, providing a diagnosis and treatment recommendations, as well as performing surgery, if needed, and overseeing the patient’s recovery and postsurgical care. The nurse coordinator is the patient’s advocate and care manager throughout care. Studies show that using nurse coordinators can reduce the length of hospital stays and enhance patient outcomes. Practice nurses provide the day-to-day care during clinical appointments or hospital stays. They administer medications, track vital signs, review general test results, respond to patients’ specific needs, and report to other members of the team. They are available around the clock to answer questions and to help patients through their care. The intake specialist helps to ensure patients are ready in advance of their appointment and have all forms and records completed and sent in advance. Intake specialists are experts at understanding the patient appointment and transfer process. If faced with a diagnosis o

Many urologic problems can affect sexual and/or reproductive health. Urologic conditions may be common, but they should not negatively impact patients’ quality of life, confidence, or relationships. Our urologists are here to discuss patients’ concerns, find solutions that work with their lifestyle, and meet their current and future goals.

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

Yale’s Department of Surgery is a premier center for adult and pediatric surgical treatment, providing comprehensive care for a full range of conditions and diseases. To ensure that our patients experience shorter hospital stays and less postoperative discomfort, we employ the latest technologies and surgical techniques, and perform minimally invasive surgery whenever possible. Our renowned surgeons and faculty continue to push the frontiers of surgical science through innovative treatment and leading-edge research, with the ability to offer treatment options that can be difficult to find elsewhere. More state-of-the-art surgical suites at Yale New Haven Hospital than in any other hospital in the region Collaboration with the Yale Department of Biomedical Engineering and with industry to develop 3-D bioprinting for the regeneration, repair, and replacement of human tissue and vessels Nationally recognized Center of Excellence and designated training center for transcatheter aortic valve replacement (TAVR) Yale’s Endocrine Neoplasia Laboratory is an internationally renowned multidisciplinary research group in which surgeons work with endocrine geneticists to decipher the molecular genetics of endocrine tumor disease First program in Connecticut to offer three different minimally invasive bariatric surgical techniques: Roux-en-Y gastric bypass, LAP-Band® surgery, and laparoscopic sleeve gastrectomy

The Center for Thoracic Cancers at Smilow Cancer Hospital consists of a multidisciplinary team of experts dedicated to providing evaluation of and treatment for patients with a thoracic malignancy, including lung cancer, esophageal cancer, thymoma, or chest wall tumors. Patients in Connecticut and beyond have access to nationally recognized expert clinicians, who provide an organized, collaborative approach to cancer care, as well as the latest technologies and treatments. Our team consists of a collaboration of specialty physicians, including medical oncology, radiation oncology, thoracic surgery, pulmonary medicine, digestive diseases, pathology, diagnostic imaging, and nursing. In addition to our expert clinicians, patients also receive comprehensive care to help with the physical, emotional, and psychological issues that are part of confronting cancer. Patients also benefit from the attention of the team's care coordinators, who make management of even the most detailed multidisciplinary treatment plan less complicated. Our team is active in clinical research, and focuses on developing advances to care in areas of thoracic oncology where the standard treatment needs improvement and where the optimal treatment approach remains unclear. To provide the best care, most of our patients are enrolled in a clinical trial where they can receive innovative therapy for their advanced disease, including immunotherapy, which was first used in clinical trials at Smilow Cancer Hospital. The Center for Thoracic Cancers offers second opinions that are easy, convenient, and all done remotely. Call (203) 200-LUNG for more information and learn how to schedule a second opinion appointment with one of our providers. Medical Oncology Our medical oncologists are nationally recognized for their leadership and expertise in lung cancer treatment and research, and are dedicated to offering personalized treatment options. Biomarker testing is often performed on the tumor to look for specific mutations that can be targeted by medication. There are currently FDA-approved lung cancer treatments for tumors showing abnormalities in EGFR, KRAS, ALK, ROS1, BRAF V600E, MET, RET , and NTRK genes. Recent studies conducted at Yale have led to FDA approval of drugs for the treatment of lung cancer, such as the immunotherapy drug Tecentriq (atezolizumab), which has been proven to improve patient survival for newly diagnosed NSCLC. This drug is designed to block PD-L1, a protein that was discovered by scientists at Yale and that has been instrumental in improving survival for lung cancer patients. Another FDA-approved drug, osimertinib, which stemmed from Yale Cancer Center and Smilow Cancer Hospital researchers, was approved for the treatment of adults with early-stage NSCLC with EGFR gene mutations. Surgery Many patients in need of surgery are referred for a minimally invasive surgery known as a video-assisted thoracoscopi

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

Lung cancer is the third most common cancer in the U.S., but it is the leading cause of cancer-related deaths. The reason is that most lung cancers are diagnosed in late stages of the disease. Hence, early detection is a key for longer survival when lung cancer is only limited to one area of the lung. A diagnosis of lung cancer often begins when a chest X-ray or computed tomography (CT) scan shows a nodule—an area of abnormal tissue—in the lungs. Lung cancer screening is one way to catch cancer early, when it is still a lung nodule. The other way, which is more common, of finding a lung nodule is incidental, while patients are getting lung imaging for other medical problems. Lung nodules that are suspicious or show signs of growth over time often need to be biopsied. Biopsy of lung nodule with bronchoscopy is preferred as risk of complications is very low and lymph node staging can be performed concurrently. However, traditional bronchoscopy has lower success for lung nodule biopsy. At the Yale Robotic Bronchoscopy Program, Yale interventional pulmonologists and thoracic surgeons will perform a next-generation bronchoscopy—robotic-assisted bronchoscopy with novel shape-sensing technology—that will allow them to visualize and biopsy remote parts of the lung that were previously inaccessible, significantly improving the success of lung nodule biopsy. The Yale Robotic Bronchoscopy Program takes a multidisciplinary approach to patient care; it is a joint program between Yale Interventional Pulmonology and Yale Thoracic Surgery, part of the Thoracic Oncology Program, which takes care of more than 40% of lung cancer patients in Connecticut while attracting patients from New England and beyond. The goal of the program is to diagnose potentially cancerous lung nodules in the periphery and hard-to-read parts of the lungs. The robotic bronchoscopy technology will help to biopsy and diagnose those nodules with significantly improved accuracy and safety. Yale New Haven Hospital offers this new technology, which has greater dexterity, reach, vision, and shape-sensing technology that offers greater stability when compared with traditional bronchoscopy. A regular bronchoscope has a camera on one end. The other end is held by a doctor who manually performs the procedure. With a robotic bronchoscopy, the endoscope is attached to a robotic arm, which the doctor operates from an independent console. The Yale doctors will be using robotic bronchoscopy concurrently with 3D fluoroscopy for real time imaging to further improve the accuracy of the procedure. Furthermore, doctors will also perform a procedure called EBUS—endobronchial ultrasound, which allows biopsy of the lymph nodes around the lungs and airways. This helps not just with the diagnosis but with the staging of lung cancer. Performing robotic-assisted bronchoscopy and EBUS under single anesthesia will help reduce the unnecessary waiting times and anxiety that patients may traditionally experience.

Diagnosing and managing many urologic conditions, including kidney stones and prostate cancer, depend on having up-to-date imaging of the pelvic area and abdomen. Our urologic care team includes radiology experts who specialize in identifying disorders of the genitourinary tract. Highly trained radiologists and urologists work together to detect and monitor our patients’ conditions using a variety of diagnostic techniques, including magnetic resonance imaging (MRI), ultrasound, computed tomography (CT) and fluoroscopy. We believe in teamwork. Our urologists and radiologist work together to provide the care from diagnosis to monitoring and treatment of each patient’s urologic condition.

Cancer Screening strategies are used to identify cancers at their earliest stage, before the onset of signs and symptoms, when the disease is most easily treated or cured. Cancer Prevention strategies are used to minimize the risk of cancer occurring. The Smilow Screening & Prevention Program brings together doctors and researchers at Smilow Cancer Hospital and Yale Cancer Center who are focused on merging the best science with the best cancer prevention and screening programs. Our goal is to provide patients in Connecticut with the tools they need to stay healthy. Screening Our Program offers many different screening tests for cancer of many types. Cancer screening tests are for patients who do not have symptoms. The goal of these tests is to find cancer as early as possible, and before any symptoms appear. Some, but not all, cancer screening tests detect potential problems and allow the doctor to remove the suspicious tissue at the time of the screening. This is important as it means that patients are less likely to develop cancer later in life. Sometimes the screening test results in a finding that requires more follow-up testing. Cancer screening offers the most protection when it is done on a regular basis as recommended by physicians. Patients should consult with their primary care physicians to determine which tests they recommend based on factors including gender, age, family history, and possibly race or ethnicity. Prevention Our program offers information to help patients make choices that can maintain their health and potentially reduce their risk of cancer. It is usually not possible to know why one person develops cancer and another does not. Healthy choices help all people--whether they have a family history of cancer or not--reduce their risk of developing cancer and many other chronic diseases. Avoiding smoking or chewing tobacco, choosing a diet that is rich in fruits and vegetables, exercising regularly, avoiding sitting for long periods, limiting alcohol, protecting skin and eyes from the sun and tanning beds are all key elements of healthy living. Following physician advice on regular cancer screening is also critical to long-term health. Types of cancer screening Click on the links below for more information on these specific cancer screening tests at Smilow Cancer Hospital: Lung Cancer Colorectal Cancer Breast Cancer Prostate Cancer Cervical Cancer Skin Cancer Head & Neck Cancer

The dedicated pediatric hematologists and oncologists of the Yale Pediatric Hematology and Oncology Program provide comprehensive and compassionate care for children with all forms of cancer and blood diseases, including leukemia, malignant tumors and lymphomas, as well as sickle cell disease, hemophilia, coagulation abnormalities, and platelet disorders. Our program utilizes a team approach to care, and is active in research that seeks to advance the diagnosis and treatment of pediatric cancer and blood diseases. Cure rates continue to rise for children with cancer. At Yale, we are determined that more and more children will survive, and that they will thrive. We work to design treatments that cause less discomfort to patients in the short term and fewer serious complications in the long term. Smilow Cancer Hospital and Yale New Haven Children’s Hospital’s care team works with patients and their families to design individual treatment plans. In addition to an oncologist, our multidisciplinary team includes advanced practice providers, registered nurses, social workers, a psychologist, psychiatrist, neuropsychologist, nutritionist, and child life specialists, all who have expertise in the medical, social, emotional and educational needs of children and teens. Understanding that children with cancer and blood disorders need more than medical care, we work with patients and their families to help them meet their social, emotional, educational, and behavioral needs. Our support services include: Routine psychosocial evaluations for newly diagnosed patients and their families. Home visits for the most gravely ill or psychiatrically symptomatic children and their families. A school integration program that includes counseling for families and children about their rights to have special services. We work with school districts to make appropriate accommodations for students returning to school, including providing special education services, if necessary. Psychoeducation and neuropsychological testing for patients at risk for neurocognitive problems. Support groups for siblings and parents. End-of-life support team for children and families. HEROS Survivorship Program The HEROS (Health, Education, Research & Outcomes for Survivors of Childhood Cancer) Survivorship Program at Smilow promotes the lifelong health of pediatric cancer patients after their cancer treatment has ended.It was the first childhood cancer survivorship program in Connecticut to offer comprehensive care for adults and children who had survived pediatric cancer. In our specialty clinic, patients receive detailed cancer treatment summaries and an individualized schedule for future screening for chronic conditions related to their original cancer treatment. Our multidisciplinary team that includes a pediatric oncologist, nurse practitioner, psychologist, registered dietician, and nurse educator are committed to caring for each patient as a whole person and empowering survivors

We recognize that anyone diagnosed with cancer is considered a survivor from the moment of their diagnosis. We provide individualized treatment summaries and survivorship care plans to support ongoing recovery and long-term survival. We are dedicated to enhancing the quality of life for individuals impacted by cancer. We value an inclusive approach and try to meet you “where you are at,” taking care of you as a whole person. Our team of experts have the highest level of oncology training in their field. We create a supportive space to hear you voice your concerns and focus on validating and empowering you to meet your goals by using practical tools. Established in 2006, our Survivorship Clinic was the first multidisciplinary resource for cancer survivors in the State of Connecticut to provide patients and their families with vital information on cancer prevention, wellness, supportive services, and the latest health research related to cancer survivorship. Our team understands that having cancer can be a life-altering experience. Survivors often have to adapt to a “new normal” that includes lifestyle changes. Because every survivor’s experience is different, each patient who visits our Survivorship Clinic receives an individualized care plan with specific recommendations and support for issues ranging from social and emotional wellness to nutrition recommendations and exercise guidance. Plan for a 2-hour visit. At the initial visit, you will meet with each provider one-on-one for 30 minutes. During this time, each provider will offer an opportunity to discuss your concerns related to their field of practice. Together, you both develop a plan to move forward living well beyond your cancer diagnosis and treatment. We see patients on average 1-3 times, depending on each patient’s needs. The Survivorship Clinic offers referrals to additional services based upon the discussion and needs identified at your visit.