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Anal, Liver and Pancreatic Cancers

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Dr. Joe Herman is an expert in treatment
anal, liver, pancreatic, and rectal cancers.

An experienced radiation oncology team at Johns Hopkins specializes in the treatment of anal, liver, pancreatic, and rectal cancers. When caught early, anal, liver, pancreatic, and rectal cancers are generally treated with surgery. In cases where the cancer has spread or if surgery cannot be done, an oncologist will recommend radiation therapy, often in conjunction with surgery and chemotherapy. 

Read more about specific radiation treatments for:

Because our radiation oncologists are part of a larger multi-disciplinary oncology team that diagnoses and treats cancer, patients can be assured that the radiation therapy developed to treat their cancers will be the most effective one possible. Our specialized teams work together to create a comprehensive treatment plan, make sure patient appointments are scheduled as quickly as possible, and that appointments with specialists are coordinated to be kept to a convenient minimum.

Our team of radiation oncology specialists, including physicians, medical physicists, dosimetrists, nurses, and therapists, creates an individualized radiation therapy plan developed for a patient’s specific needs.

The safety and well being of our patients and their families are always the primary concern of every member of the radiation oncology team. We have developed a comprehensive safety program that is unique to Johns Hopkins. As an international leader in radiation safety, our standards for safety serve as an example for other academic and community-based radiation practices. Our safety program not only complies with state and national protocols, it goes well beyond those protocols by integrating innovative safety techniques developed by experts on our staff.

Through our clinical research, we offer our patients the most effective and safest therapies available, in addition to clinical trials that patients can choose to participate in.

To find out more about radiation oncology at Johns Hopkins, call 410-502-8000 or e-mail hopkinsradonc@jhmi.edu.

Anal cancer

If radiation treatment is recommended, a radiation oncologist will work with our radiation oncology team to create a course of treatment. At Johns Hopkins, external beam radiation is most commonly used for anal cancer.

This type of radiation therapy delivers a beam of high-energy x-rays to a patient’s tumor site, in order to destroy the cancer cells. External beam radiation gets its name from the fact that the beams come from an external source (a machine called a linear accelerator) and are aimed at the site of the tumor. Radiation oncologists at Johns Hopkins use intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) to treat patients with anal cancer.

In some cases, anal cancer may spread (or metastasize) to the liver. Because Johns Hopkins physicians work in teams, patients whose cancer has metastasized will benefit from the expertise of a team of physicians who are part of the Liver Tumor Center, including medical oncologists, surgeons, hepatologists, endocrinologists, radiation oncologists, and others.

The Sidney Kimmel Comprehensive Cancer Center offers an overview of treatment for anal cancer at Johns Hopkins.

Liver cancer

The Johns Hopkins Liver Tumor Center offers multidisciplinary teams of specialists, including oncologists, surgeons, hepatologists, endocrinologists, radiation oncologists, and others, that work together to treat liver cancer, using surgery, chemotherapy, and radiation to create a plan that is individualized to the patient’s diagnosis. Three types of radiation therapy are used to treat liver cancer:

The Sidney Kimmel Comprehensive Cancer Center offers an overview of treatment for liver cancer at Johns Hopkins.

Pancreatic cancer

At Johns Hopkins, a team of specialists, including oncologists, surgeons, hepatologists, endocrinologists, radiation oncologists, and others, works together to create a comprehensive treatment plan. Patients can be seen in our pancreatic multidisciplinary clinic.

“Johns Hopkins is recognized as one of the leading pancreatic cancer centers in the country. Our pancreatic multidisciplinary clinic is staffed by national experts in each discipline, which isn’t the case at very many other hospitals. In fact, we see six to twelve patients with pancreatic cancer per week in that clinic,” says the clinic’s director, Joseph Herman, MD, who specializes in the treatment of gastrointestinal malignancies.

“We offer multiple clinical trials directed to pancreatic cancer patients, which look at treating pancreatic cancer with radiation and both chemotherapy and radiation. Our goal is to offer the most cutting edge technology and research for patients with pancreatic malignancies, with a focus on minimizing toxicity and improving quality of life.”

These types of radiation treatments are used for pancreatic cancer:

The Sidney Kimmel Comprehensive Cancer Center offers an overview of treatment for pancreatic cancer at Johns Hopkins.

Rectal cancer

For patients with rectal cancer, radiation therapy can be used to shrink the rectal tumor, in cases where the cancer has spread or if the oncologist thinks the rectal cancer is likely to recur. When radiation treatment is recommended, a radiation oncologist will work with a radiation oncology team to create a course of treatment.

Joseph Herman, MD, who specializes in treating rectal cancer, says that the ability of Johns Hopkins to combine cutting-edge research with clinical practice sets it apart from most other centers that treat rectal cancer. “For example, we are currently are the only center in the country to offer a prospective clinical trial evaluating endorectal brachytherapy for early stage rectal cancer and its results so far look promising.”

Types of radiation treatments used for rectal cancer include:

  • External beam radiation delivers a beam of high-energy x-rays to a patient’s tumor site, in order to destroy the cancer cells. External beam radiation gets its name from the fact that the beams come from an external source (a machine called a linear accelerator) and are aimed at the site of the tumor. Radiation oncologists at Johns Hopkins use intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) to treat patients with rectal cancer.
  • Brachytherapy is a targeted high-dose radiation treatment that can be delivered via radioactive "seeds" or wires that are placed directly in or near the tumor or via an applicator device placed at the tumor site. The Radiation Oncology Department at Johns Hopkins is currently the only center in the country to use endorectal high-dose rate brachytherapy to treat rectal cancer. Radiation oncologists here may also opt to use high-dose rate intra-operative radiation therapy (HDR-IORT) if that will offer the patient better outcomes.
  • Fractionated radiosurgery (FRS) also provides high doses of radiation to the tumor site while shielding nearby tissues and organs. It is used to treat larger tumors and those located near critical organs and nerves. Our radiation oncologists are among a very few in the country who have successfully used FRS to treat pancreatic cancer.

In some cases, rectal cancer may spread (or metastasize) to the liver. Because Johns Hopkins physicians work in teams, patients whose cancer has metastasized will benefit from the expertise of a team of physicians who are part of the Liver Tumor Center, including oncologists, surgeons, hepatologists, endocrinologists, radiation oncologists, and others.

The Sidney Kimmel Comprehensive Cancer Center offers an overview of treatment for rectal cancer at Johns Hopkins.

 

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