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The GI Center Patient Experience
Introduction | People who are referred to Roswell Park Cancer Institute with a suspicion of cancer have many questions about the disease and its diagnosis, treatment and prognosis. General information on these subjects is presented here so that you will know what to expect when you visit Roswell Park for the first time. Your doctor will explain your specific situation and answer your questions at that time | |
Initial Evaluation | An attending physician will coordinate your care at Roswell Park. Her/she will be a specialist in gastrointestinal (GI) oncology who is also a faculty member of the University at Buffalo School of Medicine and Biomedical Sciences. Your attending physician will review your medical history, perform a complete physical examination, and review your pathology slides and past medical records. Following this initial evaluation, your attending physician will recommend that any or all of the following procedures be scheduled for you either on the same day or in the near future:
After you have completed the testing process, your attending physician will evaluate the results, discuss them with you and, if needed, outline your treatment plan. | |
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Treatment |
| A surgical procedure called an exploratory laparotomy may be the first procedure performed to confirm or rule out the presence of GI cancer. Your surgeon will make an incision in the abdomen and examine your organs. If cancer is found in any organ, that organ, as well as any other organs the cancer may have spread to, will be removed. |
Following surgery, your attending physician will review the results of pathology studies, determine if your condition warrants radiation therapy and/or chemotherapy, and discuss the treatment plan with you and your family. Radiation therapy and chemotherapy are both designed to kill cancer cells that the surgeon was unable to remove but each does so in a different way. Radiation therapy is a localized therapy. Strong x-rays are used to kill cancer cells that appear on imaging studies to be clustered in isolated areas. Chemotherapy is a systemic therapy. Medications, usually given intravenously (through a vein), travel throughout the entire body in search of cancer cells which may have spread to other parts of your body through your lymphatic system or the blood stream. | ||
Planning for Hospital Admission | The Gastrointestinal Oncology office staff will schedule the day of your surgery, the time of your hospital admission, further tests requested by your attending physician and your preoperative visit to the clinic. The office staff also can answer many of your questions about hospital routines, financial coverage or other services you might need. You should inform your insurance company of your planned hospitalization. Roswell Park will call to pre-certify hospitalization for a limited time: for example, three or four days. However, your medical team at Roswell Park will evaluate your condition daily and communicate with your insurance company to justify additional days of hospitalization, if needed. Most patients who have surgery for cancer stay in the hospital from four to seven days. | |
The GI Oncology Team | The GI Oncology Team includes health professionals with different specialties to meet your needs and those of your family. Attending Physicians perform surgery and manage all aspects of your care. Surgical Oncology Fellows have completed 4-year residency programs in surgery and are training to become surgical oncologists. Fellows assist with your treatment and may see you in the clinic. A Fellow is on-call after office hours and on weekends and holidays to deal with emergencies and to answer questions. | |
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| Nurse Practitioners help arrange your surgery and assist with your care following surgery. Nurse Leaders coordinate the scheduling and organization of the GI Center and are available to help you with any concerns or questions you or your family may have. Social Workers are available to meet with you and your family to discuss topics such as social and psychological support. Case Managers communicate with your insurance company while you are hospitalized and will coordinate home care services if needed. If you require chemotherapy after surgery, the GI Center nurses will meet with you to discuss the type of medicines you will receive and what to expect. |
Preparing for Surgery | Your preoperative visit to the GI Center usually will be scheduled before your surgery. During your visit a surgical oncology fellow will meet you to review the treatment plan initiated by your attending physician, answer your questions, and explain, and ask you to sign, the informed consent form for surgery. You may have routine urine and blood studies, as well as a chest x-ray, EKG (electrocardiogram) or other tests before surgery. Then an anesthesiologist will examine you, discuss the surgical anesthetic you will receive and order medications for sedation before surgery, including sleeping medications for the night before, if you like. The nurse will teach you breathing exercises that will help prevent lung congestion and leg exercises that will help improve blood circulation while you are less active after surgery. You will also receive instructions to drink only clear liquids 2 days before surgery, not to eat or drink (nor even water) anything after midnight and what bowel prep is needed for your procedure. If you normally take important medications (e.g. heart, blood pressure, and diabetic medications) in the morning, remember to ask your attending physician whether you should take them with a sip of water in the morning of your surgery. | |
Surgery and the Postoperative Period | Your family or significant others are welcome and encouraged to join you for any of the preoperative discussions or orientations. They also may be with you before you go to the operating room. Surgery will take several hours, followed by two or three hours in the Post Anesthesia Care Unit (PACU) while you recover from the anesthesia. An operating room nurse will keep your family informed during surgery and your attending physician will talk to them about your condition after surgery. As you awaken, you will become aware of the nurse checking your blood pressure, pulse and temperature frequently. You will also have an intravenous (IV) line and a urinary bladder catheter. Do not be alarmed if you receiving oxygen or having a blood transfusion. These procedures are common following surgery. | |
Back in Your Hospital Room | Incision: Stitches or staples closing the surgical incision usually will be removed 10 days after surgery. Emotions: Major surgical procedures consumer a great deal of physical and emotional energy. Increased fatigue, hospital confinement and temporary physical limitations may lead to feelings of nervousness, frustration and even anger. Although these reactions are normal and temporary, they may distress you. It often helps to share your concerns with a close family member, friend or a member of our staff. | |
Recovering at Home | Before you leave the hospital, you will be told what to expect in the coming days. Although complications are unusual after you leave the hospital, inform your doctor if you have any of the following:
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During your recovery, be sure to get adequate rest and nutrition and participate in mild physical and enjoyable activities. A balanced diet of high protein foods will help build your strength and aid healing. Light activity only is encouraged in the first 2 weeks after surgery or until you are seen in the GI Center for the first time after surgery. Delay driving or prolonged sitting for 3 or 4 weeks after surgery. You may begin isometric (tightening) exercises of the abdomen after 3 or 4 weeks but avoid lifting anything over 10 pounds and strenuous exercise for 2 to 3 months after surgery. Cancer is stressful disease and the treatment can be complicated. Each person reacts differently. You may feel anxious, worried, depressed or bewildered about the way your life and the lives of those close to you will be affected. Allow yourself some time to adjust. Talking to your nurse, physician, family or close friend can help you find answers and emotional support. | ||
GI Center Contacts | For more information about the Gastrointestinal (GI) Center, you may contact: GI Oncology Social Worker (716) 845-8022 GI Center (716) 845-4774 After Hours (716) 845-2300 |
