Second Annual Update on Gastrointestinal Cancers CME: Interview with Dr. Tyvin Rich and Dr. Michel Kahaleh

by Columbia Surgery on August 2, 2013


The Second Annual Update on Gastrointestinal Cancers will be held on Friday, September 27, and will feature lectures, case presentations, and Q&A panels with expert faculty.

Doctors Tyvin Rich, Michel Kahaleh, K.S. Clifford Chao, and Ravi P. Kiran are co-directors of this program and leading experts in the fields of radiation oncology, colorectal cancer, and gastroenterology. An interview was held with Dr. Rich and Dr. Kahaleh to gain more insight into the conference, its history, and what attendees will learn about gastrointestinal cancer.

What were the goals in creating a CME that focused on gastrointestinal cancer? What specialties would be interested in this program?

Dr. Tyvin Rich

Dr. Tyvin Rich

We believe that doctors from various specialties will be interested in attending this program. Oncologists, surgeons and gastroenterologists could all benefit from this conference. The conference itself is essentially an extension of an ongoing program that has taken place for over twenty years. It began as an effort between Dr. James Ahlgren, a medical oncologist in Washington D.C., and a few of his colleagues in Bordeaux, France. The meeting eventually flourished into an annual event, moving between France and the United States each year. Although the conference has been held for twenty years, this is only the second year that it is being held in New York City. In the past it has been held in Bordeaux and Montpellier, France, as well as Washington D.C., Charlottesville, and Williamsburg, Virginia.

The event is really a great opportunity for American and European researchers to exchange ideas, and one such exchange is going to be a discussion between Francis Levi, from Paris, and Nancy Kemeny, from Sloan Kettering. If you attend just this one session it would be worth the trip. Both of these doctors are world experts in their field and have had separate but parallel experiences in treating rectal cancer. This in itself is going to be a fascinating session, and should really highlight why this program was organized in the first place.

Dr. Michel Kahaleh

Dr. Michel Kahaleh

Is there something different about GI cancer that warrants a single program dedicated to it?

Many people are not completely aware of all the new things happening in the field of gastrointestinal cancer. A lot of medical institutions still use older treatments, and our goal was to create a conference that presented the newest and most cutting edge approaches to treating GI cancer. This CME conference is our way of presenting these new findings.

What aspects of GI Cancer treatment will the program focus on?

We designed this program to focus on new and novel approaches to detecting and treating GI cancer. We did not want to go over tried and true treatments, but rather focus on the latest advances. There are new chemotherapy agents out there, new ways of performing radiation therapy, and there are new minimally invasive procedures being developed such as ablation. These sorts of advances are going to be the focus of the conference.

What, within the last year, has changed in the screening of GI cancers? How will these changes be addressed in this year’s program?

Over the past year there have been no Earth-shaking developments, but during the last five years or so there have been many improvements in the screening of GI cancers. For example, we have become more able to investigate relationships between early inflammatory changes and the possible progression of distal esophageal upper gastric cancer. In addition, there has been improvement in the methods for screening stomach cancers. In places like Japan they have made it very easy and accessible to screen for Gastric cancer, and you can almost walk outside of a subway station and get a GI/Endocrine scoping. This is of course due to the fact that GI cancer is the most deadly cancer in Japan, but overall we have learned various new screening methods from other cultures, some of which we should be employing ourselves.

How is robotics changing the treatment of GI cancer? Will this be covered in this year’s program?

Robotic surgery is mainly used in laparoscopic procedures, and the primary discussion involving robotics will revolve around how it is used in minimally invasive procedures for colorectal cancer. It has become a much more accepted procedure for colorectal cancer, and most of the headway in robotic surgery has been in this field. In terms of other cancers, it is mostly being employed for staging and screening purposes at this point in time.

The recent phase III classic trial just reported that chemotherapy after surgery can improve the results for advanced gastric cancer. What is the role of adjuvant chemotherapy in the treatment of gastric cancer?

After the phase III classic trial completed there were some more recent studies on adjuvant chemotherapy in the United States and Europe. As far as these recent trials are concerned, attendees will learn from discussions that both adjuvant chemotherapy and adjuvant radiation for cancer are clearly testable procedures, and both have been shown to benefit the gastric cancer population. Whether one is better than the other is still to be determined. I don’t think we are ready to throw out radiation, because it is a very useful procedure and needs further study in regards to sequencing and with what agents it is most effective.

Dr. Rich will be leading a discussion on Stereotactic Body Radiation Therapy for Pancreatic Cancer. Can you provide us with a preview for this topic?

A stereotactic radiation treatment for the body means that a specially designed coordinate system is used for the exact localization of the tumors in the body. This is done in order to treat the cancer with limited but highly precise treatment fields.

There is no question that this treatment is moving into the main arena of radiation oncology and will be useful in helping us determine where to put the radiation field during therapy. We are currently looking to see what advantages and disadvantages come along with these procedures, and these are some of the theoretical points that will be covered in this talk.

Because pancreatic cancer is an important sub-specialty of GI cancer, is there anything else that needs to be pointed out regarding this topic?

Pancreatic cancer still remains a very lethal disease, although we are making some small headway in both single and multi-institutional trials as well as in national trials. I think that we are approaching it in the fashion that it needs to be approached. In America, irradiation is a key part of the treatment program, but this is different than the programs in Europe where it plays less of a role due to the interpretation of their research studies.

What makes this CME different than others covering GI cancer?

The faculty is what makes this CME different. The faculty at Columbia and Cornell are at the forefront of new technologies and procedures involving the treatment of GI cancer.

Beyond attending this conference, what’s the best advice you can give to clinicians who are treating patients with GI Cancer?

Our sense of what this conference is designed to teach, and what we hope attendees walk away with, is that the synergism of a team approach adds up to the patients’ benefit. When you have people who work together, do things following a protocol, and who have the communication to be able to skillfully and easily work together in a team fashion, it is a huge benefit to the patient. The patient can immediately sense the added benefit of a place where doctors and the rest of the staff work towards a common goal.

To learn more about the upcoming Second Annual Update on Gastrointestinal Cancer, please visit our event site:

Second Annual Update on Gastrointestinal Cancers


{ 1 comment… read it below or add one }

Jorge Córdova August 21, 2013 at 5:55 pm

Realmente la tematica a tratarr es muy intresante y de mucha actualidad

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