Conquering Colon Cancer - Renown Health

Renown institute foR canceR
20
Feature WRITTEN by bRANDI SCHLoSSbERG
ahead of the trend
experts unite to treat digestive and liver cancers
T
hRoughout hIs 25-yeaR CaReeR, John gRay,
md, found hImself In a seRIes of fRustRatIng
sItuatIons. a specialist in digestive and liver care,
dr. gray dealt with patient cases on a regular basis that
would benefit from the input of other experts, such as surgeons or
oncologists.
whenever possible, he would reach out to these other experts
for discussion on complex patient cases. he also had doctors
coming to him, to hear his opinion on their own patient cases that
had ties to the digestive system or liver. however, finding time
for such in-depth discussions among busy physicians made this
spontaneous system at best hit-or-miss.
“It is frustrating when you come up with clinical issues that you
know you need to discuss with all your colleagues, but there is not
really a way to have that discussion,” dr. gray said.
Impelled to provide the best possible patient care, dr. gray
buckled down and began working with colleagues and hospital
administrators to create a diverse forum for doctors. today, the
Renown Institute for digestive and liver Care exemplifies this
latest approach to healthcare: Bring together an array of medical
experts to plan treatment for a specific disease, often on a case-bycase
basis.
since 2007, the Renown Institute for digestive and liver Care
has been one of the few centers in the nation that uses a team
approach to address digestive and liver diseases, including cancer.
“It’s a crucial way for us to improve the quality of care to our
community in the broad spectrum of digestive diseases,” said dr.
gray, medical director of the Renown Institute for digestive and
liver Care. “there are over 100 digestive diseases, and most are
treated by several different physicians.”
these digestive diseases span the spectrum from constipation
and peptic ulcers to colon and pancreatic cancer. Conditions
that affect the bowels, intestines, colon, esophagus, gallbladder,
pancreas, stomach and liver all fall under the umbrella of digestive
and liver disease.
the institute is dr. gray’s brainchild: from primary care
doctors, gastroenterologists and hospitalists to radiologists,
oncologists and surgeons, he hoped to create a forum for the host
of experts who deal with digestive and liver diseases.
caNcer QuicK Fact:
Regular use of established screening tests can
prevent the development of cancer by finding and
removing abnormalities.
Renown joURneY
— American Cancer Society
John Gray, mD, medical Director of the renown institute for
Digestive and Liver care.
dr. gray presented his vision for this institute to key leaders at
Renown roughly four years ago.
Renown health leaders, along with dr. gray, worked for about
three years to secure the technology, experts and organization
necessary to open the Institute for digestive and liver Care.
“we started out with a few projects we felt would benefit the
community most — areas that needed the most improvement,” dr.
gray said. “for instance, we know that in our community, colon
cancer screening compliance is lacking. the institute is working
with the nevada Colon Cancer task force to increase colon cancer
screening.”
addressing pancreatic cancer also has been a priority for the
institute. a complicated and potentially lethal disease, pancreatic
cancer requires top-notch care, including the most advanced
“it’s a crucial way for us to
improve the quality of care to our
community.”
John Gray, MD, Medical Director of the
Renown Institute for Digestive and Liver Care
technology and experienced physicians.
according to dr. gray, pancreatic cancer is especially dangerous
because it typically doesn’t create symptoms until the cancer
has grown large enough to spread — and by that time, it’s often
inoperable. he suggests screening for those who have a family
history of pancreatic cancer and also avoiding cigarettes, which
have been linked to this type of cancer.
the location of the pancreas within the body — close to several
key structures, like the stomach and liver — adds to the lethality
of the disease and increases the complexity of treatment and
surgery. fortunately, Renown Institute for digestive and liver
Care has stepped up to help patients with pancreatic cancer by
providing top-notch care.
“we’re setting up a pancreatic cancer center of excellence,” dr.
gray said. “we now have a very large team to develop protocol on
how best to assess and treat pancreatic cancer.”
the Institute of digestive and liver Care also is home to a stateof-the-art
technology known as endoscopic ultrasound, or eus,
which can be used to detect and provide detailed information on a
variety of digestive and liver diseases, including pancreatic cancer.
“eus did not exist in our community, and Renown was the
first to bring this new technology to nevada,” said alan olive,
administrator for Renown south meadows medical Center.
“purchasing this equipment, and hiring two physicians who are
experts in eus, was the first step in establishing the Institute for
digestive and liver Care.”
according to dr. gray, Renown is the only facility in nevada
that offers eus, a procedure that allows a doctor to obtain images
and information about the digestive tract and the surrounding
tissue and organs. “It’s the most accurate way to stage (pancreatic)
cancer and know if it’s operable,” dr. gray said. “the very best
pancreatic cancer surgeons won’t even consider working in a
facility without endoscopic ultrasound.”
with this top technology, Renown Institute for digestive
and liver Care has drawn these expert surgeons, along with
other experts, to become a center of excellence in the west for
pancreatic-cancer care. as such, the Institute is equipped to
participate in national research, giving patients access to the
newest care through clinical trials.
similar programs currently are under way for liver cancer, as
well as esophageal and colon cancer, as the Institute for digestive
and liver Care strives to become a center of excellence across the
board.
“we plan on addressing at some point all forms of digestive
cancer,” dr. gray said. “we addressed pancreatic cancer first
because we thought it had the most room for improvement.”
each disease-specific program within the Institute for digestive
the institute for Digestive and Liver care committee meets monthly.
committee chairs (pictured from left to right): Dr. chen,
Dr. Pezanoski, Dr. Nachiondo. (Not Pictured: Dr. Gray and Dr. Nason).
and liver Care is led by a physician with expertise in the treatment
of that particular disease.
“we have physician champions in each area — an expert or
sponsor who is leading each team,” olive said. “they, in turn,
work with a team of specialists to come up with best practices.”
Renown Institute for digestive and liver Care is at the leadingedge
of a healthcare trend that calls for physician collaboration in
the patient treatment.
“this approach really applies across all disease spectrums,” dr.
gray said. “It’s a fertile ground where we can get new ideas and
help solve major problems and ensure patients are receiving the
highest level of care.” ■
John F. Gray, mD, FacG
John Gray, MD, has specialized in gastrointestinal (GI) and liver
care for the past 25 years. He is the Medical Director of the
Renown Institute for Digestive and Liver Care and a physician
with GI consultants, both located in Reno. Dr. Gray has served
as President of the Washoe County Medical Society, former
Chief of Staff of Renown Regional Medical Center and Nevada
State Governor for the American College of Gastroenterology.
renown institute for Digestive
and Liver care committee chairs
John Gray, MD, Steering Committee Chair
and CME Subcommittee Chair
Daniel Nason, MD, Esophageal Subcommittee Chair
James Nachiondo, MD, Tube Team
Subcommittee Chair
Jon Pezanoski, MD, GI Bleeds Subcommittee Chair
Victor Chen, MD, Pancreatic Subcommittee Chair
renown.org 21