Looking ahead: Growth and advancements in surgical oncology at Providence Cancer Institute

Wednesday, April 3, 2024

Author: R. Bryan Bell, M.D., D.D.S., FACS, FRCS(Ed), division director of Surgical Oncology, Radiation Oncology and Clinical Programs for Providence Cancer Institute


In this article:

  • Providence Cancer Institute is expanding surgical services in the Portland area by opening two liver, pancreas and surgical oncology clinics.
  • Two new hepatobiliary surgeons joining our Hepatobiliary and Pancreatic Cancer Program add another layer of expertise to our multidisciplinary team.
  • Research is a priority of the surgical oncology programs at Providence Cancer Institute, with a focus on developing novel immunotherapy approaches to improve surgery and radiation outcomes.

In the dynamic landscape of cancer care, the Division of Surgical Oncology, Radiation Oncology and Clinical Programs at Providence Cancer Institute of Oregon is experiencing significant growth and is a source of advancements in research and clinical innovation. At the center of this activity is the expansion of surgical services beyond the Portland metropolitan area, and the recruitment of key surgeons and scientists to support growth and deepen our expertise.

In the past four years, we’ve established a new Gynecologic Oncology Program, growing the team and opening clinics at both Providence Portland Medical Center as well as Providence St. Vincent Medical Center. We opened breast cancer clinics at Providence Newberg Medical Center and at the Providence Cancer Institute Willamette Falls Clinic and recruited a plastic and reconstructive surgeon to provide complex microvascular reconstructive options for patients with breast cancer and other diseases. We’ve also expanded dental/oral oncology services to patients with cardiovascular disease as well as those with cancer.

New surgical clinics for hepato-pancreato-biliary (HPB) cancer patients
Our path toward providing multidisciplinary cancer care close to home extends into 2024. In April, we plan to open two liver, pancreas and surgical oncology clinics at Providence Portland and Providence St. Vincent. Establishing clinics on both sides of the Willamette River will ensure that patients with liver, pancreas and gallbladder cancers, as well as sarcomas, have easy access to cutting edge surgical care, multidisciplinary oncology expertise and promising clinical trials within the cancer institute.  

Providing comprehensive, coordinated care holds profound importance for patients facing complex abdominal diseases. The team includes HPB surgeons, interventional radiologists, gastroenterologists, medical oncologists, radiation oncologists and oncology nurse navigators. This team meets every week to review individual patient cases and to determine the best approaches to treatment and care.

New surgeons add depth to multidisciplinary team
To support the new clinics, we’re pleased that Jon Gerry, M.D., and John Creasy, M.D., hepatobiliary experts, are joining our surgical oncology team on April 1. Their addition to the multidisciplinary team aligns seamlessly with the expansion of our Hepatobiliary and Pancreatic Cancer Program, adding depth of expertise.

Both surgeons will transition from The Oregon Clinic to employed surgeons at Providence Cancer Institute.

Dr. Gerry's appointment as the medical director of hepatobiliary surgery in the Hepatobiliary and Pancreatic Cancer Program underscores our commitment to addressing the complexity of HPB cases. Dr. Gerry will also serve as director of the Hepatobiliary and Pancreatic Surgical Fellowship at Providence Cancer Institute.

Dr. Creasy specializes in HPB diseases and sarcoma and has special expertise in minimally invasive and robotic surgery. His keen interest in research aligns with our surgical oncology program’s effort in the Earle A. Chiles Research Institute, a division of Providence Cancer Institute, to foster collaborative studies centered on pancreatic cancer and sarcomas. 

Multidisciplinary care in esophageal cancer surgery
Complimenting the expansion of the Hepatobiliary and Pancreatic Cancer Program are the appointments of Navi Dharampal, M.D., and Melissa DeSouza, M.D., as co-directors for esophageal cancer surgery. Dr. Dharampal is a thoracic surgeon and Dr. DeSouza is a foregut surgeon who specializes in minimally invasive surgery and advanced endoscopic approaches to treat esophageal and stomach diseases.

Their joint leadership in the Foregut Cancer Program ensures that patients with esophageal cancer receive comprehensive, multidisciplinary care, which is essential to treating the complex conditions of this disease.  

Clinical research: A catalyst for surgical advancement
The focus of the surgical oncology team at Providence Cancer Institute is to provide the most technically advanced care to our patients, including robotic or minimally invasive surgery. While advancements in these techniques and instrumentation have improved for our patients, recurrence and metastasis after surgery remain challenging and result in a high rate of mortality and diminished quality of life for some patients.

It is essential that we continue to explore effective methods to eliminate residual disease in the surgical site and/or circulating tumor cells to inhibit tumor recurrence and minimize the risk of distant metastasis. To that end, we are committed to pioneering research and clinical trials in partnership with the Earle A. Chiles Research Institute.

Leveraging expertise in immunology and genomics in parallel with ongoing translational research, the research priority of our surgical oncology programs is to develop novel immunotherapy approaches to enhance the effectiveness of surgery and radiation, with a particular emphasis on:

  1. Neoadjuvant immunotherapy
  2. Local drug delivery
  3. Cellular therapy 

Relevant research and groundbreaking studies
Here are some recent studies that are contributing to the development of practice-changing therapies.

  • Physician scientists Marka Crittenden, M.D., Ph.D., and Kristina Young, M.D., Ph.D., have been nationally recognized for their pioneering work in studying the effect of radiation therapy on immune response. Their work contributed to the rationale for and design of two clinical trials testing short-course radiation in combination with immunotherapy prior to surgery in patients with head and neck cancer and rectal cancer. The results were recently published in leading journals. Both studies demonstrated a high rate of complete and major pathologic response prior to surgery, and in most cases eliminated the need for adjuvant therapy and shortened the length of treatment. This approach is being expanded to include other immunotherapy combinations and disease sites and has the potential to eliminate or reduce the extent of surgery in some cases.

  • In 2022, Eric Tran, Ph.D., and Rom Leidner, M.D., treated a patient with metastatic pancreatic cancer with second generation adoptive cell therapy using engineered T cells. This was the first time in history that such an approach resulted in a durable tumor regression. The study generated international media attention and a paper in The New England Journal of Medicine. Recently, members of Earle A. Chiles Research Institute contributed to the clinical development of a related approach to adoptive cellular therapy, leading to FDA approval of lifileucel, a type of immunotherapy for patients with melanoma.
     
  • A clinical trial enrolling patients soon at the Earle A. Chiles Research Institute is a phase II/III study to evaluate a neoadjuvant and adjuvant personalized mRNA-based cancer vaccine. In this study, the vaccine (V940) is evaluated in combination with pembrolizumab versus standard of care and pembrolizumab alone in patients with locally advanced, resectable cutaneous squamous cell carcinoma.

Serving the Mission
Our Mission, vision and values serve as a guide for the growth and expansion of our surgical oncology division to ensure we are moving forward in service to our patients and for the betterment of our field.  Our flexible model leverages a strong nucleus of physicians working within Providence clinics at numerous sites in Oregon, with strategic partnerships in community practices and close to where our patients live and work.

Learn more about our Hepatobiliary and Pancreatic Cancer Program and the Foregut Cancer Program.

To refer a patient to a clinical trial, or to learn more, contact our clinical research office:    

Call 503-215-2614  

Submit a referral form   

Send an email       

Dr. DeSouza is a bariatric and general surgeon with The Oregon Clinic and affiliated with Providence Digestive Health Institute.

Dr. Crittenden and Dr. Young are radiation oncologists with The Oregon Clinic and affiliated with Providence Cancer Institute and Earle A. Chiles Research Institute. 

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