MemorialCare Cancer Institute is using advanced technology called endoscopic ultrasound (EUS), a minimally invasive imaging technique that uses sound waves to create a detailed, high-definition image of the inside of the digestive tract.
“Endoscopes are thin, lighted tubes widely used to diagnose a range of throat, stomach and intestinal issues,” said Jose Aranez, M.D., gastroenterologist and director of advanced therapeutic endoscopy procedures at MemorialCare Cancer Institute at Orange Coast Medical Center.
In a standard upper endoscopy procedure, doctors insert an endoscope through the mouth to view the esophagus, stomach and small bowel, as well as nearby organs like the liver and pancreas. Physicians may remove precancerous or other abnormal tissue for biopsies.
Sophisticated technology has expanded the endoscopes’ capabilities to help perform new procedures, that until now, only mega-medical centers have offered. MemorialCare Health System has provided access to these specialized services for
patients in the region, from Long Beach and the South Bay, and throughout Orange County— and beyond.
“This is important because the endoscopic ultrasound yields clearer and more detailed images that allow physicians to examine areas deep within the lining of the organs and to retrieve samples for more accurate biopsy results,” Dr. Aranez said.
“A standard procedure might detect a lump or nodule on the pancreas, and a CT scan or MRI can show what might be tumors,” said Dr. Aranez. But with endoscopic ultrasound, we can see quite clearly where and what they are. We can see how deep the cancer is and whether or not it has spread to the lymph nodes.”
Dr. Aranez has collaborated with cancer experts on ways to use the advanced endoscope. For example, he consulted with a radiation oncologist on planning a targeted radio frequency ablation on a pancreatic tumor. This treatment uses small metal seeds to pinpoint the tumor for radiation therapy. Using EUS, the doctor could see the dimensions of the tumor and plant the seeds as markers, creating a precise target for the radiation treatment.
Additionally, EUS can guide specialists to assist in treatments for fluid buildup in bile ducts or the pancreas, whether the cause is cancer or other disease. Using sound wave technology, physicians precisely place stents inside the duct to allow the fluid to drain. This can potentially eliminate or be another option for stent placement surgery.
“We’re blurring the lines between minimally invasive surgery and endoscopic technology,” said Dr. Aranez.“EUS is huge — and the core of our toolbox day to day. But the most important message is that this technology is now available within our community.”
The idea of traveling to a large medical center often conjures up anxiety, whether it’s about congested freeways in Los Angeles and Orange County or concerns about insurance coverage for treatment in distant locations.
“During my subspecialty training, it really impacted me when a patient asked why he needed to drive more than two hours for the procedure,” Dr. Aranez recalled. ”He said, ‘Why don’t we have someone in my community that can do this?’
“That’s when I realized what I wanted to do,” Dr. Aranez said. “I wanted to fill that niche and offer specialty care more locally, so for patients, the advanced technology is close to home.”