After returning from a relaxing Florida vacation just days before, Fairfield resident Peg Clark found herself in a situation she never anticipated: in Bridgeport Hospital, overcome with fear and uncertainty. Bridgeport Hospital’s team of expert pathologists confirmed that Peg had a GIST—a gastrointestinal stromal tumor. It was cancer.

A Very Rare Cancer
Also known as gastrointestinal stromal sarcoma, a GIST is an uncommon cancer. According to the National Cancer Institute, only about 9,500 new cases were diagnosed in the United States in 2006, which is less than 1 percent of all new cancer cases.

A GIST can develop anywhere in the digestive tract, although it most often grows in the stomach or small intestine. Peg’s tumor was growing from the muscular wall in her rectum, making her case extremely rare.

Upon diagnosis, Peg met with her primary team of physicians—oncologist Neal Fischbach, MD, and surgeon Scott Thornton, MD, co-medical director of The Norma F. Pfriem Cancer Institute at Bridgeport Hospital—to discuss next steps and the various treatment options available.

Comprehensive Care Right Next Door
At first fearful and full of questions, Peg was now relieved to encounter the integrated care of The Norma F. Pfriem Cancer Institute. The diagnosis of this rare tumor… the accomplished physician… the skilled surgeon… and tireless support of the entire cancer team provided Peg with the assurance she needed to undergo treatment.

Oncology Patient Navigator Donna Gonsalves, RN, BSN, provides patients and their families with guidance at each point of cancer care.

Team Conferences
To determine the best possible treatment for every cancer patient at Bridgeport Hospital, no stone is left unturned. This is exactly what led to Peg’s exceptional care.

Her treatment plan was the topic of several tumor conferences at Bridgeport Hospital. At these weekly meetings, Bridgeport Hospital surgical and medical oncologists, radiologists, radiation oncologists, pathologists, patient navigators, nurses and other healthcare providers discuss ongoing or unusual patient cases and conditions, as well as emerging cancer treatments and procedures. The benefit? It’s not just a single physician who is caring for a patient, but an entire group of specialists that works as a team to contribute their knowledge and experience to the treatment.

"Multidisciplinary cancer conferences are an important part of what we do in oncology," says Dr. Fischbach.

Bridgeport Hospital is a leader in this regard, with established conferences in breast, gastrointestinal, genitourinary, gynecologic and thoracic cancers, as well as general medical oncology.

As a result of these discussions, Peg’s treatment plan was continually reviewed using important input from several physicians, including Bridgeport Hospital Chief of Radiation Medicine Paul Berger, MD, and Gastroenterologist Howard Taubin, MD.

Physicians on the Cutting Edge
A GIST is resistant to chemotherapy and radiation treatment. The doctors knew that removing Peg’s tumor was ultimately necessary, but due to its significant size and unusual location, immediate surgery would have resulted in Peg also losing a large part of her colon, leading to a colostomy. (A colostomy is a procedure that brings the end of the large intestine through an incision in the abdominal wall and into a bag attached to the abdomen.) Instead, Dr. Fischbach suggested that Peg first try a relatively new medication that could possibly shrink the tumor to a more operable size. This would eliminate the need for a colostomy and preserve her lifestyle, long-term.

Success!
In just a few months, the daily pill was shrinking the tumor. And seven months into treatment, Peg’s tumor was an operable size. Her physicians recommended surgery to remove it.

Although chances for a colostomy were slim, Peg was still very worried about how much of her colon would have to be removed. "I was sure I would still require a colostomy, which upset me quite a bit," she remembers. "That's when Dr. Fischbach told me about Donna."

Oncology Patient Navigators
Donna Gonsalves, RN, BSN, a Bridgeport Hospital Oncology Patient Navigator with years of experience in oncology nursing care, called Peg right away. They spoke several times to discuss Peg's condition and her medications, but most importantly, her fears about the upcoming surgery. "Through these conversations, we were able to address her concerns and prepare her for the surgery. We talked about what to expect before and after, as well as what might help with recovery," says Donna.