Oncology

No matter what type of cancer you have, our team provides everything you need — from diagnosis and staging to treatment and follow-up care. Our services are recognized by the American College of Surgeons' Commission on Cancer as a Comprehensive Community Cancer Program. Our treatment services include:

• Biotherapy
• Chemotherapy
• Immunotherapy
• Medical oncology
• Radiofrequency ablation (RFA)
• Radiosurgery
• Radiation oncology
• Surgical oncology

For more information about our oncology services, please call askSARAH at (352) 339-7000.

Genetics can play an important role in the development of certain cancers known to be associated with a hereditary cancer syndrome. NFH offers genetic screenings which help identify individuals at an increased risk of developing some cancers due to family history. Patients who choose to be tested due to personal and/or family history will meet with our certified genetics provider to review their results and receive further management recommendations. For more information, please call (352) 333-5840.

Cancer is diagnosed in stages. Our cancer care team will determine the stage of your cancer, which will guide the treatment plan.

To better understand a diagnosis, additional testing is often required. Tests will differ based on the type of cancer that is diagnosed but may include diagnostic imaging, blood work, biopsies and scope procedures.

We know receiving a brain or spine tumor diagnosis can be overwhelming. That's why we are here to offer the care you need, from diagnosis through treatment and into recovery. The neurologists and oncologists at our hospital work together to provide complete care to patients with benign (noncancerous) and malignant (cancerous) brain and spine tumors. In addition to brain tumors, we also treat skull-based lesions.

We offer stereotactic radiosurgery to treat tumors in the brain. This nonsurgical treatment delivers targeted doses of radiation to help preserve healthy brain tissue.

We treat the following types of brain neurological tumors conditions:

• Glioblastoma
• Astrocytoma
• Oligodendroma
• Transnasal pituitary tumors
• Schwannomas
• Meningiomas
• Malignant primary tumors
• Metastatic tumors
• Benign tumors
• Arteriovenous malformation

Breast cancer is most commonly diagnosed in women, but it can also affect men. The Florida Breast Center and the women's care team work together to detect breast cancer early, when treatment is most effective.

We offer breast health services, including digital mammography. If breast cancer is diagnosed, our oncologists are here to help you understand your diagnosis and treatment options. In addition to breast cancer treatments, such as chemotherapy and surgical intervention, we also offer breast reconstruction services.

GI cancers affect the organs that make up the digestive system. When a patient is diagnosed with GI cancer, our oncology and gastrointestinal services combine to offer interdisciplinary care. We treat a variety of GI cancers, including:

• Colon and rectal cancer
• Esophageal cancer
• Stomach cancer
• Pancreatic cancer
• Small and large intestinal cancer
• Liver cancer

GI cancers are often complex, which is why our multidisciplinary care team meets regularly to review cases and develop personalized care for each patient. Treatments may include surgical intervention, nonsurgical therapies and/or palliative care services.

Hyperthermic intraperitoneal chemotherapy (HIPEC)

HIPEC is a procedure in which heated chemotherapy drugs are administered directly into the inside of the abdomen. It is a part of the treatment plan that is often used before or after IV chemotherapy. Our hospital offers HIPEC to appropriate patients through our complex GI providers.

Your abdomen (or belly) is the space between your chest and pelvis. Many of your organs, such as your intestines, liver and spleen, are located inside the abdomen. The lining that covers the inside of your abdomen is called the peritoneum. Cancer can start in the peritoneum or cancer can spread there from other organs. This type of cancer is known as peritoneal carcinomatosis. HIPEC is a treatment option for some patients with peritoneal carcinomatosis.

The most common cancers treated with HIPEC are:

• Appendix cancer
• Colorectal cancer
• Peritoneal Mesothelioma
• Pseudomyxoma peritonei (PMP)

Some patients with ovarian cancer, primary peritoneal cancer or stomach (gastric) cancer may also benefit from HIPEC.

Benefits of HIPEC

With HIPEC, the chemotherapy is targeted to a specific area of your body instead of going throughout your entire system. This method reduces or eliminates some of the side effects you would get with IV administration. Heating the chemotherapy makes the cancer cells more receptive to the drug. This means that the drugs will be more easily absorbed and more effectively kill the cancer.

How HIPEC works

This is a two-step procedure. First, you will need an operation to remove all of the tumor your surgeon is able to see. This is called cytoreductive surgery. Next, the surgeon will administer the HIPEC treatment while you are still in the operating room. The chemotherapy solution is heated to 41-42 C/107.5 F and infused continuously into the abdominal space for 90 minutes. This procedure allows the chemotherapy to bathe all of the surfaces inside of the abdomen and kill the remaining microscopic (non-visible) cells. You will remain asleep and comfortable during the entire procedure.

After HIPEC is completed, your surgeon may need to create an ostomy, which is an opening from the intestine to outside the body. This opening allows stool/feces to exit into a bag called a pouch. A special nurse will visit you to train you how to care for the ostomy.

HIPEC can also be beneficial for people with frequent build-up of fluid in their abdomen, known as ascites. This procedure is completed through a scope (laparoscope), not an open cut, so recovery time is shorter.

Common side effects of HIPEC include nausea, tiredness and thinning hair. Your doctor will explain more details about this risks and benefits of HIPEC and what to expect before, during and after this procedure.

Hepatic artery infusion therapy

Hepatic artery infusion therapy is a treatment for colorectal cancer or bile duct cancer (intrahepatic cholangiocarcinoma) that has spread to the liver.

Chemotherapy is administered to the liver by way of a pump implanted in the abdominal cavity. This provides a more concentrated and targeted delivery of the drug to the liver versus traditional systemic chemotherapy.

The pump is implanted during a scheduled surgery such as removal of the primary tumor in the colon/rectum or removal of tumors from your liver. After the pump is implanted, proper testing will occur to ensure targeted perfusion to your liver.

After discharge, your surgeon works collaboratively with a medical oncologist to arrange the filling of your pump with a specific chemotherapy drug. During active treatment, you need to see your medical oncologist every two weeks to refill the pump. Once active treatment has been completed, your medical oncologist will determine a maintenance schedule. Removal of the pump will be determined by your medical team.

Gynecologic cancer is found in the female reproductive system and is often treated by physicians specializing in gynecologic oncology. We treat the following types of gynecologic cancer:

• Cervical cancer
• Endometrial cancer
• Ovarian cancer
• Uterine cancer
• Vaginal cancer
• Vulvar cancer

Gynecologic cancer screening begins with regular pelvic exams and Pap smears performed during by your healthcare provider. Discuss any symptoms with you provider, such as abdominal, menstruation and urinary issues, to determine if additional tests are needed to screen for gynecologic cancer.

Treatment options for gynecologic cancer may include surgical intervention, nonsurgical therapies and/or palliative care.

Our oncologists treat a variety of cancers in the head and neck affecting the following areas:

• Oral cavity
• Pharynx
• Larynx
• Paranasal sinuses
• Nasal cavity
• Salivary glands

Treatment options for head and neck cancers vary but may include surgical intervention, nonsurgical therapies and/or speech pathology.

There are two main types of lung cancer: small cell lung cancer and non-small cell lung cancer. Our specialists provide comprehensive care for both types of lung cancer.

The earlier lung cancer is detected, the better the outcome. We offer a lung cancer screening program for patients at a high risk of developing lung cancer. This program promotes early detection and increase survivorship.

If you receive a lung cancer diagnosis, our cancer care team is here every step of the way. We also have a dedicated lung cancer nurse navigator who will coordinate your care. Treatments for lung cancer may include surgical intervention, chemotherapy, radiation therapy, immunotherapy, palliative care services and/or participation in clinical trials.

Metastatic cancers are cancers that have spread from the primary site into other areas in the body. We approach metastasized cancers with a multidisciplinary approach that includes surgeons, medical oncologists, radiation oncologists, pathologists, nurse navigators, radiologists and other support services.

Metastatic cancer treatment varies based on the site(s), stage and symptoms.

The pancreas is a gland that makes hormones such as insulin. Hormones help your body to function. Pancreatic cancer is caused by pancreatic cells growing out of control. As the number of cells grow, they form into a tumor.

A Whipple procedure is a surgery that can be used to treat some cases of pancreatic cancer. There are two types of Whipple procedures commonly used:

• Standard whipple (pancreaticoduodenectomy): removal of the pancreatic head (and at times the body), gallbladder, bile duct and a part of both the stomach (pylorus), small intestine (duodenum) and nearby lymph nodes; pancreas that is left will continue to make digestive juices and insulin.
  • Robotic-assisted surgical approach now available
• Pylorus-preserving Whipple: the same as a standard Whipple, but the pylorus (the opening from the stomach to the small intestine) is left in place

During these procedures, the remaining common bile duct and pancreas will be connected to the small intestine. This is done so that pancreatic enzymes and bile can pass through to the small intestine.

A Whipple procedure can be done to treat some cases of:

• Pancreatic head cancer
• Duodenum cancer
• Cholangiocarcinoma
• Cancer of the ampulla
• Pancreatic neuroendocrine tumors
• Some benign (non-cancerous) conditions

Skin cancer is the result of an uncontrolled growth of abnormal skin cells and is one of the most common types of cancer diagnosed every year. Our cancer team treats multiple types of skin cancer, including:

• Basal cell carcinoma
• Melanoma
• Squamous cell carcinoma

Treatment plans may vary but can include surgical intervention, radiation therapy and/or plastic and reconstructive surgery.

Thyroid cancer develops from the tissues of the thyroid gland, which are found at the front of the neck. Our cancer care team uses the least invasive therapies available to treat thyroid cancer at its earliest stage possible. Additional treatments are available and depend upon each patient's needs.

Urologic cancer is found in the organs that make up the urinary system, which includes the bladder, kidneys, prostate and testicles.

Treatments will vary based on your specific diagnosis but may include surgical intervention and nonsurgical therapies. Many urologic cancers can now be treated with the aid of robot-assisted surgery, a type of minimally invasive surgery.

Prostate cancer treatment

The prostate is the male reproductive gland that produces fluid found in semen. It is typically the size of a walnut and located below the bladder, in front of the rectum and surrounds the urethra. Prostate cancer affects the prostate gland and has the ability to spread to surrounding structures.

Most men with prostate cancer do not experience any symptoms, which is why routine physical exams are so important. Prostate cancer can be diagnosed in a physical exam or with a blood test.

Treatments for prostate cancer may vary but can include conservative management, radiation therapy or a prostatectomy — the surgical removal of the prostate.

Our partners at ReQuest Physical Therapy offer a cancer survivorship program that is designed to address cancer-related fatigue, malaise or weakness by stimulating metabolic changes. The program includes exercise, nutrition counseling and massage therapy.