When a person feels deep sadness, we sometimes say they have “a heavy heart.” These feelings could be more than emotions at play for people at risk of heart disease, especially if they last a long time. The American Heart Association notes evidence linking mental health with cardiovascular health, known as the mind-heart-body connection, and recommends improving psychological health as a way to improve heart health. 

Part of this connection between the head and the heart stems from hormones released when someone deals with a stressful situation. These hormones—adrenaline, cortisol, and noradrenaline—give the cardiovascular system an energy jolt to help the body get through taxing moments. Stress hormones can rise during brief events like narrowly avoiding a car crash, or prolonged experiences like caregiving for aging parents.

When a person has chronic mental stress day in and day out over a long period of time, the heart can become stressed as well. Consistently higher stress hormone levels can elevate blood pressure, heart rate and blood sugar—cardiovascular risk factors for:
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• Heart attack

• Heart disease

• Inflammation

• Stroke

Heart health can also be connected to behavioral health conditions, such as clinical depression or generalized anxiety disorder. These conditions can make it difficult to eat, sleep, or enjoy social activities. A person may try to cope with symptoms on their own, or self-medicate by drinking alcohol, or smoking tobacco. Depression can make it hard to get out of bed and be active. These activities can raise the risk of developing heart conditions.

The connection between mental health and heart health goes both ways. Patients with undergoing treatment for heart conditions may experience depression due to grieving the change in their health or low energy from medications such as beta blockers. They may feel anxious about medical procedures or develop post-traumatic stress disorder. 

The good news is there are ways to boost heart health, reduce stress, and improve mental health all at the same time. Consider these three action-oriented tips to help.
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1. Add healthy habits to daily routines.

Have a conversation with your primary care provider about healthy changes you could make to your lifestyle to support heart and mental health. Here are some great starting points:
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• Evaluate your exercise level. A sedentary lifestyle occurs when little to no physical movement is part of a daily routine, which can contribute to poor heart health-. The Centers for Disease Control and Prevention (CDC) recommends 30 minutes of physical activity per day and 2 days of strength-strengthening activity each week to counter the effects of a sedentary lifestyle. Regular exercise not only contributes to a stronger and healthier body but also helps reduce anxiety and depression symptoms while promoting better sleep quality. 

• Choose a heart-healthy diet. Include a balance of fruits, vegetables, whole grains, and healthy fats. Whole foods—like those included in the Mediterranean Diet—are research-proven to support heart health by lowering cholesterol, blood clot risks, and inflammation. 

• Limit alcohol intake and quit smoking. Excessive alcohol use can lead to high blood pressure and could cause heart failure, while tobacco causes artery-blocking plaque to build up and calcify. Curbing both activities may help your mind stay clear while reducing cardiovascular risks.
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2. Rest and recharge your emotional battery.

The National Heart, Lung, and Blood Institute recommends 7 to 9 hours of sleep for adults each night to maintain good health.   Achieving this goal can be challenging due to various obligations but sleep deprivation and deficiency can wreak havoc on both heart health and emotional well-being. 

Some mindful ideas for building more rest into your day include:
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• Try yoga and mindfulness. A type of exercise that incorporates strength-building postures with meditation techniques that link body and mind—or calming deep-breathing exercises can help reduce stress. Deep breathing exercises are easy to squeeze in during breaks at work because they can often be performed in minutes.

• Slow down before agreeing to extra commitments that can cause anxiety. It can be hard for some people to say no. But saying no can be done tactfully, and setting personal boundaries can help free up more time in a busy day. That newly found time can be spent in ways that bring you joy.

If an abundance of anxiety is keeping you up at night, talk with your doctor about treatment options.

3. Stay connected with the people you care about.

There are factors in society that influence overall health. Things like access to food, stable housing, employment, and being near other people can have an impact on our mental and physical well-being. 

Social isolation can impact your heart risk. The CDC notes that older adults who are isolated have a significant increase in their risk of heart disease higher risk of stroke, and higher rates of depression and anxiety. 

Be sure to stay social and avoid isolation. Friends, family, and coworkers play a vital role in our quality of life. When you’re able to share your worries with a trusted confidant, or have a laugh with a good friend, stressful loads feel lighter.

Related reading: Research: Loneliness and Social Network Impact on Mental Health Well Being.

Know when it’s time to talk with your doctor.

While lifestyle changes, getting plenty of rest, and maintaining relationships can go a long way in improving heart and brain health, it’s important to understand that stress can’t always be managed on your own. 

Remember, mental health conditions deserve treatment just like physical health conditions. Therapists can help you learn stress management techniques. Psychiatrists or primary care providers can discuss potential medications to help reclaim a happy, healthy life. Your mind—and heart—will reap the benefits.

Preparing for a new baby—especially your first—can bring a mix of excitement, uncertainty, and anxiety. Often, not knowing what to expect is scarier than the facts themselves.

Even as an OB/GYN, there are many things I wish I had known before having my first child. Understanding how to prepare before your baby's arrival can help you feel more confident and calm as you enter motherhood. Here’s what you need to know—from pre-pregnancy planning and prenatal testing to caring for yourself and your baby throughout each trimester.
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1. You can start preparing for pregnancy even before you conceive.

If you're considering starting or growing your family, preconception counseling can help set the foundation for a healthy pregnancy. During this visit, a maternal-fetal health specialist can assess your risk of inheritable diseases, help you manage your weight, and recommend any lifestyle adjustments needed before conception.

Certain ethnic groups are at higher risk for conditions like sickle cell disease or Tay-Sachs disease. Carrier screening can identify these risks and guide partner testing if needed. We can also check your immunity to infections like rubella and chickenpox.

At your consultation, we’ll recommend starting a prenatal vitamin or folic acid supplement to support early fetal development. We’ll also review any medications you’re currently taking and help you achieve a healthy body mass index to reduce the risk of complications like gestational diabetes, preeclampsia, and labor dystocia.

Preconception appointments are available virtually, offering you the convenience to start planning from the comfort of your home.
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2. Regular exercise and healthy eating are essential.

Managing weight gain is important during pregnancy—too much or too little weight gain can affect both you and your baby. Exercise can feel challenging during the first trimester when fatigue and nausea are common, but it remains one of the best ways to maintain healthy weight gain.

Unless otherwise advised by your physician, aim for 30 minutes of moderate-intensity exercise daily, or break it into three ten-minute sessions if needed.

It's normal to have cravings, but remember: you're eating for one and a quarter—not two!
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3. Early prenatal testing offers valuable information.

Many insurance plans cover a wide range of prenatal tests, though not all. It’s important to verify what’s included in your coverage. Non-invasive prenatal screening (NIPS) can begin as early as nine weeks, offering early insights into genetic conditions and chromosomal abnormalities. Having information early can give you time to prepare and plan for your baby's care, if needed.
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4. You can manage many pregnancy discomforts.

Pregnancy can bring a range of physical discomforts, but there are many ways to ease them:
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• Nausea and vomiting: Consider natural remedies like ginger or vitamin B6 supplements for morning sickness.

• Round ligament pain: Common between weeks 16–22. A prenatal support belt can reduce abdominal aches.

• Sleep challenges: Unisom is a safe, over-the-counter option if you’re struggling with insomnia.

• Heartburn: Avoid lying down immediately after eating, elevate your head at night, and use approved over-the-counter remedies, if needed.

• Hemorrhoids: Witch hazel pads, Preparation-H, and a donut pillow can provide relief.

Prenatal yoga and physical therapy are also safe and effective ways to manage discomforts such as sciatica or carpal tunnel syndrome. Virtual visits with trained physical therapists are available to guide you.
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5. Choose a pediatrician before the third trimester.

Ideally, establish care with a pediatrician by the end of your second trimester. Many pediatricians offer introductory visits, allowing you to ask questions and understand their approach to care. 

Whether you’re pregnant or just starting to plan for a baby, we can help you feel prepared to grow your family. Contact us today to learn more about pregnancy services at MedStar Montgomery Medical Center.

Our research commentary, published in Medical Design briefs, examines the workflow and other challenges of adopting new digital health technologies.

Digital technology moves fast. It seems there’s always an update with new features for your smartphone. The same is true in healthcare. As digital technology gets faster, hardware, apps, and wearable devices are helping more people understand and improve their health. 

Yet, the pace of change can be a challenge for resource-constrained health systems because we require significant safety data before adopting any new practices. It’s worth considering what digital health technology means for patients and providers.

We’ve published a research commentary in Medical Design Briefs. It examines the speed with which healthcare systems across the country adopt technologies. Consider the example of maternal health. Remote self-monitoring of blood pressure helps keep patients safer—but there are workflow challenges with receiving and responding to this large increase in data that can strain limited resources.

How remote blood pressure monitoring can save mothers’ lives.

Hypertensive disorders of pregnancy are among the leading causes of death and illness for new mothers. They impact about 15% of women in the U.S. High blood pressure is one key sign of these disorders. Spotting it early can prevent serious complications such as preeclampsia, eclampsia, stroke, and long-term heart problems.

To address this risk, we partnered with a Washington, D.C.-based technology firm that developed a smartphone app called BabyScripts. The app helps mothers check their blood pressure at home and upload the results to their MedStar Health care team. That way, we can identify issues before they become serious.

Between January 1 and December 31, 2023, 741 birthing individuals were invited to use the BabyScripts app. In all, users completed 12,537 sessions and 47,480 hours on the platform.

During this period, participants uploaded 8,500 blood pressure readings in the weeks before delivery. Of these, 634 were considered “abnormal,” and 8.4% were “critical.” During the postpartum period, 16% of blood pressure fell into the critical range. 

This data can be lifesaving. Getting home-based blood pressure measurements allows our providers to help before an emergency happens. It also reduces the number of visits pregnant people need to make to the clinic, many of which are just for blood pressure checks.

BabyScripts have been a game-changer for maternal health. The result is better, more convenient care for our patients. But this new part of how we do our jobs comes with change, which is often challenging for people and systems. As digital technology becomes more common in health care, it’s also worth considering the impact of staffing and workflow.

Related reading: Technology Supports Maternal Health with Remote Blood Pressure Monitoring.

Challenges of new technologies.

One potential barrier to adopting new digital health technologies is how much data a platform like BabyScripts can generate. 

A provider had to respond to each of the 634 abnormal blood pressure readings logged in 2023. Instead of a single blood pressure check during an in-clinic visit, providers must respond to blood pressure readings continuously at the time a patient takes their blood pressure. As a result, there’s an increased stream of information. 

Without consideration and planning, this might strain already limited staffing resources, challenge tight schedules, and increase unscheduled patient assessments. To make the best use of this data, information systems must be able to communicate together, and we need to plan for the ways technology changes workflows.

Related reading: Research: Machine Learning Can Identify Maternal Heart Disease Risk Earlier in Pregnancy.

The future of digital healthcare is bright.

Digital technologies can do great things to improve patient care. Easier ways to monitor your health, earlier detection of problems, more time spent with your doctor, and personalized care delivered from home are all improvements that have already arrived or will soon. 

To realize these benefits when a health system invests in new technology, health systems like ours must consider how adopting new technologies changes care delivery.

For digital health to make a real difference in patient care, it means ensuring digital tools fit seamlessly into existing systems, including the daily routines of care providers and support staff. This may entail more investment upfront before benefits are realized downstream. Training for care teams, education for patients, and ensuring integration with existing systems can give new digital health technologies the best chance of success.

Trust is central to any relationship, especially in healthcare. In fact, trust is crucial between any service provider and consumer. Without trust, service can be impossible to supply. If I don’t trust that the mechanic will fix my car, I won’t take it to the shop when it is broken. It’s similar in health care: Trust is at the core of our ability to improve health in our communities, and trust is running low.

A 2023 Gallup poll shows that only about 33% of people in the U.S. have “a great deal” or “quite a lot” of trust in the health system. That dwindling number continues a downward trend. 

Of course, trust must be earned through the actions of individuals and health systems. Trust in the expertise and ethics of scientists, researchers, and medical professionals has led to incredible advances. Modern medicine has extended the human life expectancy from 47 years in 1900 to 77.5 years by 2022. This is due in part to generations of effort to:

• Control and prevent previously fatal infectious disease

• Develop treatments and technologies that have lowered mortality rates

• Improve quality of life by better managing chronic conditions such as diabetes, and acute conditions like heart attacks

When trust in our work erodes, our ability to care for our neighbors suffers too. 

Therefore, the question we must address is why society has lost trust in healthcare and how can  we rebuild that trust? I contend that academic health systems are well positioned to re-build trust by truly partnering with patients to collectively advance everyone’s health. How can we do this? 

Reinventing the patient-provider relationship.

On a recent visit to a national park, I became friendly with a fellow traveler. After sharing our professional journeys, I was surprised that he responded with “I never met a scientist before.”  It reminded me that science and researchers are far removed from most people’s daily life. A 2021 survey found that 72% of people in the U.S. couldn’t name a living scientist—and that’s a 7% improvement from 2017. In the same survey, more than half of survey participants could not name a medical or health research organization.

Just as science and research are further removed from most people’s experience, our society’s relationship with medical experts and expertise has dramatically changed over time.

Missing the personal touch.

It wasn’t all that long ago that doctors were viewed as benevolent authority figures who “know best.”

Millions of U.S. households tuned their television sets to programs like Dr. Kildare, Marcus Welby, M.D., and M.A.S.H. Throughout the 1960s and 70s, we watched these kindly practitioners bring a wealth of experience, knowledge, compassion, and training to their patients’ bedside.

Like viewers, these patients did not have the expertise or information their providers had accumulated. They trusted their doctors to guide them back to health. But a lot has changed since then. 

Modern medicine has made incredible advances, but this has resulted in many more specialists and more fragmented care. House calls are less common and primary care physicians rarely have the same personal relationship with their patients today as in the past. Not to mention, the information providers once spent a lifetime gathering through their studies and medical practice, is now available on demand on a device that fits inside anyone’s pocket! Rather than trusting and relying on a kind, caring sole who is the expert, we are often involved in a transaction with a clinician we don’t know, who provides information we already have access to, without the context of how that information is informed from research that can be far removed from our lives. No wonder trust has eroded so much!

The work to restore and reinvigorate a trusting relationship between our communities and our health systems will only happen if we build the bridge from the academicians who create new medical knowledge through the clinicians who use it to care for people, and to those receiving the care. An academic health system, which lives at the crossroads of academia and real-world medicine and is embedded within the community, is best positioned to build those bridges. This will take meaningful, heartfelt conversations in the boardroom and one-on-one in the clinic, our neighborhoods, restaurants, and our patients’ homes. It will mean meeting the patient where they are, listening to their questions and concerns, and sharing information transparently and with goodwill.

MedStar Health is a broad, diverse academic health system. Through our more than 300 sites of care, we are embedded in the communities we serve. Our research-based initiatives and partnerships across MedStar Health Research Institute enable us to partner with our patients to identify and investigate important questions that directly impact community health.

Doctors as partners, not authorities.

The internet has fundamentally changed the relationship society and individuals have with the healthcare system. We no longer need to rely on experts for the evidence-based information—it’s at our fingertips. Instead, we now rely on experts for their judgment. We ask doctors to help us integrate the information, to understand what applies to us, and to chart a course for action. 

Sometimes, the provider’s goal to cure disease or prolong life may conflict with a patient’s goals for improved quality of life. In these instances, mismatches can lead to resentment that “elite” physicians are imposing their values where they’re unwelcome.

Instead, providers must do the hard work of truly listening to patients, and many do. This means engaging with the patient’s perspective and spending time working toward truly shared decisions that help accomplish the patient’s real-life goals. 

Getting in front of the people.

We know patients can be inconvenienced and frustrated by how healthcare in the country works, from costs to scheduling difficulties to long waits. Messages of skepticism about scientific concepts are amplified by social media and government officials, adding to our challenge.

To achieve our goals of advancing health in our communities, we partner with people and organizations throughout our region to develop and activate programs that make a difference. This real-world work helps us restore trust, one person at a time.

Related reading: How Research Can Drive Improved Healthcare Safety and Equity When Using AI.

How academic health systems can help.

An academic health system like MedStar Health is uniquely positioned to help rebuild trust. Unlike many hospitals and academic medical systems, our emphasis is on health and wellbeing, not just diagnosis and treatment. 

That wider lens enables our health experts to partner with community organizations to address challenges such as social determinants of health (SDOH). These are factors outside of the hospital that can have a significant impact on health, and include things like economic stability, food instability, environmental factors, neighborhood challenges, and access to high quality education and health care. Studies show SDOH can influence as much as 80-90% of a person’s health outcomes.

Related reading: Health Systems and Researchers Can, and Must, Work to Advance Community Health and Equitable Access.

How MedStar Health works to rebuild trust.

Throughout MedStar Health, we’re working to be trusted collaborators working to improve health in our communities. There are many examples of how we place patient perspectives and community partners at the center of our actions and our research. 

Here are a few of my favorites:
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• Community Violence Intervention Program: Designed to reduce and prevent new injuries and retaliatory violence by promoting an improved sense of self for each patient. Through culturally competent and trauma-informed care and strategic partnerships, the program works to heal physical and hidden wounds. 

• D.C. Safe Babies Safe Moms Program: This partnership between MedStar Health, Community of Hope, and Mamatoto Village focuses on families to improve the health and well-being of mothers and infants in the District. 

• PG Healthy Start Program: One of our newest programs, which aims to significantly reduce infant mortality and improve maternal health by addressing needs during pregnancy and up to two years after delivery. 

• Ryan White Program (RWP): Through MedStar Washington Hospital Center and community partnerships, RWP works to identify neighbors at risk of HIV disease, help them learn their status with HIV testing, and ease access long-term care to improve their quality of life and reduce the chances of transmitting the virus.

Researchers and clinicians share the same responsibility: to help our patients and our population achieve better health. By building intentional partnerships that place our patients’ perspectives at the center of our work, we can begin to restore the trust in health, technology, and science that benefits all of us.

This article was written by Hilary Hancock BSN, RN, CWON.

From the day we’re born, or at least the day we’re potty trained, we come to expect that using the toilet is a fact of life. For people with an abdominal condition or surgery, that can change in a heartbeat, when an ostomy surgically alters how waste is removed from the body.

This can be a challenging adjustment. 

About 1 million people in the U.S. live with an ostomy, and about 100,00 ostomy surgeries are performed each year. Studies have shown that it takes an average of three months for a patient to feel comfortable managing their ostomy independently. Often, patients are going through the emotional and physical challenges of another serious diagnosis or treatment while they’re getting used to having an ostomy.

Our patients have a lot of questions, and sometimes they need a shoulder to cry on. That’s why we focus on education, support, and guidance to help them through the adjustment period ahead. From understanding your ostomy to finding support and getting active, we’re here to help patients make this change.

1. What is an ostomy?

An ostomy is a hole in the abdominal wall that a surgeon creates to detour urine (pee) or stool (poop) away from its usual route outside the body. The intestines, or urine-passing tubes called ureters, are connected to this opening to allow waste to pass outside the body. 

Surgeons create an opening in the abdominal wall and connect the intestine. Called a stoma, this opening allows waste to pass outside the body and into a special pouch system for collection. This pouch sticks to the skin around the stoma with a gentle but firm adhesive.

There are many reasons why an ostomy could be needed, including:

• Cancer of the bladder, colon, or elsewhere in the abdomen 

• Inflammatory bowel disease such as diverticulitis, Crohn’s disease, or ulcerative colitis

• Abdominal trauma such as from a traffic accident or gunshot wound

• A perforation, which is a hole in the intestine

There are three main types of ostomies, depending upon where and why it’s created.

• Colostomy: Routing the large intestine, or colon, to the abdominal wall

• Ileostomy: Routing the small intestine to the abdominal wall

• Urostomy: Urine is routed through the stoma, bypassing the bladder

Related reading: Warning Signs of Bladder Cancer.

2. Is an ostomy permanent?

Ostomies can be temporary, such as when the intestines have been surgically repaired. In this case, an ostomy could be used to divert stool so the intestines can heal and recover. After the patient has healed from the surgery, the intestines can often be reconnected so stool passes through the rectum as usual.

Or an ostomy can be permanent, such as when the bladder or intestines have been surgically removed. Sometimes, patients with cancer must have some or all their affected organs removed. In these cases a stoma can be a new, permanent route for waste.

3. Does an ostomy smell bad?

Ostomy pouching systems have come a long way in the last few decades. Back in the 1990s, pouches weren’t odor proof, and they tended to crinkle like a potato chip bag. Patients were understandably self-conscious, and many avoided social contact.

Today, pouches keep odors inside and they’re made of a soft, quiet fabric. These low-profile systems can be worn under clothing for discretion. Improvements in adhesive technology mean modern pouches are designed to be worn for 3-5 days and shouldn’t irritate the skin when they’re removed.

Related reading: 5 Myths About Gastrointestinal Cancer Debunked.

4. Will an ostomy limit my activities?

No. Adjusting to an ostomy can take time, but once patients’ surgical incisions are healed and they get used to their new toileting procedure there should be no limits on daily life.

At first, adjustments can include becoming comfortable with managing the pouching system, such as knowing when to anticipate emptying the pouch (usually about every three hours) and how many supplies to bring on an outing. Sometimes, changes to nutrition are needed, such as eating more processed foods and fewer whole grains, fruits, and vegetables after ileostomy.

There is stigma surrounding ostomy because, frankly, there is stigma surrounding poop. The truth is everybody does it. We just don’t talk about it. The more we can normalize life with an ostomy, the better it is for everyone.

Many patients love to camp, hike, and swim. Their ostomy doesn’t slow them down. They just bring along their pouching supplies, do a little extra planning, and enjoy the great outdoors. 

These days, there are plenty of clothes designed for people with an ostomy. From covers and belts to conceal the pouch to swimsuits and lingerie that let you strut your stuff with confidence, there’s no shortage of active lifestyle products to support life with an ostomy.

There are even ostomy influencers on YouTube and Instagram, such as Hannah Witton and Ostomy Diaries. They’re normalizing ostomy management and showing off their scars and success to help more people get comfortable with their ostomy.

5. What resources can help with my ostomy?

We know that having an ostomy is difficult at first, and we’re here to help. That often means a sympathetic ear and a shoulder to lean on. But soon we move on to learning how to manage your ostomy.

There’s a lot to think about when you’re recovering from surgery, and everyone learns differently. So we show patients videos, talk with them about the details, and provide printed materials with careful instructions and pictures. We connect our ostomy patients with a pouching system supplier, where they can order supplies and receive troubleshooting support.

Before patients go home, we practice using their new pouching system, and make sure it fits properly. We know most people need support at home. We connect every patient with MedStar Health Home Care so a visiting nurse can assist in the early days. Plus, we have a clinic here at MedStar Washington Hospital Center every Wednesday where patients can come for help.

Many patients and family members benefit from the community of support groups for living with ostomies. The United Ostomy Association of America has a tool on their website where patients can find a group near their home, along with many other useful resources.

Living with an ostomy can be tough, especially at first when adjusting to new toileting routines. After time, most patients find they are not limited by their ostomy and can enjoy all the activities they love.

A burning discomfort in the chest after eating is painful and frustrating. Heartburn that gets worse or keeps coming back can sometimes be an early sign of esophageal cancer, one of the most aggressive types. There’s good news: with early detection and a team of experts on your side, surviving—and thriving—after treatment is possible.

The esophagus is the tube that connects the throat to the stomach, passing food and drink along for digestion. Cancer of the esophagus is rare, making up about 1% of cancers in the U.S. 

If you have heartburn that comes back more than twice a week or doesn’t respond to over-the-counter medications, talk with your doctor about esophageal cancer at your next appointment. Also known as gastroesophageal reflux disease (GERD), chronic heartburn can lead to a precancerous condition called Barrett’s Esophagus, so it’s best to get it checked out early. The sooner cancer is found, the better the chances of successful treatment. 

There are two primary types of esophageal cancer that impact different cells. Each has different risk factors and may need different treatments:
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• Squamous cell carcinoma most commonly affects the upper and middle parts of the esophagus. The most important risk factors for this type are smoking tobacco and drinking alcohol. It is most common outside of the U.S.

• Adenocarcinoma is cancer that most commonly begins lower in the esophagus near the stomach. The most common risk factor for adenocarcinoma is acid reflux, or heartburn, when the contents of the stomach move back into the esophagus. This type makes up about 80% of esophageal cancer cases in the U.S.

If your doctor finds you’re at risk, they may recommend regular screening with a process known as endoscopy. During this screening, a gastroenterologist uses a thin, flexible tube with a camera to look for signs of cancer. 

If you’re diagnosed with esophageal cancer, it’s ideal to have a team on your side working for the best outcomes. At MedStar Georgetown Cancer Institute, our collaborative teams of experts work together at the forefront of science to find and treat cancers of the esophagus. 

Diagnosis, staging, and treatment of esophageal cancer.

Most esophageal cancers are found and diagnosed with endoscopy. To diagnose cancer and determine how advanced it is, our teams may use other methods, including:
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• A physical examination and medical and family history

• Biopsy, during we use an endoscope to remove a small sample of esophageal tissue. These cells are examined in the laboratory for signs of cancer.

• Advanced imaging such as CT scan, PET scan, MRI, or endoscopic ultrasound to determine whether and how far the cancer has spread.

These steps guide the best treatment options. Our team of experts tailors a personalized treatment plan based upon the size, location, and stage of your cancer. Our deep experience with effective care and the latest research-backed advancements means you’ll have access to the best treatment. 

At the Institute, we work closely with researchers from Georgetown Lombardi Comprehensive Cancer Center, so our patients always have access to the latest clinical trials and advanced treatments.

For most patients, surgery is an important part of treatment. Our expert surgeons use minimally invasive, robotic-assisted esophagectomy techniques to speed up recovery time and reduce pain while safely removing the tumor and affected portions of the esophagus.  

For instance, we’re one of the few centers that performs esophageal cancer surgery with the Da Vinci 5, the latest technology in integrated robotic-assisted surgery. This remarkable machine enables us to see more clearly and operate more precisely. Instead of large incisions in traditional “open” surgery, this technique involves a few smaller incisions through which surgeon-controlled robotic arms access and remove the tumor.

While some Centers will take a hybrid approach to surgery with a portion of the operation performed open, but my partners and I find that our approach offers the greatest benefit to patients, including:
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• More precision: The small size and flexibility of the robotic instruments makes it easier to remove cancerous tissue without impacting nearby healthy structures.

• Significantly less pain: Patients experience less pain following robotic-assisted surgery, so they need less medication and recover more quickly.

• Lower risk of infection and less blood loss: Small incisions lower infection risk and minimize blood loss.

• Less time in the hospital: Most patients can go home sooner following robotic-assisted surgery.

• Less scarring and shorter recovery: Smaller incisions tend to heal faster, so patients can get back to work and life sooner.

With advanced robotic surgery, we can achieve all these benefits for patients without sacrificing high-quality cancer care. 

Treatment for esophageal cancer also can include:
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• Chemotherapy: Powerful drugs to eliminate cancer cells throughout the body.

• Immunotherapy: Treatments to boost the immune system can help kill cancer cells.

• Radiation therapy: High-energy radiation beams delivered with external and internal techniques to destroy cancer cells.

Related reading: Is Chronic Acid Reflux Just Heartburn? Understand the Risk of Esophageal Cancer.

Team-based care is the best care.

Working collaboratively allows us to provide the best care for our patients. Surgical oncologists like my partners and me, medical oncologists, radiation oncologists, gastroenterologists, and nutritionists care for our patients together.

When we bring this expertise together for our patients, the result is the safest, most effective, and most advanced treatment. 

All our patients also benefit from enhanced recovery protocols, sometimes known as fast-track recovery. These techniques help minimize patients’ time in the hospital and reduce their exposure to opioid medications that can have side effects including addiction.    

To accomplish this, fast track recovery involves:
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• Making sure patients get up and moving right away after surgery to reduce the risk of complications and promote blood flow

• Minimizing drains and tubes to make walking easier

• Using as little fluid as possible during surgery to avoid complications including delayed bowel function and breathing difficulties

• Alternative pain management techniques, such as long-acting nerve blocks and gentler, non-addictive pain relievers

Taken together, these techniques have been shown to keep patients comfortable with fewer opioid medications while improving recovery. Research has shown enhanced recovery programs demonstrate better outcomes for patients, including fewer complications and less time in the hospital.

There are more effective treatments for esophageal cancer than ever before, and finding cancer early gives us the best chance of success. With the right team and technologies on your side, patients with esophageal cancers can live high-quality lives long after treatment.