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
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.
"There's been a fundamental change in oncology in
the last 10 years," explains Dr. Fischbach, who earned his
degrees at the University of California-San Francisco and
Harvard University. "Skilled subspecialists and top-notch
technology are now available in community hospitals like Bridgeport Hospital. As a result, oncology services are what
you’d expect to find in any major cancer center. You can
have it all right here, right where you live."
Oncology Patient Navigator Donna Gonsalves, RN, BSN, provides
patients and their families with guidance at each point of cancer care.
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
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.
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
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."
Cancer Clinical Trials at Bridgeport Hospital
Cancer patients can choose to participate in one of Bridgeport Hospital’s cancer clinical trials. Clinical trials
are studies that measure the effectiveness of new drugs or treatments not yet available to the general public.
These studies provide participants access to emerging medications. At any given time, there are at least 30
cancer clinical trials at Bridgeport Hospital. For more information, contact The Dr. Richard W. Kmetzo
Cancer Resource Center at Bridgeport Hospital at 203-384-3904 or e-mail firstname.lastname@example.org.
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.
Bridgeport Hospital's Oncology
Patient Navigator program is a premiere
cancer service designed specifically
for patients and their families. The only
service of its kind in the area, the Oncology
Patient Navigators are matched with patients and
families to provide guidance at each point of cancer care.
Bridgeport Hospital Oncology Patient Navigators can help
by explaining the healthcare system, preparing patients for
treatments, serving as a communication bridge between
patients and the cancer care team, helping find ways to pay
for treatments and scheduling appointments.
Did You Know…?
The Norma F. Pfriem Cancer Institute at Bridgeport Hospital delivers care to nearly 1,000 new cancer patients each year—more than any other hospital in Fairfield County.