Malignant cancers of the adrenal glands can affect the cortex of the adrenal (adrenocortical tumors) or the medulla (neuroendocrine tumors). Dana-Farber Cancer Institute has become a leading international referral center for patients with neuroendocrine and adrenocortical tumors, reflecting both our expertise in the clinical care of these patients and our leading research efforts to better understand these cancers and develop novel therapies.
Patients with paraganglioma and pheochromocytoma face particular challenges, due to the rarity of their condition but also the complexity of their medical management, which requires expertise from multiple disciplines including medical endocrinologists, genetic counselors, surgeons, and medical oncologists. We provide expert care within the neuroendocrine and carcinoid tumor program at Dana-Farber Cancer Institute.
This program is led by Matthew Kulke MD, and falls within the broader Dana-Farber Cancer Institute Gastrointestinal Cancer Center. A major focus of our program is to evaluate novel and promising therapies for neuroendocrine tumor patients. Our active clinical research program also serves the purpose of making promising therapies available to our patients, many of whom do not have access to treatment in the absence of FDA approved drugs for this indication.
The diagnosis of adrenocortical carcinoma (ACC) presents a particular challenge given the relative rarity of the diagnosis as well as the lack of a “gold standard” for treatment. Our treatment of ACC incorporates a multidisciplinary and multi-institutional approach combining the skills of medical endocrinologists, medical oncologists, specialized surgeons, and radiation oncologists. This program is led by Dr. Aymen Elfiky under the auspices of the Lank Center for Genitourinary Oncology at the Dana-Farber Cancer Institute in collaboration with colleagues at Beth Israel Deaconess Medical Center and the Brigham and Women’s Hospital. An important element of our work is the continuing clinical and lab research components which look at genetic and biomarker components of ACC in an effort to develop better therapies and improve the outcomes of our patients.
Patients with known or suspected pheochromocytoma or paraganglioma will be evaluated by a multidisciplinary clinical team including dedicated medical, surgical and radiation oncologists, in conjunction with pathologists, radiologists, nursing specialists, social workers, and nutritionists, many of whom are nationally recognized experts in this area and are attuned to the needs of neuroendocrine tumor patients. After a careful assessment of the history and a physical examination, we develop a treatment plan together with the patient. We arrange future appointments with physicians and support staff, as well as arrange referrals to other specialists as needed. We have initiated one of the first hospital-based Neuroendocrine Tumor support groups in the country. This bimonthly support group for neuroendocrine tumor patients and caregivers is coordinated by Susan Englander LICSW and Jane Bausch LICSW.
Patients with known or suspected adrenocortical cancer will be evaluated by Drs. Elfiky or Choueiri at the Dana Farber Cancer Institute. In conjunction with adrenal surgeons, radiation oncologists, nursing specialists, and personalized recommendation for further therapy will be made. Future appointments and referrals to surgery, radiation oncology, and for chemotherapy will be arranged as needed.
Dr. Elfiky is a medical oncologist at the Dana-Farber Cancer Institute with a focus on genitourinary malignancies. He has developed a particular expertise in adrenocortical cancer including ongoing development of ACC specific clinical trials. Dr. Elfiky’s research has focused on exploring the genetic drivers of ACC progression and the use of novel targeted agents in the treatment of advanced cases of ACC.
Dr. Choueiri is the leader of the Kidney Cancer Program at Dana-Farber Cancer Institute and Co-Director of the Kidney Cancer Clinic at Brigham and Women’s Hospital. As a natural progression of his expertise in renal cell cancer, he has developed an expertise in ACC and has been an investigator on a national clinical trial. In addition, he continues research collaboration with Dr. Elfiky on genetic and biomarker components of ACC progression and development of new therapies for advanced cases which have proven resistant to standard therapies.
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