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Gastroenterology

Center for Hereditary Gastrointestinal Cancer

If you or a family member has a history of stomach, colon or other gastrointestinal cancers, you can make an appointment with the Center for Hereditary Gastrointestinal Cancer at Tufts Medical Center to better understand and reduce your risk for developing these cancers.

Should I be seen by hereditary GI cancer specialists? 

You should talk to your primary care doctor or specialist about a referral to the Center for Hereditary GI Cancer if you have a personal or family history of one or more of the following:

  • Cancer at an early age (before the age of 50)
  • Multiple primary cancers (2 or more separate cancers in one person)
  • Cancer in multiple generations of your family
  • Early-onset or multiple colon polyps
  • Multiple family members affected with cancer
  • A known hereditary colon or GI cancer syndrome (listed below)

Some of the cancer syndromes that we see and may discuss with you include:

  • Lynch syndrome (HNPCC) (link to brochure)
  • Familial Adenomatous Polyposis (FAP) (link to brochure)
  • MYH-Associated Polyposis (MAP)
  • Hereditary Diffuse Gastric Cancer (HDGC) syndrome
  • Peutz-Jeghers syndrome
  • Juvenile Polyposis syndrome

What to expect

The hereditary GI cancers team at Tufts Medical Center in Boston, MA talk with a patient.During your first appointment, you’ll meet with a genetic counselor and a physician to discuss your family and medical history in detail.  Please come prepared for this meeting and provide as much information on your family cancer history as possible. Also, any medical records from outside Tufts Medical Center should be sent to the team for review before your appointment.

After the appointment, our expert team may recommend genetic testing to determine whether you or your family members may be at higher risk for developing gastrointestinal cancer. Information learned from genetic testing will be used to help guide you in risk reduction or treatment decisions.

Patients who are found to have a genetic change that predisposes them to cancer will be fully managed according to state-of-the-art clinical guidelines. Surveillance and treatment plans will be discussed with the patient, to ensure patient understanding and comfort. Cancer risk reduction options offered at Tufts Medical Center include:

  • Upper endoscopy or colonoscopy at specific intervals to screen for and try to catch any cancer growth as early as possible
  • Elective surgery
  • Additional screening tests

A team focused on determining your cancer risk and working toward reducing it

The Center for Hereditary GI Cancers at Tufts MC is home to expert clinicians who are up-to-date on the most advanced genetic testing options and are trained to help patients understand cancer risk.

Our clinical team is led by a gastroenterology physician and genetic counselor with specific expertise in GI cancer genetics. Other members of the clinical service include gastrointestinal pathologists, colorectal surgeons, medical oncologists and surgical oncologists. Our patients will have access to all of the resources here at Tufts Medical Center, including opportunities to participate in research studies and clinical trials.

Dr. Jatin Roper, a gastroenterologist at Tufts Medical Center in Boston, MA, conducts research.Q: What is genetic testing? What does it entail?

A: Genetic testing is most commonly performed on a sample of blood. When a specific genetic condition or syndrome is suspected, a single gene or a few genes are tested. When the clinical team is unsure of which genetic condition is most likely, but suspects that a genetic change could be present, a larger number of genes are tested (commonly referred to as panel testing). The patient’s sample is then sent to the laboratory, where the specific genes in question will be read like a book to determine whether there are any missing or extra pieces of the gene(s) or any “spelling changes” in the gene(s). These changes can cause a person to be at an increased risk for developing certain types of cancer (depending on the specific genetic change).

Q: How expensive is genetic testing? Is it covered by insurance?

A: Most insurance companies see the benefit of genetic testing and cover the costs, especially when the genetic test results can have implications for treatment. Laboratories that we work with will often contact your insurance company before running the test to determine if there will be any out-of-pocket cost to you. They will not run the test if the cost is prohibitive for you. For patients who do not have medical insurance, the Cancer Resource Foundation (http://www.cancer1source.org/) can, in many instances, pay for genetic testing. The team will work with you to determine which options will work best for you.

Q: Am I the best person in my family to have genetic testing?

A: The best person to initiate genetic testing in a family is someone who is affected themselves with cancer. We realize that this isn’t always possible and that sometimes, the only family member who is available for testing does not have cancer. Your genetic counselor will work with you to decide on a testing strategy that provides us with the most valuable information. This may require requesting testing records from, or contacting, other family members.

Q: What will happen during my appointment?

A: The genetic counselor will take a detailed medical/family history, assess your risk for having a hereditary cancer syndrome, discuss the benefits and limitations of genetic testing, and discuss the possible results of genetic testing. The physician will discuss management guidelines and risk-reducing screening/surveillance options with you if you are found to have a hereditary cancer syndrome.

Q: How will I receive the results of my genetic testing?

A: All patients receive the results of their genetic testing in-person at a follow-up appointment. We do this because of the possible complexities of these genetic testing results and because of the possible medical and psychological impacts of positive test results

Roger Graham, MD

Roger Graham, MD

Title(s): Chief, Division of General Surgery; Chief, Surgical Oncology; Director, Breast Health Center; Surgeon; Associate Professor, Tufts University School of Medicine
Department(s): Surgery, General Surgery, Surgical Oncology
Appt. Phone: 617-636-8270
Fax #: 617-636-9095

General surgery, surgical oncology, thyroid surgery, breast cancer

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Lilian  Chen, MD

Lilian Chen, MD

Title(s): Colon and Rectal Surgeon; Assistant Professor, Tufts University School of Medicine
Department(s): Surgery, Colon and Rectal Surgery
Appt. Phone: 617-636-6190
Fax #: 617-636-6110

Minimally invasive and robotic surgery, colon and rectal cancer, inflammatory bowel disease including Crohn's disease and ulcerative colitis, anorectal disease, rectal prolapse and sacral nerve stimulator for fecal incontinence

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Martin D. Goodman, MD

Martin D. Goodman, MD

Title(s): Surgeon; Director, Peritoneal Surface Malignancy Program; Assistant Professor, Tufts University School of Medicine
Department(s): Surgery, General Surgery, Surgical Oncology
Appt. Phone: 617-636-9248
Fax #: 617-636-9095

General surgery, advanced abdominal tumors, peritoneal surface malignancies, hepatobiliary/pancreatic/colorectal minimally invasive surgical oncology

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Chelsea A. Mandigo, MS

Chelsea A. Mandigo, MS

Title(s): Genetic Counselor
Department(s): Genetics and Metabolism
Appt. Phone:
Fax #:

Hereditary cancer syndromes, neurodevelopmental disabilities

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Robert Martell, MD, PhD

Robert Martell, MD, PhD

Title(s): Medical Oncologist; Associate Professor, Tufts University School of Medicine
Department(s): Medicine, Hematology/Oncology
Appt. Phone: 617-636-6227
Fax #: 617-636-8538

Phase I clinical trials, GI oncology, breast cancer, head and neck malignancies, liver tumors

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Jatin Roper, MD
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Jatin Roper, MD

Title(s): Director, Center for Hereditary Gastrointestinal Cancer; Assistant Professor, Tufts University School of Medicine
Department(s): Medicine, Gastroenterology, Molecular Oncology Research Institute
Appt. Phone: 617-636-5883
Fax #: 617-636-4505

Familial colorectal cancer, Lynch syndrome, familial adenomatous polyposis, Cowden’s syndrome, general gastroenterology, gastric cancer screening, gastrointestinal endoscopy and colonoscopy

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Wasif M. Saif, MD

Wasif M. Saif, MD

Title(s): Director, GI Oncology Program; Leader, Experimental Therapeutics; Professor, Tufts University School of Medicine
Department(s): Medicine, Hematology/Oncology
Appt. Phone: 617-636-6227
Fax #: 617-636-8538

Chemistry and pharmacology of folate antagonist, experimental therapeutics, clinical trial design (Phase I and II), cancers treated include pancreas, gall bladder, cholangiocarcinoma (bile duct), anal, colon (including Rectum), neuroendocrine (carcinoid), psedomyxoma peritonei, esophagus, gastroesophageal (including Stomach), liver, unknown primary, GIST, adrenal, peritoneum, phase I clinical studies of novel cancer drugs and/or combinations

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Barbara J. Weinstein, MD

Barbara J. Weinstein, MD

Title(s): Staff Pathologist; Assistant Professor, Tufts University School of Medicine
Department(s): Pathology and Laboratory Medicine
Appt. Phone: 617-636-5829
Fax #: 617-636-8302

General surgical pathology, cytopathology, gastrointestinal pathology

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James Yoo, MD

James Yoo, MD

Title(s): Chief, Division of Colon and Rectal Surgery; Assistant Professor, Tufts University School of Medicine
Department(s): Surgery, Colon and Rectal Surgery
Appt. Phone: 617-636-6190
Fax #: 617-636-6110

Minimally invasive surgery, colon and rectal cancer, inflammatory bowel disease including Crohn's disease and ulcerative colitis

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The clinic is held on alternating Tuesday afternoons. Patients are seen in the Gastroenterology Clinic, Proger Building, 3rd floor, 800 Washington Street, Boston. To schedule an appointment, call 617-636-5883.