To participate in our program, the patient or family member will first have to contact our dedicated nurse navigators. The patient must be newly diagnosed with gastric or GEJ cancer and be within 60 days of being first diagnosed.  

After contacting us:

• Our team will review your medical records.
• A clinical research coordinator will contact you to determine whether you are able to participate in the study. 
• If you are eligible, the coordinator will review with you the risks and benefits of participation.

The program’s primary intervention is patient navigation, conducted by qualified oncology nurses under the supervision of physicians at the University of Florida in Gainesville, Fla., or Mount Sinai Medical Center in Miami Beach, Fla. 

The navigators will assist patients and their families in receiving care according to national guidelines that optimize the treatment of their cancer. The type of care will be determined based on the stage of the cancer and the treatment goals desired by the patients and their families. 

Our nurse navigators will refer patients and their families to the most qualified experts who treat gastric and GEJ cancer in their part of Florida or by directing them to the most appropriate center where they wish to receive care. 

Patient care will be re-reviewed at each treatment step to continue navigation until care is finished, or the study ends. Patients will be asked to provide feedback by completing quality-of-life surveys at intervals during the course of their treatment.

Based upon data from high-frequency incidence hotspots for gastric and gastroesophageal junction (GEJ) cancer throughout Florida, phone number hotlines and supplementary websites have been set up to put patients and families in communication with our centers for navigation.

• One is located at Mount Sinai Medical Center in Miami and will focus on high-incidence and mortality areas in South Florida.
• The other is located at the University of Florida in Gainesville and will focus on high-incidence and mortality areas in North and Central Florida.

Nurse clinician navigators located at either location will evaluate patients referred to us to identify action steps in accordance with well-accepted national cancer guidelines, in order to customize the patient’s pathway based on locally available expertise or through referral to nearby health care providers.  

These nurses will have access to social workers, dietitians, and physicians at Mount Sinai Medical Center or at the University of Florida who will assess and evaluate patient complaints and/or concerns regarding their new diagnosis of gastric or GEJ cancer.

With the consent of the patients, the following will occur:

• The patient will be referred to an endoscopy center (one that has significant experience and patient volume with gastric and GEJ cancer) in close proximity to the patient’s home address or elsewhere, depending on the patient’s preference.
• Educational material regarding the endoscopic protocol for suspected gastric or GEJ malignancy will be made available through guidelines via the American Society for Gastrointestinal Endoscopy.
• Endoscopy findings and biopsy results will be forwarded to our navigators for review. With the diagnosis of invasive adenocarcinoma, national practice guidelines will be utilized to refer patients for appropriate testing (i.e., contrast-enhanced CT scan of the chest, abdomen, and pelvis, and/or other imaging as needed).
  • For those patients identified to have findings of concern for metastatic disease, they will be referred to a medical oncologist who specializes in the care of gastric or gastroesophageal cancer.
  • For those patients deemed to have locoregional disease, they will be referred to a surgical specialist.
  • For those patients with early stage disease, they will be referred to an advanced endoscopist.
• Once patients have completed therapy, they will be informed about survivorship aspects and steps to return to wellness.
• Patients with progressive, incurable disease will be advised on end-of-life care and hospice options.The table below marks the test, intervention or procedure recommended by national experts, depending on the stage of the cancer.
  

  Cancer Stage	EGD/EUS	PET/CT	Diagnostic Lap	Perioperative or Trimodality  Chemotherapy	Surgery/Endoscopic Resection	Clinical Trial (if available)	Palliative Therapy	Tumor Board
  Tis/T1	x	x			x	x		x
  T2/T4	x	x	x	x	x	x		x
  N+	x	x	x	x	x	x		x
  M+						x	x

  
  X marks the test, procedure, or intervention recommended by national experts, depending on the stage of the cancer (shown in the left column).