GIST Specialist for Calabasas, CA
Choosing a surgeon for a rare tumor is difficult because the usual signals do not help much. Hospital reputation, bedside manner and years in practice tell you less than you would hope. This page sets out what actually distinguishes one option from another.
- Specific answers about case volume and proposed operation
- Clinical Professor of Surgery, Cedars-Sinai Medical Center
- Published operative videos you can assess yourself
- Thirty five to forty five minutes via the 101 and 405
What Actually Distinguishes One Surgeon From Another
For a common cancer the ordinary heuristics work reasonably well. A good hospital, a well regarded department, a surgeon who does a lot of that operation. Volume takes care of itself because the disease is frequent enough.
Gastrointestinal stromal tumors are around one percent of gastrointestinal cancers, which breaks that arithmetic. Even inside an excellent institution, GIST cases are distributed across a general surgical roster, so a capable and well credentialed surgeon may be operating on their third or fourth. That is not a criticism of anyone, it is what rarity does.
Which means the signals worth attending to are narrower and more specific than reputation. Can they tell you how many they have personally performed? Do they know your mitotic index without looking it up twice? Was mutation testing ordered? Can they say precisely which operation is proposed, how much of the organ stays, and what happens if the tumor turns out to be more difficult than the scan suggested?
Those are all answerable questions. When they are answered specifically and without hesitation, that tells you something real. When they are met with generalities, or with reference to the hospital rather than the individual, that also tells you something. It is a more useful test than any ranking.
Signals Worth Weighing, and What They Do Not Tell You
Apply these to any surgeon you consult, including this one. Several of them are things a good local surgeon will pass easily.
| Signal | What it indicates | What it does not indicate |
|---|---|---|
| Personal case volume in GIST specifically | The strongest single marker for a rare tumor | Nothing about technical skill in general surgery, which may be excellent regardless |
| Knows your mitotic index and mutation subtype | That the plan is built on your tumor rather than a template | Not a guarantee of surgical judgement, but its absence is a genuine warning |
| Can specify the operation and how much is removed | The case has been thought through in detail | Confidence is not the same as being right. Ask for the reasoning too |
| Discusses whether medication should come first | Familiarity with sequencing, which is where GIST outcomes are often decided | Little about operative technique itself |
| Published operative video | Unusually assessable evidence, since you can look rather than trust | Plenty of excellent surgeons publish nothing at all |
| Relevant board certification | Baseline training, and directly relevant for rectal cases | Expertise in a rare tumor. Certification is broad by design |
| Institutional reputation | Pathology depth, intensive care, multidisciplinary review | How many of your specific operation the individual has done |
| Bedside manner | How the conversation will feel | Competence. The correlation runs in both directions and is weak |
If your local surgeon answers the first four of these well, travelling further may add little. That is a legitimate conclusion and worth establishing before assuming you need to go elsewhere.
The Situations Where a Second View Is Clearly Warranted
General unease is a poor basis for shopping around and tends to produce unproductive appointments. Specific findings are different, and these are the ones that reliably justify another opinion.
A Whipple procedure proposed for a duodenal tumor. It is one of the largest operations in abdominal surgery, and many duodenal GIST can be removed with the pancreas left intact. A permanent stoma proposed for a rectal tumor, when several months of targeted therapy might shrink it away from the sphincter first, and the decision cannot be revisited afterwards. Removal of most or all of the stomach, when GIST rarely involves lymph nodes and a wedge resection is usually sufficient.
Then the informational gaps. Nobody has told you your mitotic index or risk category. No mutation testing has been ordered, so the drug plan is being made blind. You have been told the tumor is inoperable, which is a different statement from not yet resectable. You have been told to watch it with no reasoning offered, when surveillance is often correct but should be justified.
Each of those is concrete. Each is worth a week or two of delay, which GIST almost always tolerates.
Look Rather Than Take It on Trust
Recordings of real GIST resections narrated by the surgeon who performed them. This is offered as evidence you can examine rather than as a claim.
Laparoscopic Resection of a Gastric GIST
A gastric GIST removed through small incisions with the capsule kept intact.
Gastric GIST Resection: A Simplified Approach
A refined approach that shortens operating time and recovery.
Robotic Resection of a Duodenal GIST
Duodenal GIST removed robotically with the pancreas and bile duct preserved, which is the operation most often replaced unnecessarily by a Whipple.
Ask Us the Same Questions
Every item on the checklist above applies here as much as anywhere. If a local surgeon answers them well, that is a good reason to stay put, and being told so is a reasonable outcome of a consultation.
The Credentials, Stated Plainly
Two American Board of Surgery certifications, General Surgery and Colorectal Surgery. Clinical Professor of Surgery at Cedars-Sinai, Fellow of the American College of Surgeons, and member of the Society of Surgical Oncology and the American Society of Clinical Oncology.
- American Board of Surgery, certified in General Surgery
- American Board of Surgery, certified in Colorectal Surgery
- California State Medical License
- Florida State Medical License
Joshua Ellenhorn, MD, FACS
Dr. Ellenhorn is a surgical oncologist and Clinical Professor of Surgery at Cedars-Sinai Medical Center, and a collaborative member of the Samuel Oschin Comprehensive Cancer Institute.
The argument for a narrow practice is simply volume in one tumor, and it is worth stating without embellishment. Concentrating on complex abdominal cancers and gastrointestinal stromal tumors rather than the breadth of general surgery means these cases are routine here rather than occasional. That is the whole claim. It does not make every other surgeon unsuitable, and for a straightforward small gastric tumor a good local surgeon may serve you perfectly well.
He is certified by the American Board of Surgery in General Surgery and in Colorectal Surgery, a Fellow of the American College of Surgeons, and a member of the Society of Surgical Oncology and the American Society of Clinical Oncology. He practises with the Surgery Group of Los Angeles.
Eight Questions for Any GIST Surgeon
Ask these of everyone you see, here included. The quality of the answers is more informative than any credential.
- How many GIST resections have you personally performed?
- What is my mitotic index, and which risk category does that give?
- Was mutation testing ordered, and what did it show?
- Which operation are you proposing, and how much stays?
- Can this be removed with the capsule intact?
- Would medication before surgery make the operation smaller?
- What happens if the tumor is more difficult than the scan suggests?
- What are the specific complications, and how often do they occur for you?
What Patients Say
Reviews left by patients treated by Dr. Ellenhorn at the Surgery Group of Los Angeles.
★★★★★The staff at the Surgery Group of Los Angeles are wonderful. They are kind, very attentive, the office is clean and I did not have to wait long at all. I cannot say enough great things about Dr. Ellenhorn. He is an excellent surgeon who is highly skilled and very knowledgeable. I cannot thank him enough for all he has done for my family and I.
Erika Frank
★★★★★I was very pleased with the office staff, they were always very pleasant and helpful. I was very impressed with Dr. Ellenhorn as well. He was very friendly and addressed all my concerns regarding my surgery and aftercare and follow up.
Terry Jackson
From Calabasas
The 101 east to the 405 south, then the 10 east and north on La Cienega, is the usual route and generally the fastest. Malibu Canyon down to Pacific Coast Highway and east is more pleasant and slower. Thirty five to forty five minutes depending on the hour.
Given the distance, remote review of records is often the sensible first step. Send the imaging and pathology and you will get a specific view on whether the proposed plan holds up, which is enough to decide whether the journey is worthwhile.
The office is in the medical plaza attached to Cedars-Sinai Medical Center, where imaging, pathology and the operating rooms are in one building.
8635 W 3rd St, Suite 880W
Los Angeles, CA 90048
Monday to Saturday, 11:00am to 8:00pm
Closed Sunday
Frequently Asked Questions
How many GIST operations should a surgeon have done?
Is a big name hospital enough?
What are the warning signs?
Should I care that a surgeon publishes operative videos?
What if I like my surgeon but the plan concerns me?
Does board certification tell me anything specific?
Is it reasonable to ask about complications?
How far is your office from Calabasas?
Ask the Eight Questions. Anywhere.
How the answers come back tells you more than any reputation. If your local surgeon handles them well, staying put is a perfectly good decision.
