GIST Specialist for Rancho Palos Verdes, CA
The operation is a morning and the medication has an end date. The part that lasts is living with having had this, and it is the part nobody prepares you for. Joshua Ellenhorn, MD, FACS treats follow up as care rather than as paperwork.
- Written surveillance schedules with a defined endpoint
- Clinical Professor of Surgery, Cedars-Sinai Medical Center
- Imaging done locally and reviewed here against prior studies
- Straight answers about what your risk category actually means
Finishing Treatment Can Be Harder Than Having It
During treatment there is structure. Appointments, a plan, medication with a schedule, people asking how you are. It is demanding but it is organised, and being busy with something is easier than waiting.
When it stops, the fear frequently arrives properly for the first time. Patients describe managing the surgery and the medication reasonably well and then finding the quiet afterwards considerably harder. That pattern is so common in cancer follow up that it should be expected rather than treated as a complication, and it is not evidence that anything has gone wrong.
With GIST there are two specific features that shape it. Follow up runs for years rather than months, which means living alongside the question for a long time. And the disease is rare enough that almost nobody around you will have heard of it, so the ordinary comfort of knowing someone who went through the same thing is usually unavailable.
What helps, practically, is having the numbers. A written surveillance schedule with defined intervals and a stated endpoint is easier to live with than a vague instruction to come back periodically. Knowing your actual risk category, rather than imagining it, tends to be more reassuring than not knowing. And understanding what genuinely warrants a phone call means the rest can be set aside more easily.
What to Report, and What Can Wait
One of the more useful things follow up can give you is permission to stop monitoring yourself constantly. These are the things that genuinely warrant contact.
| Symptom or situation | Report it | Reasoning |
|---|---|---|
| New persistent abdominal pain in one location | Yes, call the office | A constant site rather than a wandering ache is the pattern worth checking |
| Unexplained weight loss | Yes | Particularly if it continues beyond the first couple of months after surgery |
| Return of the symptoms that led to your diagnosis | Yes | Whatever brought you in originally is the most meaningful thing to watch for |
| A falling blood count on routine bloodwork | Yes | Slow bleeding is how many GIST first announced themselves |
| Occasional indigestion, wind, mild aches | Generally not | Common after abdominal surgery and rarely significant. Mention at your next visit |
| Ordinary tiredness | Generally not | Though persistent fatigue while on medication is worth raising, since a dose adjustment may help |
| Anxiety before scans | Worth mentioning | Extremely common, and sometimes the scheduling itself can be arranged to reduce the waiting |
Nobody will mind you calling about something that turns out to be nothing. The purpose of this list is to make the rest of the time easier, not to discourage contact.
Surveillance Is Not Waiting for Bad News
The purpose of surveillance is that recurrent GIST caught early is highly treatable. That is the whole rationale, and it is a considerably more constructive framing than watching and hoping.
If a GIST does come back, it is generally in the liver or on the peritoneal surfaces, and it responds to targeted therapy in a way most recurrent cancers do not. Deposits can frequently be resected or ablated once the drug has established control, and there is an established sequence of further agents if resistance develops. People live for many years with recurrent GIST that is being actively managed. Catching it at one centimetre rather than eight is what the scans are buying you.
It is also worth knowing how to read the reports if you look at them. In GIST, stable disease is a good result rather than a disappointing one. And a report describing new lesions in the liver frequently reflects deposits that were always present becoming visible as they respond to treatment, which is why comparison against your earlier scans matters so much.
Lower risk tumors need less of this than people expect, and the schedule should taper and finish. If yours has no stated endpoint, ask for one.
What Was Actually Done
Recordings of real GIST resections narrated by the surgeon who performed them. Some patients find it settling to see the scale of the operation they had. Others would rather not, which is equally sensible.
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.
When Does My Surveillance End?
An open ended schedule is harder to live with than a defined one, and for lower risk tumors it should genuinely finish. If nobody has given you an endpoint, your risk category may never have been calculated.
Certifications and Appointments
Two American Board of Surgery certifications, a Cedars-Sinai teaching appointment, and membership of the societies that publish the surveillance guidance for this disease.
- 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.
Long term follow up is the part of rare disease care most likely to fall apart, and not for clinical reasons. Surgeons move, oncologists rotate, and a schedule that depended on someone remembering quietly lapses. A practice built around a single tumor type does not have that problem in the same way, and a meaningful share of patients here were operated on elsewhere years ago and simply want someone to hold the thread.
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.
What Patients Say
Reviews left by patients treated by Dr. Ellenhorn at the Surgery Group of Los Angeles.
★★★★★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
★★★★★Very kind stuff, great service. Dr Joshua Ellenhorn is a very calm doctor who takes time with his patient.
Anita Lukacevic
From Rancho Palos Verdes
Hawthorne or Western north off the hill to the 405, then the 10 east and north on La Cienega. Forty five minutes to an hour depending on the traffic.
For long term follow up that distance need not mean repeated journeys. Routine surveillance imaging can generally be performed closer to home and reviewed here against your prior studies, which is the part that actually requires continuity. In person visits then happen when there is something to discuss rather than at every interval.
If you would value support beyond the medical appointments, Cedars-Sinai has social work and psycho-oncology services, and there are patient organisations specific to GIST that connect people with a disease their friends will not have heard of. Asking about either is entirely reasonable.
8635 W 3rd St, Suite 880W
Los Angeles, CA 90048
Monday to Saturday, 11:00am to 8:00pm
Closed Sunday
Frequently Asked Questions
Is it normal to feel worse emotionally after treatment finishes than during it?
I get anxious for weeks before every scan. Is that common?
Should I be reading my scan reports myself?
When can I say I am cured?
What symptoms should I actually report between appointments?
Is there support beyond the medical appointments?
Does surveillance ever actually stop?
How far is your office from Rancho Palos Verdes?
Ask for the Schedule, and the Endpoint.
A written surveillance plan with defined intervals and a stated finish is easier to live with than an open ended one, and for lower risk tumors it should genuinely end.
