GIST Specialist for Westwood, CA
Westwood patients usually arrive already inside a good system, with scans done and an oncologist assigned. What they often want is a surgeon who does this particular operation repeatedly. Joshua Ellenhorn, MD, FACS operates fifteen minutes east at Cedars-Sinai.
- Second opinions on surgical planning, without changing your oncologist
- Clinical Professor of Surgery, Cedars-Sinai Medical Center
- Published operative videos of his own GIST resections
- Remote review of imaging and pathology before you travel
Institutions Are Not the Same as Operators
Westwood is a short walk from one of the best hospitals in the country, and nothing here suggests otherwise. Academic medicine does several things very well: multidisciplinary review, pathology depth, access to trials.
What no institution can standardise is how many times the individual holding the instruments has done your specific operation. GIST is about one percent of gastrointestinal cancers. Even within a large centre, cases are distributed across a general surgical roster, so an excellent surgeon may still be operating on their third or fourth GIST.
That matters because the difficult parts are judgment rather than dexterity. Whether a wedge resection clears this tumor or its position forces a formal gastrectomy. Whether the capsule survives a laparoscopic approach, since rupture spreads tumor cells and permanently worsens the outlook. Whether three months of imatinib first would turn a major operation into a minor one. None of that is protocol driven.
The sensible arrangement is usually both: keep your oncologist and your institution, and have the surgical plan read by someone who does only this.
What Makes GIST Its Own Category
GIST arises from the interstitial cells of Cajal, the pacemaker cells within the wall of the digestive tract that coordinate peristalsis. It is a sarcoma, and it sits apart from the carcinomas that make up most gastrointestinal cancer.
Two consequences follow. Lymph node spread is uncommon, so the extensive nodal clearance a gastric adenocarcinoma requires is usually unnecessary and a limited resection can be curative. And nearly all GIST carry a driver mutation in KIT or PDGFRA, which is why tyrosine kinase inhibitors work here and do almost nothing for other sarcomas.
Mutation subtype is not academic detail. KIT exon 11 tumors respond to standard dose imatinib. Exon 9 tumors often need double. PDGFRA D842V tumors respond poorly to imatinib altogether. Wild type tumors, more common in younger patients, need a different approach again. Treating without that result is guessing.
Imaging, Biopsy, and When to Skip It
Most GIST are identified on CT, PET/CT, or upper endoscopy. Because the tumor sits inside the wall rather than on the lining, a standard endoscope may show only a smooth bulge, which is where endoscopic ultrasound becomes the instrument of choice for assessing depth and obtaining controlled samples.
Biopsy is not automatic and should not be. Rupturing the capsule can seed the peritoneum. Where imaging is characteristic and the tumor is clearly resectable, proceeding to resection often gives better information anyway, because the intact specimen yields a far more reliable mitotic count than a needle core.
Where a biopsy does change management is when preoperative therapy is being considered, since you cannot rationally start imatinib without knowing the mutation. Recognising which situation you are in is much of what a specialist consultation provides.
The Decision Tree, Simplified
Size, site, mitotic index, mutation subtype, and whether disease has spread. Those five inputs produce the plan.
Resection Alone
Complete removal with the capsule intact, no adjuvant medication, and a tapering surveillance schedule. For a small gastric tumor with a low mitotic count this is the whole of the treatment.
Resection Plus Imatinib
Larger tumors, small bowel origin, or high mitotic counts warrant roughly three years of adjuvant therapy after surgery. Mutation subtype determines whether standard dosing is adequate.
Therapy First
Preoperative imatinib can downstage a difficult tumor into a straightforward one. In metastatic disease the drug leads and surgery becomes selective. Getting the sequence right is where specialist input has the most leverage.
The Operations Themselves
Recordings of real resections narrated by the surgeon who performed them. When you are evaluating a surgeon rather than a hospital, this is the relevant evidence.
Laparoscopic Resection of a Gastric GIST
A gastric GIST removed laparoscopically with the capsule kept whole.
Gastric GIST Resection: A Simplified Approach
A refined approach that shortens operating and recovery time.
Robotic Resection of a Duodenal GIST
Duodenal GIST is among the least forgiving sites. Robotic assistance allows resection while preserving the pancreas and bile duct.
How Many Have You Done?
It is an entirely reasonable thing to ask any surgeon before an abdominal cancer operation, and the answer should be specific. These videos exist so the question can be answered with something more than a number.
Appointments, Certifications, Societies
Two American Board of Surgery certifications, a Cedars-Sinai teaching appointment, and membership of the bodies that set standards 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. He is regarded as one of the leading GIST surgeons in the United States.
The practice is narrow by design, concentrating on complex abdominal cancers and gastrointestinal stromal tumors rather than the breadth of general surgery. That concentration is why academic oncologists across Los Angeles refer these particular cases to him, and it is what makes the level of detail in his operative videos possible.
He is certified by the American Board of Surgery in General Surgery and 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.
★★★★★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
★★★★★Very kind stuff, great service. Dr Joshua Ellenhorn is a very calm doctor who takes time with his patient.
Anita Lukacevic
Adding a Surgical Opinion Without Disrupting Your Care
Send the File
Call (310) 356-3792 or book online, then forward imaging, endoscopy reports, and pathology including mutation testing. Nothing needs to be cancelled or transferred to do this.
Get the Surgical Read
Dr. Ellenhorn reviews the material himself and gives a specific opinion on the operation: which approach, what is removed, what the realistic recovery is, and whether medication should come first.
Decide Where to Have It
Some patients proceed here, others take the opinion back to their existing team. Both are legitimate outcomes and you will not be pressured toward either.
Fifteen Minutes East of Westwood
Wilshire Boulevard east through Beverly Hills, then south to 3rd Street, is the usual route from Westwood Village and the UCLA campus. Santa Monica Boulevard east and then south on La Cienega is the alternative and often quicker in the late afternoon. From the Wilshire corridor high rises it is a twelve minute drive outside of peak hours.
The office is in the medical plaza attached to Cedars-Sinai Medical Center, so imaging, pathology, and the operating rooms are all in one building. For anyone already managing appointments across a large campus, that consolidation is worth something.
Patients travelling from outside California, including Arizona and Nevada, can have imaging and pathology reviewed remotely first.
8635 W 3rd St, Suite 880W
Los Angeles, CA 90048
Monday to Saturday, 11:00am to 8:00pm
Closed Sunday
Frequently Asked Questions
I am already being seen in an academic centre. Why add another surgeon?
Will a second opinion delay my treatment?
What is a tumor board and does my case need one?
Should I be considering a clinical trial?
What does wild type GIST mean?
How far is your office from Westwood?
Can you review my imaging without a full consultation first?
Who manages my medication if you do the surgery?
Keep Your Team. Add a Surgical Opinion.
A second reading of your imaging and pathology by a surgeon who operates on GIST routinely costs you one appointment and can change the operation you end up having.
