Join Now
Sign In
William Hawkins, MD
WilliamHawkinsMD (Physician (Verified) )| Communities: Liver and Intraheptic Cancer , Pancreatic Cancer , Stomach Cancer , Sarcoma | Answers: 8 |
| Member Since: Sep. 2012 |
Ask WilliamHawkinsMD a question:
0
Cc:
Twitter
Facebook
Professional Statement
William Hawkins, MD is Associate Professor in the Department of Surgery, in the Hepatobiliary-Pancreatic and Gastrointestinal Surgery Section at Washington University School of Medicine and Siteman Cancer Center. He specializes in benign and malignant diseases of the liver, biliary tract, pancreas and stomach utilizing multi-modality treatments and minimally invasive techniques, whenever possible. In addition Dr. Hawkins also specializes in the management of soft-tissue sarcomas.
Professional Info
Credential: MD
Medical school: State University of New York at Stony Brook
Residency: Beth Israel Deaconess Medical Center; Massachusetts General Hospital
Fellowship: Memorial Sloan-Kettering Cancer Center
Areas of expertise: Minimally invasive foregut and solid organ surgery, pancreatic cancer, liver cancer, sarcoma, abdominal wall hernia, and biliary tract disease, hepatocellular cancer, hepatoma, gastric cancer, revision surgery
Research interests: Tumor immunology
Hospital affiliation: Washington University School of Medicine, Siteman Cancer Center
Practice address:
4921 Parkview Place, C, 8
St. Louis, MO
63110
Practice phone number: 314-362-7046
WilliamHawkinsMD Activities
Minimally invasive liver surgery has increased dramatically and defining appropriate situations is difficult because it is a moving target. Almost as soon as you define the appropriate situation, we move the benchmark because our tools keep improving. At present about ½ of the common liver operations can be performed safely using minimally invasive techniques. The long term benefits of this are not proven but there is growing evidence that patients who undergo minimally invasive surgery have less incisional pain and go home sooner. They also may experience less average blood loss.
New answer by WilliamHawkinsMD (Physician - (Verified))
1
Answer |
7 months ago
We do several things to maximize our chance of success. First we look really hard for tumors outside the liver that suggest spread has already occurred. If we find spread, and surgery will not help, then we avoid the surgery in favor of treatments which treat both the liver and the spread. Second, we look very hard at the liver we plan to leave behind. In addition to all the pre-operative imaging, we perform an intraoperative ultrasound and biopsy anything that is suspicious. Sometimes it is possible and safe to resect more than one area of the liver. Ultimately time is the proof of our efforts. We follow all the patients we resect for cancer for at least five years. We repeat images and tumor blood markers several times each year. Depending on the type of tumor and the stage we will inform patients about what we think the risk of the cancer returning is.
New answer by WilliamHawkinsMD (Physician - (Verified))
1
Answer |
7 months ago
It generally takes several weeks to several months to get a transplant liver which gives us a chance to maximize the potential for success. This ranges from the simple like nutrition and exercise to the complex like pre-operative chemotherapy to control tumors. It really depends on the patient’s individual needs, the cause of the liver failure, and the stage of the tumor. Often embolization can be used to keep a tumor in check while we wait for a liver to become available.
New answer by WilliamHawkinsMD (Physician - (Verified))
1
Answer |
7 months ago
Patients are recovered for about a week in the hospital and then for several more weeks with close monitoring at home. A lot depends on the health of the patient prior to the transplant. Healthier patients have shorter hospitalizations. The requirements for discharge are similar to other major operations. The patient needs to be able to sustain themselves on food, have working intestinal tract and good pain control. The medicine to prevent rejection is a long term commitment and is followed closely for a very long term.
New answer by WilliamHawkinsMD (Physician - (Verified))
1
Answer |
7 months ago
This is a question most relevant to hepatocellular cancer (HCC). This tumor arises most frequently in a sick liver where there is a chronic infection. Liver transplant can be the best option to remove the tumor and replace the sick liver. Transplant works best when the tumor is not very advanced and the liver is at high risk for developing new tumors. Surgery works best when the tumor is not very advanced and the remaining liver is relatively healthy. Transplant livers are a scarce resource and we must balance the risk of giving a liver to a patient who is likely to have a recurrent cancer so we go back to surgery when the liver tumor is more advanced even when the liver would do better with a transplant. Sometimes we get into a situation where the patient’s tumor is too advanced for transplant and the liver is not healthy enough for surgery and then we try to shrink the tumor so that we can do one or another of these therapies at a future date. There are other patient requirements for a transplant like not drinking if the patients liver disease is partly or wholly related to alcohol abuse.
New answer by WilliamHawkinsMD (Physician - (Verified))
2
Answers |
7 months ago
This will depend on the answer to the following three questions. 1) What type of liver tumor? Hepatocellular, cholangiocarcinoma and metastasis (from colon) are the three most common malignant liver tumors. 2) What stage is the tumor? We will want to know if the tumor confined to the liver or if it has already spread elsewhere. If it is confined to the liver we will try to determine how much of the liver is involved and how healthy is the remaining liver is. 3) What is the fitness of the patient? Treatments for liver surgery range from relatively mild to maximally invasive. Surgery and chemotherapy are both relatively involved treatments and require a greater degree of fitness.
New answer by WilliamHawkinsMD (Physician - (Verified))
1
Answer |
7 months ago
This depends on what is already known at the first visit. There is a process that we go through in working up a potential liver cancer. Step one is to name the lesion. This can often been accomplished by history, physical exam, radiologic assessment, blood work and sometimes a biopsy. Step two is to stage the tumor and asses the patients and the liver’s fitness for treatment. This is generally accomplished with radiologic tests and blood work. Step three is to determine the optimal treatment for tumor, stage and patient fitness. If the patient presents with an incidentally found mass we start at step one. If the patient comes with a diagnosis and imaging we may skip directly to step three.
New answer by WilliamHawkinsMD (Physician - (Verified))
1
Answer |
7 months ago
It takes a team of doctors to take care of patients with liver cancer in an optimal fashion. At different times one or another of the doctors will be the captain of the ship depending on the needs of the patient and the stage of the tumor. Patients may come to the team through any door, and the surgeon, oncologist, or gastroenterologist will sort out the most appropriate next step. The surgeon is often the best first visit when the diagnosis is uncertain and in early stage cancers when resection is most likely the best option.
New answer by WilliamHawkinsMD (Physician - (Verified))
1
Answer |
7 months ago
WilliamHawkinsMD's Profile
Newsletters
Sign up for email updates of the latest news, best answers, and featured experts.
Benefits
Custom health, wellness, & medical offers including clinical trials, market research opportunities, & new programs.
Share TalkAboutHealth
To share TalkAboutHealth with friends, type their email addresses here (separated by commas):
From:
Add a personal note here:
Please join TalkAboutHealth and you will be able to ask questions.
Your question to WilliamHawkinsMD:
2) Background Info (optional): What context or background information is relevant to this request?
Notes:
The more clear and thorough your request, the more likely you will receive support.
Many of our members are learning from this information or english might not be their first language. Please use standard english and spell out all words. For example, use 'you' instead of 'u'.
The more clear and thorough your request, the more likely you will receive support.
Many of our members are learning from this information or english might not be their first language. Please use standard english and spell out all words. For example, use 'you' instead of 'u'.
Newsletters
