STAGE Center at Methodist Hospital Provides Full Scope of Gastroenterology Care to South Texas

By: Carrie Frye
Wednesday, March 25, 2015

The South Texas Advanced Gastroenterology (STAGE) Center at Methodist Hospital combines experience and expertise to deliver comprehensive care to patients throughout the region.

Abdominal pain, the most common gastrointestinal symptom, prompted more than 15 million clinical visits in the U.S. in 2009, according to a study published in Gastroenterology. Additionally, the CDC identifies diseases of the digestive system as the cause of 51 million visits to physician offices, hospital emergency rooms and outpatient clinics nationwide annually. Recognizing South Texas’ need for advanced diagnostic and therapeutic treatments for digestive disorders, the STAGE Center at Methodist Hospital was formally established in mid-2014, offering specialized gastroenterology care provided by an expert, multidisciplinary team with a patient-centered approach.

“Methodist Hospital is committed to serving the needs of this community and sought to meet this important healthcare need through the formation of the STAGE Center,” says Christopher Fincke, MD, Co-medical Director of the STAGE Center at Methodist Hospital. “Many patients’ lives have been positively influenced, and many more patients will benefit in the future.”

Specialized GI Care

The STAGE Center’s advanced diagnostic and therapeutic capabilities, along with its accessible technologies, extend its treatment proficiencies so that patients with the most complex conditions may be referred confidently.

“We are highly experienced in diagnosing, staging and treating both benign and malignant gastrointestinal tumors,” says Alejandro Pruitt, MD, FACG, Co-medical Director of the STAGE Center at Methodist Hospital. “As an example, utilizing innovative endoscopic ablation and resection techniques, we can treat the esophagus, stomach or colon for pre-cancerous and early cancerous lesions. This technique obviates the need for much more aggressive, risky and costly surgery. We also help surgeons and gastroenterologists throughout South Texas manage complex biliary and pancreatic problems, working closely with our team of highly skilled technicians, nurses, surgeons and radiologists.”

The STAGE Center’s five procedure rooms are outfitted with state-of-the art equipment, helping the center remain on the cutting edge of advanced endoscopic techniques. Patient safety and comfort are also high priorities of the center, augmented by ease of access to top-notch anesthesia services.

“We perform a multitude of services, including the evaluation and treatment of pancreatic cancer, pancreatic cysts, submucosal lesions in the upper gastrointestinal tract, biliary tract tumors, early cancers and Barrett’s esophagus,” says Dr. Fincke, a board-certified gastroenterologist who has served patients at the hospital for seven years and who trained with Dr. Pruitt. “Methodist Healthcare has a full-time genetic counselor who provides complimentary consultative services, which are invaluable when a patient may have a genetic syndrome.”

Endoscopic Expertise

The specialized expertise of Drs. Fincke and Pruitt allows them to perform more than 1,500 advanced endoscopic procedures annually in the treatment of digestive disorders at the STAGE Center. They pride themselves on being accessible to referring physicians, providing expedient service to their patients, communicating results and helping to orchestrate treatment plans.

“Advanced endoscopic treatments are growing both in the number of techniques available and the volume of demand by patients,” Dr. Fincke says. “We have state-of-the-art diagnostic studies and endoscopic therapies available here in San Antonio to keep patients from having to travel long distances for these procedures.”

“From the routine to the advanced, we can provide the full spectrum of endoscopic procedures,” says Dr. Pruitt, who brought his endoscopic expertise to Methodist Hospital in 2006. “We can complete failed or incomplete colonoscopies or ERCPs from other institutions. We can also perform tissue acquisition via endoscopic ultrasound from gastrointestinal and non-gastrointestinal organs, including all regions of the pancreas and liver as well as the lymph nodes in the chest and abdomen.

“We are a high-volume Barrett’s treatment center, performing HALO radiofrequency ablations, a service that draws patients from local and distant regions. This procedure eradicates Barrett’s esophagus, a condition that has resulted in an epidemic of esophageal cancer.”

Another procedural technique, gastrointestinal endoscopic mucosal resection (EMR), allows Dr. Fincke and Dr. Pruitt to remove cancerous lesions from the digestive tract safely and efficiently, optimizing patient outcomes, often eliminating the need for more aggressive surgery or chemotherapy.

“We do endoscopic mucosal resections of the upper and lower gastrointestinal tract routinely, removing small and large mucosal and submucosal lesions that would typically require surgery,” Dr. Pruitt says. “We also ease the suffering many of our patients experience when they have an obstruction of their esophagus or stomach, offering endoluminal stenting to palliate their malignancies. In addition, we perform celiac nerve blocks to alleviate abdominal pain.”

Multidisciplinary Team Approach

Methodist Nurses 175STAGE Center clinicians and practitioners embrace a multidisciplinary approach in order to provide the highest-quality patient care.

“Our team of skilled specialists, nurses and technicians work together to ensure patient needs are met throughout the treatment process,” Dr. Pruitt says. “Collaborating with our interventional radiology, oncology and surgical colleagues allows us to provide the most advanced cancer therapies for the betterment of our patients.”

As another aspect of collaboration, the STAGE Center physicians participate in a multidisciplinary tumor board conference. Using NCCN Guidelines, clinicians can discuss complex cases in a formal, academic environment.

“We confer and share ideas regarding patient cases with surgeons, oncologists, gastroenterologists, pathologists and radiologists,” Dr. Fincke says. “We are taking these cases in-depth to examine and further explore treatment options for our patients.”

Enrolling patients in clinical trials pertinent to their disease is one of the ways STAGE Center physicians can potentially optimize outcomes by working side by side with oncologists.

“Dr. Pruitt and I support clinical research,” adds Dr. Fincke, who currently has multiple patients participating in clinical research trials. “The information transmits to our oncologists, who are participating in phase 1 to phase 3 clinical trials.”

The STAGE Center is also involved in a tissue program, in which patients’ tumors are biopsied and samples are donated for further research and study.

“After obtaining the tumor sample for the Cancer Genome Project, researchers study the tumor for DNA mutations that may foster the development of novel treatment agents,” Dr. Pruitt explains. “Patients are able to help others facing a cancer diagnosis with the knowledge gained by this important research.”

Complex GI Nurse Navigator

At the STAGE Center, a Complex GI Nurse Navigator is the direct point of contact for patients and referring physicians. The nurse navigator guides patients through every step of the treatment journey.

Mandy SanMartin 150“As the Complex GI Nurse Navigator at Methodist Hospital, I serve as an advocate for patients diagnosed with cancer or a complex gastrointestinal diagnosis from point of entry, diagnostic studies and treatment plans, through survivorship,” says Mandy San Martin, BSN, RN. “This service reinforces the advice of the physician.

“Our goal is to ensure our patients have adequate knowledge and understanding of their diagnosis and plan of care,” she continues. “Hearing the terrifying and life-changing diagnosis of cancer can be quite devastating. Collaborative efforts of the physicians and the navigator allow the STAGE Center to customize patient care according to individualized needs. We keep referring physicians updated throughout the process and increase communication between the entire multidisciplinary team.”

The Complex GI Nurse Navigator provides concierge-level assistance by addressing patient concerns and coordinating follow-up care, Dr. Pruitt notes.

“The nurse navigator provides an interface between the patients and the medical community,” he says. “She is accessible to alleviate intimidating situations by helping patients navigate the system when they are facing a serious and often life-threatening diagnosis.”

“The whole idea behind the nurse navigator is improving the patient experience,” Dr. Fincke adds. “Any time a patient is diagnosed with a malignancy or a potential malignancy, it is a very overwhelming process. Having a personal assistant to guide patients through the diagnosis, staging and treatment of a potential malignancy is vital to successful outcomes. The nurse navigator makes them feel connected, and we guide the patient through the whole experience via this one point of contact.”

Serving South Texas

Methodist Doctor 175Widening the scope of gastroenterology services and its community reach, the STAGE Center takes patients through diagnosis and treatment, transitioning them back to the care of their referring physicians upon the conclusion of the plan of care.

“We are respectful of the relationship between referring physicians and their patients, and keep communication lines open,” Dr. Pruitt says. “We do not take over the care of the patient unless asked to do so. Many physicians may not know or realize all of the STAGE Center’s capabilities, or that we see patients from Laredo, Del Rio, Victoria, San Angelo and across South Texas.”

Referring physicians can determine their level of involvement in a patient’s plan of care and have one contact in the nurse navigator to discuss all aspects of patient progress.

“The referral process is easy,” San Martin says. “I have physicians who have their staff provide patient records, and I have others who call me directly and some who complete a form. We expedite this process as much as possible.”

“It is a one-stop-shop referral process,” adds Dr. Fincke. “Our nurse navigator ensures that each patient is evaluated, treated and given follow-up care. We strive to maintain the patients’ relationships with their community physicians, and want them to know advanced gastroenterology care is available in South Texas.”

For more information about the STAGE Center at Methodist Hospital, call 210-575-9086 or visit