The Colon Cancer-Free Zone

Dr. Kenneth Chang developed one of the first programs in the United States to integrate research in gastroenterology with leading-edge cancer diagnosis, prevention and care.

When Dr. Kenneth Chang comes home each night to his wife and three children, the answer to “What did you do today, Daddy?” is pretty phenomenal. On a routine day, Chang, who is chief of gastroenterology and hepatology and executive director of the H.H. Chao Comprehensive Digestive Disease Center, has saved a cancer patient’s life or even spared someone from ever having the disease.

In the early 1990s, Chang, a gastroenterologist, began to use endoscopic ultrasound—an imaging technology he was interested in for gastrointestinal (GI) disorders but one that would later become crucial for cancer staging, prevention and treatment. “I knew this technology might eventually help many people, but my focus wasn’t cancer yet,” he says.

Around the same time, though, Chang’s father was diagnosed with colon cancer. Chang moved his dad from the East Coast to UC Irvine Medical Center for successful treatment.

“That’s when I really had an eye-opening experience,” he recalls. “I saw firsthand that there were GI doctors who understood everything about the digestive system but little about cancer treatment. And there were cancer doctors who knew about chemotherapy, but little about the digestive system.” In this “ah-ha” moment, he realized there was a need for GI specialists with a focus on cancer.

“One of our aims here is to make Orange County colon cancer-free.”

Chang believes the next turn of events was nothing short of divine intervention: He received a job offer from the Chao Family Comprehensive Cancer Center. He was tasked with developing one of the first programs in the United States to integrate research in gastroenterology with leading-edge cancer diagnosis, prevention and care.

A decade later, with a generous grant from the Chao Family, he founded the H.H. Chao Comprehensive Digestive Disease Center (CDDC), where a multidisciplinary team of gastroenterologists, surgeons, medical oncologists, radiation oncologists and other healthcare professionals treat more than 20,000 patients a year. The CDDC is one of the few facilities in the nation to provide full-spectrum care specifically for disorders of the esophagus, stomach, liver, pancreas, small intestines, colon and rectum.

“I came to work here and never looked back,” he says. “I immediately knew this was the place for me. I’m grateful every day that I’m able to help treat and prevent cancer.”

Pioneering Research

Chang and his team fight some of the most daunting cancers: esophageal, pancreatic and colon cancers, for example. His pioneering research with endoscopic ultrasound (a sophisticated tool to detect and stage cancers of the GI tract) and radiofrequency ablation (a less invasive and more effective treatment for an esophageal precancer called Barrett’s esophagus) spares lives and has been the source of more than 200 publications.

Pancreatic cancer, one of the deadliest cancers, has also met a formidable enemy in Chang, who at UC Irvine Health has introduced processes that detect and treat precancerous pancreatic cysts, essentially curing some people before they ever develop cancer. He’s also incorporates gene sequencing for patients with pancreatic cancer, which means these patients immediately get the most effective treatment for their tumor’s individual genetic makeup.

As if this isn’t enough, he has other lofty goals for the cancer center. “One of our aims here is to make Orange County colon cancer-free,” he says. Since early detection could almost entirely eliminate this formidable cancer, under Chang’s direction an innovative public health campaign is quickly making “colonoscopy” an OC buzzword.

Chang’s route to cancer maverick, however, was a bit circuitous. He was accepted out of high school to an accelerated program at Brown University. Young for his graduating class, he took time off prior to his last year of medical school and volunteered with doctors in a remote fishing village in Taiwan.

“That’s where I really learned the power of innovation. The veteran doctors there became my heroes because they solved problems using whatever they had,” he says. At times these doctors fashioned IVs and needles out of fishing supplies, doing whatever they needed to do to save lives.

Every day Chang brings the courage and innovative spirit of the doctors in that remote village to work with him at the cancer center. “Some people say it’s crazy that I think Orange County can be colon cancer-free or that I believe pancreatic cancer can be a disease that’s entirely manageable, like many other cancers. When I look at my patients, though, I know it’s not crazy. It’s simply what needs to be done. You have to put the idea out there. That’s the only way you can turn the impossible into the possible. That’s what we do here.”