The MUHC's Therapeutic Endoscopy Unit: A global leader in bile duct cancer care

At the McGill University Health Centre, Dr. Yen-I Chen and Dr. Ali Bessissow are pioneering therapeutic endoscopy, an innovative spin on endoscopy—a diagnostic procedure performed using a flexible tube and camera that allows physicians to examine the digestive tract, take biopsies, and remove foreign objects. Supported by the MUHC Foundation, the MUHC’s gastroenterologists are taking endoscopy one step further, from diagnostic to interventional—enabling complex interventions that particularly benefit people living with bile duct cancers, like colon and pancreatic.

“One of the reasons why pancreatic cancer patients suffer from difficult symptoms is because of the high rates of local complications around the tumor, particularly when it grows and blocks the intestines or bile duct—meaning that the patient can no longer receive chemotherapy or even eat,” explains Dr. Chen.

In 2018, Dr. Chen and Dr. Bessissow performed Canada’s first endoscopic bypass, a procedure that not only gets around these deadly complications by making a new connection between the stomach and small intestines, but that can get patients eating again and back on track for their cancer treatments.

“That first procedure really transformed our practice and the landscape of what’s possible in terms of caring for patients with pancreatic cancer. Before endoscopic bypass, the typical path forward for these patients was regular stents—thin tubes inserted to relieve blockages, offering only temporary relief—or palliative care. Now, they’re not only able to eat again, but they can be discharged from the hospital,” says Dr. Chen.

This groundbreaking procedure is providing hope to patients living with pancreatic cancer and their families in a way that once wasn’t thought possible. For example, cancers that previously required a surgical bypass—entailing a hospital stay of at least two weeks—can now be treated through this minimally invasive endoscopic bypass. Since patients can begin eating immediately and return home after 48 hours, this approach is highly beneficial to both the patient and the hospital, freeing up valuable resources for those who need them. 

Not only is pancreatic cancer very aggressive, but it is also the third most common cause of cancer-related deaths in Canada. There is a great urgency to offer new treatment options for these patients, and the therapeutic endoscopy approach is seen as having immense potential to increase positive outcomes and extend lives.

“At the MUHC, we are exploring promising new techniques to address complications related to these cancers, like making new connections to drain the bile duct in a way that is less invasive than the classic approach. We are proud to have conducted the first randomized trial here in Canada,” adds Dr. Chen.

The MUHC’s Therapeutic Endoscopy Unit isn’t just globally recognized for its leadership—it also attracts world-class talent like Dr. Jeremie Jacques, a renowned visiting professor from France who is training the team on a very specialized technique known as endoscopic submucosal dissection (ESD). ESD is a minimally invasive procedure that removes early cancer from the colon without ever opening the patient up. For doctors like Yen-I Chen, it’s transforming the future of cancer care and raising the standard of care for patients at the MUHC.

“This procedure is very difficult to do,” explains Dr. Chen. “But thanks to Dr. Jacques, doctors from the MUHC and its research institute are among the first in Canada to learn these lifesaving and life-changing techniques. We’re talking about techniques that are on the cutting edge of health care innovation. Think of the lives we can impact.”

Four endoscopists working with Dr. Jacques have already begun removing these early cancers from MUHC patients, demonstrating just how the MUHC and RI-MUHC’s proximity—facilitating a unique bench-to-bedside approach—directly benefits our patients. Essentially, the new knowledge being uncovered in training at the RI can immediately impact patients being treated just a few floors away.

“It really is innovation at its finest. We're literally going to be the leaders within North America, not just in Canada,” shares Dr. Chen.

Despite making incredible strides and receiving global recognition for therapeutic endoscopy, Dr. Chen and his team have been working with limited resources—both in terms of spacing and needed technology. This is why the MUHC Foundation is committed to raising critical funds for a new, state-of-the-art Therapeutic Endoscopy Unit, which will be equipped with highly specialized equipment that cannot be found in regular gastroenterology units.

“This support from the MUHC Foundation is crucial because a new unit will enable us to treat even more patients endoscopically, reduce wait times, and free up space for patients who truly don’t have any other options besides surgery,” says Dr. Bessissow.

As therapeutic endoscopy undergoes rapid expansion, this new unit will not only sustain the ongoing transformation in the treatment of pancreatic diseases and cancers but also serve as a platform to initiate a wide range of new, minimally invasive procedures that are currently evolving at an extraordinary pace. With the support of MUHC Foundation donors, the MUHC will be able to offer the highest standard of care to patients across Quebec and Canada.

Because the doctors believe so deeply in the need for this new unit, the gastroenterology team is matching every donation, dollar-for-dollar, up to $50,000—showcasing their commitment to optimizing care and truly maximizing the potential of this innovative treatment for bile duct cancers.

“The MUHC Foundation is thrilled to support the Therapeutic Endoscopy Unit, as it represents the type of medical innovation that sets the MUHC apart and cements its leadership in this evolving field. With support from our donors, we are helping redefine what is medically possible and bringing hope to the most vulnerable patients and their families,” says Marie-Hélène Laramée, President and CEO of the MUHC Foundation.

Click here to support the Therapeutic Endoscopy Unit and have your donation go twice as far. You can be a part of this revolutionary moment in cancer care, helping to bring innovative and minimally invasive solutions to patients who once thought they had none.