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Dr. Hwang specializes in early detection of gastrointestinal malignancies including esophageal cancer, gastric (stomach) cancer, pancreatic cancer, bile duct cancer and colon cancer. Dr. Hwang performs advanced endoscopic procedures including EUS-FNA, ERCP and enteroscopy. In addition, Dr. Hwang also performs per-oral endoscopic myotomy (POEM), endoscopic mucosal resection (EMR) to resect large colorectal polyps, and endoscopic submucosal dissection (ESD) to resect early esophageal, gastric, and colorectal cancers. Dr. Hwang has both a clinical and research interest in improving the early detection of gastric cancer. He is the Principal Investigator of the GAstric Precancerous conditions Study (GAPS), a prospective study of patients with gastric intestinal metaplasia and other precancerous conditions which combines comprehensive clinical and endoscopic data with a large bio-specimen repository. His research group uses both epidemiologic and translational approaches to understand risk factors for gastric cancer, and develop biomarkers to improve the early diagnosis of gastric cancers. He also directed public policy efforts to increase recognition of gastric cancer risk among high-risk populations, and serve as the Chairperson of the Asian American Stomach Cancer Disparity Task Force. Dr. Hwang received his bachelor's degree from the University of Illinois at Champaign-Urbana in electrical engineering. He then received his M.D. degree from the University of Chicago and his Ph.D. in bioengineering from the University of Washington. He did his residency in internal medicine and fellowship in gastroenterology at the University of Washington and was a faculty member at the University of Washington from 2004 to 2017. He has been selected as one of “Seattle’s Top Doctors” by both Seattle Magazine and Seattle Metropolitan Magazine. Dr. Hwang is board certified in gastroenterology. He is active with local, national and international professional societies. He is a fellow of the American Society of Gastrointestinal Endoscopy (FASGE) and is a past-president of the Pacific Northwest Gastroenterology Society.In addition to his clinical activities, Dr. Hwang is interested in medical device innovation. Dr. Hwang actively participates in research related to treatment of pancreatic cancer with focused ultrasound. He currently has NIH funding to investigate the use of focused ultrasound for enhancing drug delivery to pancreatic tumors. He is the current president of the International Society for Therapeutic Ultrasound (ISTU).
Specialize in early detection of gastrointestinal malignancies including esophageal, gastric, pancreatic, bile duct & colon cancers. I have both a clinical & research interest in improving the early detection of gastric cancer in particular. I am the PI of the Gastric Precancerous conditions Study, a prospective study of patients with gastric intestinal metaplasia & other precancerous conditions which combines comprehensive clinical & endoscopic data with a large bio-specimen repository.
Magnesium for Peroral Endoscopic Myotomy
Postoperative pain after peroral endoscopic myotomy occurs due to involuntary esophageal
smooth muscle spasms. Magnesium has antispasmodic properties as a smooth muscle relaxant.
This study hypothesizes that among patients having peroral endoscopic myotomy, magnesium will
reduce the incidence of postoperative pain while decreasing perioperative opioid
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The GAstric Precancerous Conditions Study
Gastric cancer afflicts 27,000 Americans annually and carries a dismal prognosis. One reason
for poor outcomes is late diagnosis, as the majority of gastric cancers in the United States
are diagnosed at a relatively advanced stage where curative resection is unlikely. Gastric
intestinal metaplasia (GIM) is a precancerous change of the stomach which increases risk for
subsequent gastric cancer multiple-fold.
The Gastric Precancerous Conditions Study (GAPS) is an observational study with two
over-arching objectives: 1) improve the non-invasive identification of patients with GIM, and
2) develop biological markers to predict the subset of GIM which will progress onto gastric
To achieve Aim 1, a case-control study (N=300 pairs) matching cases of GIM with
age-/gender-matched controls will be recruited form the population of subjects undergoing
clinically-indicated endoscopy. Determination of gastric pathology will be made by two,
independent gastrointestinal pathologists. At time of endoscopy, a detailed clinical
questionnaire is administered by face-to-face interview. Saliva and blood is collected prior
to endoscopy. At time of endoscopy, protocoled clinical biopsies (per Revised Sydney
Protocol) as well as additional research specimens are collected. Scoring of GIM will be
performed based on the Operative Link for GIM scoring system.
To achieve Aim 2, patients with histologically-confirmed GIM (N=300) will be followed
longitudinally. Biennial endoscopic surveillance will be performed, with repeat biopsies,
specimen collection, and histologic scoring. Progression of GIM will be defined as upstaging
of GIM score, or development of either dysplasia or carcinoma on any biopsy.