Treatment for oesophageal cancer, gastric cancer and GIST

Gastro-intestinal or GI cancer is a term for the group of cancers that affect the digestive system. Oesophageal cancer, gastric (stomach) cancer and gastro-intestinal stromal tumours (GISTs) are types of GI cancers that affect both men and women.

What is oesophageal cancer?

Oesophageal cancer occurs when malignant cancer cells form in the tissue of the oesophagus – the tube that transports food and drink from your mouth to your stomach. It can occur in any part of the oesophagus and within different cells. In Australia, oesophageal cancer is most often found at the lower end of the oesophagus where it joins the stomach. If undetected, oesophageal cancer can enter the blood stream or lymph nodes which allows cancer cells to spread to nearby organs (eg lung, liver or bowel) and other parts of the body.

Oesophageal cancer is more common in men, who are more than twice as likely as women to be diagnosed with the disease.

What is gastric (stomach) cancer?

Stomach cancer occurs when malignant cancer cells form in the wall of the stomach. Stomach cancer is a slow-growing cancer that usually begins in the stomach lining before it spreads to the outer layers of the stomach. If undetected, stomach cancer can enter the blood stream or lymph nodes or abdominal cavity around the stomach which allows cancer cells to spread to nearby organs (eg liver or bowel) and other parts of the body.

Worldwide, stomach cancer is the fifth most common cancer type. In Australia, men are approximately twice as likely as women to be diagnosed with it.

What is a GIST?

A gastro-intestinal stromal tumour (GIST) is a rare type of cancer that grows in cells found between muscle layers of the gastro-intestinal tract. The tumour growth usually begins in the connective tissue in the wall of affected organs and grows outwards. GISTs are most often found growing around the stomach and upper intestines but they can occur anywhere in the digestive system and other parts of the body.

GISTs are estimated to cause between 0.1% and 3% of gastro-intestinal cancers in Australia. The risk increases with age, peaking among people in their 50s and 60s.

What is the treatment for oesophageal cancer, gastric cancer and GIST?

Being diagnosed with cancer can be overwhelming. It’s helpful to know what to expect as you begin treatment.

Staging

You may have already had a series of tests to confirm whether you have cancer and if it has spread to other parts of your body.  Working out how far it has spread is called staging. This helps Dr Hopkins and your medical team recommend the best treatment for you.  

The system used to stage oesophageal and gastric cancer is TNM staging. This applies numbers to the size of tumours, whether the lymph nodes are affected and whether the cancer has spread. These scores are combined to provide an overall stage of cancer, from stage 1 (early or limited cancer) to stage 4 (advanced cancer).  

Neo-adjuvant therapy

Today cancer treatment usually involves a combination of therapies. Treatment plans will often include a primary therapy or main treatment (eg surgery to remove the cancer) as well as neo-adjuvant and adjuvant therapy. Neo-adjuvant simply refers to treatment given before the main treatment, while adjuvant refers to treatment given after the main treatment.

Neo-adjuvant therapy may include chemotherapy and/or radiotherapy before any scheduled surgery. The benefits of neo-adjuvant therapy include the opportunity to: 

• Shrink the size of tumours to make them easier to remove with surgery.

• Assess how your cancer responds to different drug combinations or treatment frequency.

• Provide more information to better inform your treatment planning including any surgery and post-surgical options.

Surgery

The surgical procedure required will depend on the type of cancer and your individual diagnosis. Surgery for oesophageal cancer is called an oesophagectomy. Surgery for stomach cancer is called a gastrectomy. The goal of these surgeries is to remove the tumour, surrounding tissues and any affected organs to ensure all the cancer is removed.

Your medical team will keep a close eye on your cancer to see how it is responding to treatment before scheduling surgery.

Adjuvant therapy

Adjuvant therapy is any treatment delivered after the primary treatment. Chemotherapy and/or radiotherapy may be recommended after your surgery to destroy any remaining cancer cells.

Where will I receive treatment?

Dr Hopkins is part of a multidisciplinary team looking after people diagnosed with GI cancers at both public and private hospitals.

If you have any questions about your surgery or would like to make an initial appointment to see Dr Hopkins, please get in touch.