Upper gastrointestinal cancer
The Royal Marsden offers a comprehensive specialist service for the staging, treatment and hospital care of patients with upper gastrointestinal cancers in Chelsea, London, and Sutton, Surrey. Upper gastrointestinal cancers include liver cancer, oesophageal cancer, pancreatic cancer and stomach cancer.
An individualised treatment plan is made for each patient by a specialist multidisciplinary team of medical oncologists, clinical oncologists, surgeons, histopathologists, molecular pathologists, gastroenterologists and clinical nurse specialists. Services available at the Royal Marsden hospital include:
| Diagnosis, tests and investigations |
Primary assessment and diagnosis (oesophageal cancer only)
Specialist review and second opinion
Staging and investigation |
| Cancer genetics |
Yes |
| Chemotherapy |
Yes |
| Radiotherapy |
Yes |
| Surgery |
Yes, including minimally invasive surgery |
| Critical care |
Yes |
| Rehabilitation |
Yes |
| Palliative and supportive care |
Yes |
| Clinical trials |
Yes |
Staging and investigation
Accurate diagnosis and staging is central to the appropriate management of patients with upper gastrointestinal cancers. Available radiological tests at the Royal Marsden include:
- contrast-enhanced spiral CT
- MRI scans
- PET/CT scans
- endoscopic ultrasound (EUS)
- endoscopic retrograde cholangiopancreatography (ERCP)
- magnetic resonance cholangiopancreatography (MRCP)
Treatment
The management of upper gastrointestinal cancers depends on the presenting stage of disease and patient fitness. Patients with disease that has not spread will be considered for surgery or radiotherapy, and chemotherapy can also be of benefit. Patients with inoperable or metastatic disease will be considered for chemotherapy and maybe radiotherapy.
Chemoembolisation for liver cancer
In some cases, chemoembolisation can be used to treat liver cancer. This involves blockage of the blood supply while anti-cancer drugs are administered directly into the tumour.
Clinical trials
We believe that research is essential in order to raise standards of cancer care, and to improve the prognosis of patients with gastrointestinal cancers. Not all patients are suitable or willing to participate in a clinical trial. However, our philosophy is to give patients the option of a research trial if one is available.