Upper gastrointestinal

Upper gastrointestinal cancers include oesophageal cancer, stomach cancer, small bowel cancer, pancreatic cancer, liver cancer and cancers of the biliary system.

Accurate investigation 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)


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.

For people who require major surgery on their stomach or oesophagus we have made a film to provide more information on what this involves when being treated at The Royal Marsden:

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.