Upper GI Cancer Surgery in Sydney
What is the upper GI (gastrointestinal) tract?
The GI or digestive tract extends from the mouth to the anus. As you chew food, saliva breaks it down. The upper GI tract starts the digestive process and once swallowed, food travels down the oesophagus and into the stomach for full digestion and processing of the food’s nutrients for use throughout the body.
What are upper GI cancers?
Upper GI cancers are those that occur in the upper section of the digestive systems. The areas of the upper GI tract that can be affected by cancer include:
Oesophagus: this is the tube or pipe that food travels down from the mouth to the stomach
Stomach: is where chewed food is introduced to gastric juices and digested.
Pancreas: this is where enzymes that help in food digestion are made along with hormones used in the body such as insulin
Liver: the liver has many functions including the making of bile – a fluid which breaks down fats in food, stores sugars as fuel for the body, and the processing of medicines, alcohol, and some poisons to remove them from the body.
Gall bladder: this is a small organ located next to the liver and attached to the bile ducts that helps make and store bile.
What is cancer staging?
Cancers that involve a tumour are staged into 5 broad groups. Cancers that involve the lymphatic system, the brain or the blood have their own staging system, but all tell how advanced the cancer is and allow your doctor to properly plan your treatment. The stages for upper GI cancer are:
- Stage 0 – also called carcinoma in situ. There is no cancer, only abnormal cells that have the potential to become cancerous. This is also called carcinoma in situ.
- Stage I –also called early-stage cancer. The cancer is small and only in one location.
- Stage II and Stage III. The cancer is larger and has grown into nearby tissues or the lymph nodes.
- Stage IV – also called advanced or metastatic cancer. The cancer has spread to other parts of the body.
What are some common symptoms of conditions of the upper GI tract that may indicate cancer?
Some common symptoms that can indicate problems with the upper GI tract include burping, difficulty swallowing, heartburn, reflux, an upset stomach, or abdominal pain. Each type of upper GI cancer has different symptoms and may require different treatment.
Oesophageal cancer – what are the symptoms?
The oesophagus connects the mouth to the stomach, and cancer may form at any point along the length of the oesophagus.
Most often, the first signs and symptoms for oesophageal cancer is pain when swallowing or the feeling that food is “sticking” when swallowing.
Initially there is difficulty swallowing solid foods, but this can progress to difficulty in swallowing liquids.
Oesophageal cancer can cause weight loss due to trouble swallowing.
Other symptoms include:
- Chronic cough
- Hoarseness
- Vomiting
Oesophageal cancer – how is it diagnosed and treated?
Oesophageal cancer is most often diagnosed by an upper endoscopy. This is a day surgery procedure where your Sydney Surgical Clinic specialist uses a scope to look at the inside of the oesophagus. If during the endoscopy a tumour is seen, the surgeon takes a biopsy which is then tested at a pathology laboratory to determine whether the tumour is cancerous.
Once diagnosis of oesophageal cancer is confirmed, more tests are generally required prior to the commencement of treatment to determine the stage of the cancer, and the type of treatment needed which may involve surgery, chemotherapy, radiation therapy or a combination of these treatments.
Tests may include:
- Endoscopy with ultrasound
- CT scan
- PET scan
Stomach cancer – what are the signs and symptoms?
Also called gastric cancer, stomach cancer starts in the stomach. Most of these cancers are slow to develop over a number of years and symptoms go undetected. In stomach cancer, the cells that form the tumour determine the type of cancer. Common symptoms of stomach cancer include:
- Fatigue
- Weight loss
- A feeling of bloating or fullness after eating small portions of food
- Persistent and severe heartburn, indigestion, or both
- Nausea and vomiting
- Stomach pain
Stomach cancer - how is it diagnosed and treated?
Procedures and tests used in the diagnosis of stomach cancer can include:
- Upper endoscopy
- Imaging tests such as CT scan, X-ray, or a Barium Swallow
In some instances, it may require exploratory surgery to fully understand the stage and extent of stomach cancer to allow your specialist to determine the best treatment. Treatment may include:
- Further surgery
- Chemotherapy
- Radiation therapy
Pancreatic cancer – what are the signs and symptoms?
Pancreatic neuroendocrine tumours are slow growing and can be either benign or cancerous. Often times symptoms are vague, and it is common for pancreatic cancer to be advanced before diagnosis.
The recognition of symptoms and early intervention plays a vital role in better outcomes.
Early signs and symptoms of pancreatic cancer are:
- Jaundice – a yellowing of the eyes and skin
- Abdominal pain
Other symptoms that can develop with pancreatic cancer are:
- Loss of appetite and unintended weight loss
- Discoloured stools
- Dark urine
Pancreatic cancer - how is it diagnosed and treated?
If your doctor suspects pancreatic cancer, they will arrange for different tests to confirm the diagnosis. This can include:
- Imaging tests such as ultrasound, CT scan, MRI, PET scan
- Endoscopic ultrasound
- Tissue biopsy
- Blood tests
The best treatment results for pancreatic cancer are surgical removal of the tumour. Unfortunately, only about 20% of those diagnosed with pancreatic cancer are suitable candidates for surgery at the time of their diagnosis. Other treatments can include chemotherapy and radiation therapy.
Liver cancer – what are the signs and symptoms?
Tumours of the liver may be primary (meaning they started from the liver) or metastatic (meaning they started at a different part of the body and have spread to the liver). Symptoms and signs of liver cancer often occur later in the disease. Often times, liver cancer symptoms do not present until the later stages of the disease. Listed are some of the symptoms related to liver cancer. It is important to note that if you have any of these symptoms, it doesn’t mean you have liver cancer as they can be related to other conditions. However, if you have symptoms, you should attend your doctor for review, as early intervention and treatment allows for better treatment outcomes.
Symptoms associated with liver cancer include:
- Unintentional weight loss
- Lack of appetite
- Feeling full after eating small portions
- Nausea and or vomiting
- An enlarged liver that can be felt as fullness under the ribs on the right side
- An enlarged spleen that can be felt as fullness under the ribs on the left side
- Jaundice (yellowing of the skin and eyes)
- Bloating or fluid build-up in the abdomen
- Itching
Liver cancer – how is it diagnosed and treated?
There are a number of tests that can be used to diagnose liver cancer including blood tests, imaging scans (ultrasound, CT scan, MRI) and in some issues a tissue sample is taken for biopsy.
Treatment for liver cancer is tailored for each individual patient and is based on the type of tumour (primary or metastatic) and the stage of the tumour. Treatment can include:
- Surgery to remove the tumour
- Ablation
- Embolization
- Chemotherapy
- Radiation therapy
- A combination of these treatment techniques.
Gallbladder cancer – what are the signs and symptoms?
As with most upper GI cancers, gallbladder cancer doesn’t usually cause symptoms until later in the disease. However, sometimes symptoms can appear sooner and assist in an early diagnosis. Early diagnosis and intervention for all cancers will usually result in better treatment outcomes. Listed are some of the more common symptoms gallbladder cancer, however it should be noted that gallbladder cancer is a rare disease and if you have these symptoms, they are likely the result of another condition.
More common symptoms for gallbladder cancer include:
- Abdominal pain – most often in the right part of the belly
- Nausea and or vomiting
- Jaundice (yellowing of the eyes and skin)
- Lumps in the belly (if the cancer blocks the bile ducts, the gallbladder can swell and spread to the liver)
Less common symptoms of gallbladder cancer include:
- Appetite loss
- Unintentional weight loss
- Swelling in the abdomen
- Dark urine
- Fever
- Itchy skin
- Stools that are light in colour or greasy
Gallbladder cancer – how is it diagnosed and treated?
If you are experiencing any of these symptoms, you should attend your doctor. Once referred to a specialist, there are a number of tests that may be arranged to confirm a diagnosis. These include:
- Blood tests
- Abdominal ultrasound
- CT scan or MRI
- ERCP (a special type of endoscopy)
If gallbladder cancer is diagnosed, the treatment plan is tailored to the individual and can include:
- Surgery to remove the tumour
- Radiation therapy
- Chemotherapy
- A combination of the above treatments
Conclusion
Cancer conditions of the upper GI tract can be difficult to detect and diagnose in the early stages of the disease. If you are experiencing worrying symptoms, speak to your GP. If they are concerned, they will arrange for a referral to an upper GI specialist such as Dr Fedorine.
