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Upper gastrointestinal (GI) cancer: Treatment, symptoms, advice and help

About upper GI cancer

The upper gastrointestinal tract consists of the oesophagous, stomach, and duodenum and cancer may occur in any one of these organs.

Upper GI cancer: Incidence, age, and sex

Cancer of the oesophagous is the sixth most common cancer in the world. In general, it is a disease of mid to late adulthood, with a poor survival rate. Only 5-10% of those diagnosed will survive for 5 years.

Stomach cancer is the fourth most common cancer worldwide. It is a disease with a high death rate (~800,000 per year) making it the second most common cause of cancer death worldwide after lung cancer. It is more common in men and in developing countries.

Signs and symptoms of upper GI cancer: Diagnosis

Most oesophageal cancers present with mechanical symptoms, principally dysphagia, but sometimes also regurgitation, vomiting, painful swallowing and weight loss.

Stomach cancer is often asymptomatic or causes only nonspecific symptoms in its early stages. By the time symptoms occur, the cancer has often reached an advanced stage.

Late symptoms include abdominal pain, vomiting ,diarrhea or constipation, bloating of the stomach after meals ,weight loss ,weakness and fatigue. Endoscopy is the first-line investigation for most patients. Biopsy specimens taken via the endoscope are crucial for accurate diagnosis.

Causes and prevention of upper GI cancer

Common aetiological factors for oesophageal cancer are tobacco and alcohol.Infection by Helicobacter pylori is believed to be the cause of most stomach cancer while autoimmune atrophic gastritis, genetic factors, smoked foods, salted fish and meat, and pickled vegetables appear to increase the risk of stomach cancer.

Eating fresh fruits and vegetables that contain antioxidant vitamins (such as A and C) appears to lower the risk of stomach cancer.

Upper GI cancer: Complications

Hoarseness due to recurrent laryngeal nerve palsy is a sign of advanced and incurable stage of the disease. Palpable lymphadenopathy in the neck is likewise a sign of advanced disease. Cancer may spread to nearby tissues and more distant organs.

Upper GI cancer: Treatment

As with any cancer, treatment is adapted to fit each person's individual needs and depends on the size, location, and extent of the tumor, the stage of the disease, and general health.

Treatment for cancer may include surgery, chemotherapy, and/or radiation therapy. New treatment approaches such as biological therapy and improved ways of using current methods are being studied in clinical trials.