Stomach and gullet cancer is medically known as oesophago-gastric (OG) cancer.
Oesophageal cancer is cancer of the gullet and gastric cancer is cancer of the stomach.
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Types
Macmillan has detailed information on the types of:
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Referral
If your GP suspects you may have stomach or oesophageal cancer, you will be referred to one of the hospitals in Belfast Trust.
You will then be contacted about an appointment.
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Investigations and diagnosis
Investigations usually begin with your GP, who will ask about your symptoms and general health before examining you.
Your GP may also:
- carry out some blood tests
- arrange for you to have an urgent endoscopy at your local hospital
An endoscopy looks inside your upper digestive tract using a flexible tube with a tiny camera attached. This passes through your oesophagus (food pipe) and stomach. Samples (biopsies) may be taken of any abnormal looking areas.
You may be sent for a barium meal following your endoscopy if you require further investigations. This involves drinking a white chalky liquid, which shows up the oesophagus and stomach on a series of x-rays. However, very few people require this test.
When your tests are complete, you will have a clinic appointment to discuss the results with your local hospital team. At this appointment, you will find out if you have cancer.
Further tests
If your initial tests confirm oesophageal or stomach cancer, you may require further tests to find out if the cancer has spread to other parts of your body. This is known as staging cancer.
You may also have some tests arranged to assess your general fitness.
These further tests may include:
- CT scan
- PET scan (oesophageal investigations only)
- endoscopic ultrasound (oesophageal investigations only)
- biopsy
- pulmonary function tests
- exercise tolerance tests
- laparoscopy
All tests are usually completed within four weeks of when the cancer was first suspected.
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Multi-disciplinary team
The Oesophago-gastric Cancer Multi Disciplinary Team (MDT) includes experts in the diagnosis and treatment of stomach and oesophageal cancer.
The team meets every week to discuss the results of tests and the best treatment plans for patients. Any decisions on treatment will then be discussed with the patient.
A copy of any discussions will be sent to the patient’s GP.
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Treatment
There are a number of treatments available for stomach and oesophageal cancer.
You may have one type of treatment or a combination of treatments depending on your circumstances.
Treatment types include:
- surgery for stomach cancer / surgery for oesophageal cancer
- chemotherapy for stomach cancer / chemotherapy for oesophageal cancer
- radiotherapy for stomach cancer / radiotherapy for oesophageal cancer
- specialist palliative care
Consent
You will be asked to sign a consent form before treatment. No medical treatment can be given without patient consent.
It is important that you read and understand this form before signing it.
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Symptom control
Difficulty swallowing
If you have difficulty swallowing, your doctor may suggest treatment to help relieve this. This may include some chemotherapy or a short course of radiotherapy.
You could be offered a number of other treatments to relieve a blockage in your gullet or stomach or improve symptoms. However, these procedures won’t cure the cancer.
Stenting
A wire mesh tube (stent) is inserted into your oesophagus.
The stent helps keep your oesophagus or stomach open, which should help you eat more comfortably.
Laser treatment
Laser treatment is usually used for oesophageal cancer. It involves the use of a powerful beam to identify and remove the cancerous tumour that has been causing the obstruction.
This procedure involves an endoscopy and is usually completed with general anaesthetic.
Laser treatment removes enough of the cancerous tumour to allow food to pass down your oesophagus.
It may need to be repeated several times for your swallowing to return to normal.
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Follow-up
After your treatment is complete, you will be asked to return to the hospital for follow-up appointments.
These review appointments allow us to check the progress of your recovery. They are also an opportunity for you to discuss any concerns you may have.
If you have any problems or notice any new symptoms in between review appointments, contact your clinical nurse specialist, consultant or GP.
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