surgery, which is usually the initial treatment of choice for GI cancers when the tumor is localized and resectable.
When cancer develops in the esophagus—the muscular tube that carries food from the throat to the stomach—it can impede swallowing and nutrition.
Surgical treatment most commonly is an esophagectomy, where the diseased portion of the esophagus is excised, sometimes along with nearby lymph nodes. The healthy portion left behind is then reattached to the stomach or portion of the intestine to reestablish the food pipe.
A gastrectomy is done when the tumor is in the stomach. It can be partial or complete based on the degree of the disease. The digestive tract is reconstructed so that food can move through from the esophagus into the intestines.
In liver cancers, surgeons can resect the tumor by removing it through liver resection or, in advanced stages, may opt for a liver transplant. In case of small or unresectable tumors, ablation methods are also employed to eliminate the tumor without surgery.
In gallbladder cancers, the routine is a cholecystectomy, which can be done laparoscopically. In advanced disease, an extended cholecystectomy might be required, including the removal of surrounding liver tissue and lymph nodes.
For cancer of the pancreas, the Whipple procedure is the most frequent use. It requires the removal of the head of the pancreas, a portion of the small intestine, gallbladder, and bile duct. Distal or total pancreatectomy are other possibilities, depending on where the tumor is found.
Following surgery, or when surgery is not an option, patients are sometimes treated with other potent treatments to reduce tumors, destroy any remaining cancer cells, and prevent recurrence.
SportingTechnologies
After surgery, patients can require drug therapies to destroy remaining cancer cells or to stop the disease from recurring. Treatments are selected based on cancer type, stage, and overall health.
Chemotherapy
One of the most popular drug treatments is chemotherapy — powerful medicine that destroys rapidly growing cells, such as cancer.
Chemotherapy may be administered in a variety of ways:
Intravenously into a vein, using either a peripheral line (such as in the arm) or a central line (placed close to the chest)
Orally, with capsules or tablets
Through infusion pumps for longer-term delivery
It's usually delivered in cycles — three days of chemo and then a period of rest, for instance. This chemo regimen allows the body time to recover between courses.
Depending on timing, chemo can be:
Neoadjuvant – administered prior to surgery to reduce the tumor
Adjuvant – administered after surgery to eliminate remaining cells
Or in addition to radiation or targeted therapies
Targeted Therapy
Targeted therapy targets distinctive genetic mutations or proteins cancer cells exploit to proliferate and spread. These drugs target only the cancer — not healthy tissues — and lower the risk of side effects.
Targeted therapy is particularly helpful in liver, stomach, and pancreatic cancers with identified mutations such as HER2, KRAS, or FGFR.
Immunotherapy
In certain GI cancers, the immune system can be instructed to learn how to recognize and kill cancer cells. That's what immunotherapy does.
Hormone Therapy
Although hormone therapy is not particularly practiced in the majority of GI cancers, it can be utilized in neuroendocrine tumors (NETs) or in a specific few rare instances when hormone control affects growth of the tumor.
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