Upper gastrointestinal (GI) cancer

Our service
Treatments available
For patients
For clinicians
Research and clinical trials
Sources for further information
Meet the team

Our service

At Barts Cancer Centre, we provide state-of-the-art treatment for patients with all types of cancer affecting their upper digestive system (also known as the gastrointestinal tract). This includes cancer of the oesophagus (the tube between the throat and stomach), stomach, liver, pancreas, gall bladder and bile ducts.

Our multidisciplinary team of experts provides some of the most complex surgical techniques and ongoing care and together with support from our dietitians, physiotherapies and occupational therapists, we care for patients at all stages of their treatment.

We have a dedicated website for our HPB service, which offers specialist care for patients with cancer of the liver, pancreas and bile duct. Please visit this website for more information about these areas.

Treatments available

The treatments and equipment used at our centre are at the forefront of modern healthcare. As with all of our services at Barts Cancer Centre, treatments offered will depend on individual cases and the stage of cancer. This will be discussed in detail with every patient by one of our medical team once a diagnosis has been made.

Our therapeutic approach ranges from state-of-the-art surgery, conventional chemotherapy, combined chemo-radiation or radiotherapy to state-of-the-art radiotherapy techniques, such as Intensity Modulated Radiation Therapy (IMRT) and gamma knife radiosurgery.

Cancer of the oesophagus (gullet)
The most common treatment options for oesophageal cancer are surgery, radiotherapy and chemotherapy. Other treatments used to help treat cancer in the oesophagus include:

Photodynamic therapy (PDT) where an inactive drug is given and when the drug is concentrated in the cancer cells, a laser light is shone at the cancer. The drug is activated and kills the cancer cells.
Laser therapy (laser treatment) uses an intense beam of light is used to destroy cancer cells. Sometimes surgery is done using a laser instead of a knife, as lasers are very precise.

Cancer of the stomach

Surgery is the main treatment for stomach cancer to help stop the cancer from spreading. We use keyhole surgery and traditional surgery to treat our patients. Our surgeons are highly skilled and havespecialist training and experience in using keyhole techniques.

Sometimes the cancer may cause a blockage, and stop food from being able to pass through the gut. If this happens, the surgeon may include a flexible tube (stent) into where there is a blockage to allow the food to go through, remove part of the blockage or create a new connection - known as bypass surgery.

For patients

We aim to treat all patients as individuals and provide care from the point of diagnosis and throughout the course of their illness. We have detailed discussions with our patients, reviewing their symptoms, and assessing them with regard to the possible benefits and risks of the various treatment options.

We take into account many factors when deciding which treatments are most suitable for our patients, including the stage of the cancer, age, general health, and their level of fitness.

For clinicians

We consistently achieve national access targets for patients with suspected cancer and for treatment following diagnosis. Referral criteria and forms are all available on our website, please click here for referral forms.

Research and clinical trials

Barts has been at the forefront of medical discovery since it was founded nearly 900 years ago and today, our research continues to be recognised for its originality, significance and rigour. The results of the work we do here means we are constantly improving the treatments and care we can offer patients.

Researchers at Barts and The London NHS Trust and Queen Mary University's Institute of Cancer have recently developed the first, reliable urine test for the most common and deadly form of pancreatic cancer.

Our team discovered raised levels of a specific protein - known as a tumour marker - in the urine of patients with pancreatic ductal adenocarcinoma (PDAC). PDAC is the most common pancreatic malignancy accounting for more than 80% of tumours which start in the pancreas.

Until December 2009, the only tumour marker for pancreatic cancer - CA19-9 - has given false positives in some healthy patients, while failing to show up in patients who do have the disease. The new marker, however, is specific to patients with PDAC and means that patients can undergo surgery at an early stage, increasing their chance of survival after five years from less than 5% without surgery, to as high as 30%.

All research is assessed by East London and the City Local Research Ethics Committee as well as the Joint Research and Development Office of the hospitals and Medical School to ensure that the highest standards of good clinical practice are adhered to.

In collaboration with colleagues at the Institute of Cancer at Barts and The London School of Medicine and Dentistry, we are also developing novel treatments for pancreatic, hepatic and colorectal cancer, including novel therapies such as therapeutic antibodies and small molecules.

The Centre for Cancer and Inflammation carries out research into cancer biology with a special focus on pancreatic cancer and cancer-related inflammation (such as hepatic and colorectal cancers). Experts at the centre are studying the links between cancer and the process of inflammation, with the aim of translating laboratory research in chronic inflammation, cancer growth and spread into new treatment for cancer, especially pancreatic and colorectal cancer.

The centre is involved in several Phase I and Phase II clinical trials. Additionally research is being done to evaluate new diagnostic markers and evaluate novel imaging techniques to improve the diagnosis and follow-up of gastrointestinal cancer.