What are gastrointestinal cancers?
Gastrointestinal (GI) cancers are a group of cancers affecting the digestive system, from the oesophagus to the rectum, together with the liver and pancreas. Together they account for a large share of cancer diagnoses worldwide.
Because the digestive tract is long and varied, these cancers differ a great deal in their symptoms, risk factors and treatment. They are usually grouped into three areas.
The three areas of GI cancer
Upper GI tract
Oesophageal cancer develops in the food pipe. The two main types are squamous cell carcinoma, linked to smoking and alcohol, and adenocarcinoma, linked to long-term acid reflux and Barrett’s oesophagus. Stomach (gastric) cancer forms in the stomach lining and is linked to long-term inflammation, a diet high in salted or smoked food and H. pylori infection.
Liver, pancreas and bile ducts
Pancreatic cancer is often found late because early symptoms are vague. Primary liver cancer, such as hepatocellular carcinoma, is strongly linked to hepatitis B or C, cirrhosis and fatty liver disease.
Lower GI tract (colorectal)
Colon and rectal cancers usually start as non-cancerous growths called polyps. They are among the most treatable GI cancers when found early, for example through screening colonoscopy.
Signs and symptoms
Early symptoms can feel like everyday indigestion. See a doctor if any of these last for more than a few weeks:
- Weight loss or loss of appetite without a clear reason
- Difficulty swallowing, or a feeling that food gets stuck in the chest
- Changes in bowel habit, such as ongoing diarrhoea, constipation or narrower stools
- Blood in the stool (bright red or black and tarry), or unexplained anaemia
- Ongoing abdominal pain, cramps or bloating, or yellowing of the skin and eyes (jaundice)
How GI cancer is diagnosed
Endoscopy
- Upper endoscopy (gastroscopy): a thin camera is passed down the throat to examine the oesophagus, stomach and duodenum and take biopsies.
- Colonoscopy: examines the whole large bowel, so polyps can be found, sampled and often removed.
- Endoscopic ultrasound: shows how deeply a tumour has grown and allows samples from nearby organs such as the pancreas.
Scans and staging
- CT scan: the main scan for locating a GI tumour and checking the lymph nodes and other organs.
- PET scan: a small dose of radioactive sugar shows active cancer cells throughout the body.
Tumour markers
Blood tests such as CEA (bowel), CA 19-9 (pancreas) and AFP (liver) cannot diagnose cancer on their own, but they help doctors follow how well treatment is working.
Surgical treatment options
| Area | Operation | What it involves |
|---|---|---|
| Upper GI | Oesophagectomy | Removes part or most of the oesophagus; the stomach is used to rebuild the food pipe |
| Upper GI | Gastrectomy | Removes part or all of the stomach and reconnects the digestive tract |
| Pancreas and bile ducts | Whipple procedure | Removes the head of the pancreas, the duodenum, the gallbladder and part of the bile duct |
| Liver | Liver resection | Removes the part of the liver containing the tumour; the rest of the liver regrows |
| Colon | Colectomy | Removes part or all of the large bowel |
| Rectum | Low anterior resection | Removes upper or middle rectal cancers while keeping normal bowel control |
| Rectum | Abdominoperineal resection | Removes very low rectal cancers with the anus; needs a permanent colostomy |
Staging and the team around you
GI cancers are staged from I to IV, based on how deeply the tumour has grown into the organ wall, whether nearby lymph nodes are involved and whether it has spread, most often to the liver or lungs.
Because these cancers affect how you eat and digest, your care involves several specialists working together:
- Surgical oncologists remove the tumour and rebuild the digestive tract
- Medical oncologists plan chemotherapy, targeted therapy or immunotherapy
- Gastroenterologists perform endoscopies and manage symptoms
- Dietitians help you keep your weight up and adapt to changes after surgery
Key terms
- Anastomosis: the join a surgeon makes between two parts of the digestive tract after removing a tumour.
- Anastomotic leak: a serious complication in which fluid leaks from that join.
- Stoma (ostomy): an opening on the abdomen that lets stool pass into a pouch when part of the bowel is bypassed or removed.
- Tumour markers (CEA, CA 19-9, AFP): blood proteins that can rise with certain GI cancers and are used to follow treatment.
Gastrointestinal Cancer Surgery procedures
Oesophagectomy
Removal of part or most of the oesophagus, with the stomach used to rebuild the food pipe.
Gastrectomy
Removal of part or all of the stomach to treat stomach cancer, with the digestive tract reconnected.
Whipple Procedure
A complex operation for tumours in the head of the pancreas or bile duct, followed by careful reconstruction.
Liver Resection
Removal of the part of the liver containing a tumour; the remaining liver regrows.
Colectomy
Removal of part or all of the colon to treat bowel cancer, often by keyhole surgery.
Low Anterior Resection
Sphincter-preserving surgery for upper and middle rectal cancers, often with a temporary stoma.
Abdominoperineal Resection
Removal of the rectum and anus for very low rectal cancers, with a permanent colostomy.
What the Gastrointestinal Cancer Surgery package includes
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Hospital and medical care
Your private hospital room, nursing care, pre-operative tests, consultations with your surgeon, anaesthesia, the operation itself and the medication you take home.
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VIP transfers
A private driver meets you at the airport and takes you between the airport, your hotel and the hospital.
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Translator and companion
A medical translator at the hospital, and a companion can travel with you at no extra cost.
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Meals and comfort
Daily meals for you and your companion throughout your stay.
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24/7 patient coordinator
A dedicated coordinator answers your questions before, during and after your trip, in your language.
Gastrointestinal Cancer Surgery FAQ
Which operation will I need?
It depends on where the tumour is, its stage and your general health. After reviewing your scans, endoscopy and biopsy results, the surgeon explains which operation is recommended and why.
Will I need chemotherapy before or after surgery?
Many GI cancers are treated with chemotherapy or chemoradiotherapy before or after surgery. Your oncology team decides the best order for you, and we can help coordinate with your doctors at home.
How long will I stay in hospital?
It ranges from around 3 nights after a keyhole colectomy to up to 2 weeks after an oesophagectomy. Each operation page lists the usual hospital stay.
