Treatment for Digestive System Neoplasms

T2T3 T4 and metastatic neoplasms have a poor prognosis. Some patients do not respond to treatment; surgical resection should be considered for patients with a life expectancy above 3-4 years.

Despite increasing acceptance of neoadjuvant chemotherapy as a standard treatment for oesophageal cancer, there are increasing indications that it is most effective in early disease.

Digestive system neoplasms are a very large and diverse group of neoplasms in which most have a poor prognosis or no treatment available. The most common types of digestive system neoplasms are carcinoma in situ and squamocarcinoma. We can summarize the common features of neoplasms of the gastrointestinal system. Digestive system cancers have very diverse natural history and they are usually not curable. Digestive tract neoplasms are frequently a reflection of normal variations of embryogenesis of these tissues and are most often due to infection of origin or neoplasia in the normal structure.

Different kinds of digestive system cancer are very differently related with their causes. Most of the other types of cancers in the digestive system are not very precisely related to their precise causes. The causes of some digestive tract cancers and other benign tumor syndromes are related. In most cases, we might not be able to determine the precise causes of the development of malignant neoplasms and some benign tumors. The causes of digestive system cancers cannot be determined on the basis of their specific causes. For most of them, we need to investigate their causes in an integrated manner based on the general causes of cancer, particularly based on the specific causes of other kinds of cancers in the same region.

Dyspepsia, weight loss and anemia denote digestive tract malignancy. Malignant tumors of the digestive system have a characteristic CT and ultrasound picture. CT is the best and only modality for diagnosis in a majority of cases. CT plays a part in staging and assessing the extent of the tumor, the possible involvement of adjacent organs and the prognosis.

Gastrointestinal neoplasms accounted for 3.4% of all cancer-related deaths and 13% of cancer-related deaths among males. These data highlight the continuing challenge in designing and conducting studies to identify appropriate gastrointestinal oncologic surveillance strategies for patients with these often hard-to-detect neoplasms.

There are many different treatments for digestive system cancers. Most commonly, patients receive multiple treatment strategies that include surgery, chemotherapy, and palliative therapy; some patients receive treatments to reduce risk of complications or regain mobility due to digestive system diseases. The decision regarding treatment options for patients with gastrointestinal cancer is complicated by comorbidities and the unique characteristics of the disease process in question. Gastrointestinal specialists are highly sought after for the management of patients with digestive system disease.

Treatment usually combined with other treatments is used rarely. The most common use of treatment combination is in combination with surgery. The other treatments have their own use in about 5% of patients. The use of treatment combination does not appear affected by any of the patient characteristics.

The majority of new cases of gastric non-Hodgkin lymphoma and of oesophageal non-Hodgkin lymphoma were detected during a period when patients survived longer. Recent findings showed that digestive system neoplasms are a distinct disease from other malignancies, and the survival of patients is shorter. When new cases of digestive system neoplasms are diagnosed, we should make an effort to find them in time so that treatment is as early as possible. For this, we should develop effective techniques in diagnosis and treatment of oesophageal lymphoma and non-Hodgkin lymphoma, and we encourage multi-centres to set up registries of patients.

For patients with gastrointestinal neoplasms, routine QOL measures improve our ability to identify patients most likely to have poor outcomes and who may benefit from a specific type of treatment.

There are various approaches in the treatment of esophageal cancer in our clinic. The most common is esophagectomy with an additional adjuvant chemotherapy or radiotherapy. However, for certain patients with esophageal cancer, we will often perform chemotherapy alone first, because then, if there is improvement we will combine chemoradiotherapy afterward. There is a high risk of relapse even if the initial chemotherapy is efficacious. In patients who can return to the [home with] their spouse or family for daily care, we will use a daily stoma.