People diagnosed with localised oesophageal or gastric cancer are candidates for curative treatment. In people with small tumours, it may be possible to remove the cancer with endoscopic treatment. However, most people are diagnosed with large tumours that can only be removed by having a surgical operation. Some patients may only require surgery to remove the cancer. For the majority, however, the current standard of care is for patients to receive chemotherapy (and potentially radiotherapy) before the surgery.
Patients with oesophageal and gastric cancer who undergo curative surgery have either an oesophagectomy (removal of the oesophagus), a total gastrectomy (removal of all of the stomach) or subtotal gastrectomy (removal of part of the stomach).
Since 2001, curative treatments for oesophageal and gastric cancer have been organised into regional Specialist Cancer Centres. This has allowed cancer services to treat higher numbers of patients each year, which leads to better outcomes for patients. As noted above, curative treatment may involve a combination of chemotherapy, radiotherapy and surgery, and is organised by multidisciplinary teams. In these teams, surgeons work closely with other clinicians to ensure patients are offered the best combination of treatments.
The performance of the operation is an area in which teamwork is becoming more common. Increasingly, two trained surgeons operate together due to the complexity of the operations for oesophageal and gastric cancer.
The care delivered by multidisciplinary teams across England and Wales to patients with oesophageal or gastric cancer has been audited by the National Oesophago-Gastric Cancer Audit since it began in 2007.