Upper gastrointestinal cancer (UGI)

Upper gastrointestinal (UGI)  cancer is a primary cancer of the  oesophagus (gullet) , gastric (stomach) , or GIST (gastrointestinal stromal tumour in the stomach or small bowel).  
Hepato- bilary (HPB) is also included involving the pancreas, liver, bile duct and/or gall bladder.
 
Further information about  UGI and HPB cancers can be found on the  Macmillan website ,  Pancreatic cancer charity website or the British Liver Trust    
 
Within  Barts Health, the care of patients with UGI/HPB cancer is provided at Whipps Cross, Newham and The Royal London hospitals.   
 
The clinic appointments and treatment can take place at all hospital sites.  
 
If you are having tests or undergoing treatment  for UGI/HPB  cancer  you will be given the contact number for a specialist nurse who will support you throughout your treatment.  

Your appointments

The  upper gastrointestinal/hepato-biliary clinics for patients under the care of the Royal London Hospital and Newham University Hospital are held at the Royal London Hospital on Tuesday mornings.   

The clinics at Whipps Cross are held alternate  Mondays and Tuesday mornings, e very Tuesday and Thursday afternoons and in some cases on an ad - hoc basis .  

The medical oncology clinics are held at St Bartholomew’s Hospital all day Monday and Tuesday afternoon for follow up clinics and Wednesday afternoon for new patients’ clinic.  

The clinical oncology clinics are held at St Barth olomew’s Hospital Monday afternoon  for new patients’ clinic and Thursday afternoon for follow up clinics .  

You will see your specialist doctor in the clinic after the multidisciplinary team has met. Your doctor might talk to you about:   

  • Diagnosis  
  • T reatment plan  

You can also talk to them about any concerns you may have.  

It may be a good idea to take someone with you to your clinic appointment.  You may also find it useful to have a list of questions ready to make sure you get the information you need.  

Investigations

Your doctor may need to do a series of tests to find out more about the cancer.  You may need to undergo one or more of the following investigations.

Oesophago - gastro- duedenoscopy (OGD)  -  a  gastroscopy is a procedure where a thin, flexible tube called an endoscope is used to look inside the oesophagus  (gullet), stomach and first part of the small intestine (duodenum) .  

Liver Ultrasound Scan

These scans listed below build up a picture of the inside of your body by taking a series of images.

Blood tests – there may be several blood tests which you may need to assess your general health.  The specific blood test for UGI/HPB  cancer is called CEA , CA 19-9  (tumour marker).

It may take up a couple of weeks to complete these investigations. Should you have any concerns during this time please contact your clinical nurse specialist (Key worker).  

Further information about all cancer  investigations can be found on the  Macm illan website ,   pancreaticcancer.org.uk or  britishlivertrust.org.uk  

Your treatment options

The u pper gastrointestinal/hepato-biliary cancer team at Barts Health have regular meetings called MDTs (multidisciplinary team meetings). This is where a group of health professionals with expert knowledg e in  upper gastrointestinal/hepato-biliary cancer will manage your investigations and treatment.  

Y ou do not attend the meeting but a member of the  team , usually your specialist nurse , will tell you about the results of the meeting. You may be given a choice of treatment options, which your specialist will discuss with you. If you don't understand what you've been told, let the staff know so they can explain again. 

Before you have any treatment, you will need to give permission (consent).  

Further information about types of treatment used for treating  upper gastrointestinal/hepato-biliary is available  on the  Macmillanwebsite , pancreatic cancer charity website , or British Liver Trust

Your cancer team

The upper gastrointestinal/hepato-biliary cancer team at Barts Health include the following staff:  
 
Surgeon
Specialist doctor who is trained in operating on upper gastrointestinal/hepato-biliary cancers.
 
Medical oncologist  
Doctor trained in diagnosing and treating cancer patients  with chemotherapy .  
 
Clinical oncologist  
Doctor trained in diagnosing and treating cancer patients with radiotherapy .  
 
Consultant radiologist  
A doctor who is expert in interpreting x -rays and scans. They may also perform biopsies (taking tissue samples) with the aid of imaging techniques.  
 
Consultant pathologist  
A doctor who looks at tissue samples under a microscope to search for cancer cells.  
 
Clinical Nurse Specialist (CNS)  
An experienced cancer nurse who acts as your key worker. They will give you advice and support as you go through investigations and treatment and support you through your care pathway.  
 
Member of the palliative care team  
The palliative care team specialises in relieving pain and other symptoms, including psychological difficulties caused by cancer.  
 
Multi-disciplinary team co-ordinator  
The co-ordinator provides administrative support to the upper gastrointestinal/hepato-biliary cancer team and aims to ease the pathway from referral to treatment. 
 
The upper gastrointestinal/hepato-biliary  cancer team are a group   of experts , and will work with you to conduct and provide the best care plan possible.  
 
If you have any concerns, please talk to the team who will be considerate of  your decisions and wishes.

Referring to our service

Sources of referrals to the  UGI/HPB teams are as follows:  

  • The two  week wait pathway from a GP   
  • In-patient referrals via the MDT co-ordinator  
  • Tertiary referrals – from other NHS organisations