Most people with cancer of the upper gastro-intestinal system survive for only a few months after diagnosis. Long-term (five-year) survival rates for England and Wales for oesophageal, stomach and pancreatic cancer are 9%, 12%, and 3% respectively.
These survival rates are generally worse than those reported by other developed countries. This is particularly apparent in stomach cancer, for which the European average five-year survival rate is 21%.
Surgery is difficult and hazardous. One English region has reported that 15% of patients with oesophageal cancer and 18% with pancreatic cancer die within a month of surgery. Equivalent figures from specialist centres are below 5%.
Clinicians and hospitals treating larger numbers of patients with these cancers achieve better outcomes. interventions for the management of upper gastro-intestinal cancers
Chemotherapy can have some impact on survival and may help with symptom control. Radiotherapy is only appropriate for a small minority of patients with oesophageal cancer.
Most patients require palliative interventions, in particular stent insertion to permit swallowing or treat jaundice.
Pain control is crucial, especially in pancreatic cancer. Surgical interventions such as destruction of the local nerve plexus are often effective.