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New diagnostic tools make it possible to more efficiently develop the drug pipeline with the pharmaceutical industry. By redesigning clini- cal trials, patients will benefit from new medi- cations more quickly and more safely.

GASTROINTESTINAL CANCERS

introDuction Gastrointestinal (GI) oncology is one of the broadest fields in cancer medicine, covering the most frequently occurring solid tumours in Western countries. These include all cancers arising in the gastrointestinal tract (oesophagus, gastro-oesophageal junction, stomach, small intestine, large intestine, rectum), as well as in the attached glandular organs and structures (pancreas, extra- or intra-hepatic bile ducts, gallbladder, and liver). Radical surgery may cure the disease. This is possible when a localised - often early diagnosed - tumour can be fully removed. As many as 30% of patients with metastatic disease also benefit from surgery and may even be cured in this manner. However, surgery is then particularly difficult, and GI oncology surgeons must be experienced and well trained. In case the disease has spread to the extent that surgery is no longer possible, palliation, rather than cure, becomes the focus. For GI cancers, as is the case for many other solid tumours, diagnosis at an early stage is a key factor for successful treatment. This requires a comprehensive approach to prevention, such as that offered at the Institute.

Fouad Awada Coordinating Nurse

Dr Fikri Bouazza Digestive Oncology Surgeon

Dr Daniel Debecker Radiologist

Dr Alain Hendlisz Gastroenterologist, Head of Clinic

screening The Institute’s screening clinic participates in the population-based regional screening programme. In addition, it offers the most relevant options for all individuals, whether their cancer risk is normal or high. This includes lower GI tract colonoscopy or flexible sigmoïdoscopy.

Diagnosis Because of the critical need for accurate diagnosis, the Institute makes it a priority to use the most advanced imaging technologies (both classical and metabolic), and it is consequently equipped with the latest generation of CT, MRI and PET-CT scanners. Endoscopic ultrasonography has also become an important diagnostic tool.

surgery Surgery is the cornerstone of curative treatment for GI malignancies, and its

outcomes have dramatically improved in the last two decades. Robotic surgery, Hyperthermic Intraperitoneal Chemotherapy, and liver surgery are carried out in the Institute. The surgeons work in close collaboration with their colleagues at Hôpital Universitaire Erasme, and their practice is tightly integrated into the Institute’s overall multidisciplinary approach.

gi Medical oncology In oesophageal, gastro-oesophageal, gastric, and rectal tumours, treatment may begin with chemotherapy or chemo-radiation. In contrast, treatment of colon cancer usually begins with surgery. However, the exact treatment sequence is determined following an analysis of individual risk factors for recurrence of the tumour.

In advanced disease, chemotherapy is often the only palliative option. Palliative treat- ment is decided in accordance with wishes of the patient and is carried out in close collaboration with the Palliative and Supportive Care Unit.

treatMent, FolloW-uP, rehaBilitation