Upper Gastrointestinal Cancer Medical Oncologists in Melbourne
Upper gastrointestinal and hepatobiliary cancers include cancers of the oesophagus, stomach, pancreas, liver, gallbladder and bile ducts. Although they are grouped together because of anatomy and the specialists involved, each cancer has different biology and treatment. Management is often complex and benefits from multidisciplinary planning involving upper-GI or hepatobiliary surgeons, gastroenterologists, radiologists, radiation oncologists, pathologists and medical oncologists.
The team includes oncologists with longstanding gastrointestinal cancer experience, upper-GI and hepatobiliary multidisciplinary involvement, and research across pancreatic and other gastrointestinal cancers.
Gastric cancer treatment depends on stage and tumour biology. Resectable cancers are commonly treated with chemotherapy and immunotherapy around the time of surgery, while some situations use a different multimodality approach. In advanced disease, HER2, PD-L1, mismatch repair and other biomarkers can influence the use of targeted therapy or immunotherapy. Supportive management of nutrition, anaemia, nausea and weight loss is often required alongside anti-cancer treatment.
Pancreatic cancer often requires close coordination between pancreatic surgeons, gastroenterologists and oncologists. If the tumour is resectable, chemotherapy is commonly used after surgery and may be used before surgery in selected patients. Borderline resectable or locally advanced cancers may receive systemic therapy first to assess biology and improve local control. For metastatic pancreatic cancer, combination chemotherapy is the main treatment for suitable patients. Germline and tumour molecular testing can occasionally identify inherited risk or a targeted treatment opportunity.
Primary liver cancer, especially hepatocellular carcinoma, is strongly influenced by underlying liver function as well as tumour stage. Treatment can involve surgery, ablation, embolisation, radiotherapy or systemic therapy, often through a hepatobiliary multidisciplinary team. Cholangiocarcinoma and gallbladder cancers are different diseases and may be treated with surgery when localised or chemotherapy, immunotherapy and targeted medicines when advanced. Molecular profiling is particularly relevant in some bile duct cancers because actionable alterations can be present.
Small intestinal cancers develop in the small bowel, which connects the stomach to the large intestine. They include adenocarcinoma, neuroendocrine tumours, lymphoma and gastrointestinal stromal tumours, each requiring a different treatment approach. Symptoms may include abdominal pain, unexplained weight loss, bleeding or anaemia. Diagnosis usually involves imaging and tissue sampling. Surgery is important for localised adenocarcinoma, while chemotherapy or other systemic treatments may be recommended according to the tumour type, stage, location and the patient’s overall health and individual preferences.
Neuroendocrine tumours (NETs) arise from specialised cells found throughout the body, including the digestive tract and pancreas. Some grow slowly, while others behave more aggressively. Certain tumours release hormones that can cause symptoms such as flushing or diarrhoea. Treatment depends on the tumour’s location, grade, extent and hormone activity. Options may include surgery, medicines called somatostatin analogues, targeted therapy, chemotherapy or peptide receptor radionuclide therapy (PRRT), a targeted radiation treatment for suitable patients. Specialist multidisciplinary assessment helps guide individual care.
Assessment often involves high-quality CT or MRI imaging and a biopsy when required. Some cancers can be diagnosed and treated surgically without a pre-operative biopsy, while others need tissue confirmation before systemic therapy. Tumour markers such as CA19-9 or AFP can be useful in selected contexts but cannot diagnose cancer reliably by themselves.
Because these cancers can affect appetite, digestion, bile drainage and weight, nutritional and symptom assessment should begin early. Biliary obstruction may require endoscopic or radiological intervention before chemotherapy can start. Pain, pancreatic enzyme insufficiency, diabetes and clotting risk may also need treatment alongside the cancer itself.
Systemic treatment can include chemotherapy, immunotherapy or biomarker-selected targeted therapy. Treatment choice is based on the specific organ of origin, stage, molecular findings, liver function, performance status and previous treatment. For localised cancers, systemic therapy is planned around surgery or radiotherapy rather than as a separate process.
Northern Blood & Cancer Care’s connection with Northern Health multidisciplinary cancer services supports coordinated decision-making while allowing patients to consult privately in the Northern Private Hospital precinct. Complex cases can be discussed with or referred to tertiary hepatobiliary and upper-GI services where appropriate.
Northern Blood & Cancer Care brings together Melbourne specialists with complementary clinical, hospital and research appointments. The clinicians most closely associated with this service include:
Northern Blood & Cancer Care brings together a highly experienced team of haematologists, medical oncologists and specialist physicians, with consultations available at Northern Private Hospital in Epping.
Contact our team to arrange an appointment or discuss a referral.
