Esophageal carcinoma

Squamous cell carcinomas of the oesophagus are often caused by chronic damage to the mucous membrane. The main causes include smoking, alcohol consumption, very hot drinks, chemical burns, radiotherapy and achalasia. These factors cause chronic inflammation and mucosal changes that can eventually lead to carcinomas.

Esophageal carcinomas often require multimodal therapy that combines surgery, radiotherapy and chemotherapy. If diagnosed at an early stage, endoscopic resection of the tumor may be sufficient. In locally advanced stages, preoperative (neoadjuvant) chemotherapy and radiotherapy are used to shrink the tumor before surgery and increase the chances of complete removal. After surgery (adjuvant therapy), further treatments are often carried out to eliminate any remaining cancer cells and reduce the risk of recurrence.

Gastric carcinomas

Gastric carcinomas are often caused by chronic inflammation of the gastric mucosa, which can lead to malignant tumors. The main risk factors include an infection with Helicobacter pylori, an unhealthy diet (especially a diet high in salt and smoke), smoking, alcohol consumption, genetic predisposition and chronic inflammation of the stomach lining (gastritis). Typical symptoms are abdominal pain, nausea, weight loss, loss of appetite and blood in the stool or vomit.

Early diagnosis through procedures such as endoscopy and biopsy are crucial for treatment. In certain cases, early carcinomas can be removed endoscopically and cured without surgery. Otherwise, surgical removal of the tumor is often the primary treatment method. This may involve a total or partial gastrectomy (removal of the stomach), depending on the size and location of the tumor. Chemotherapy is often used in addition to this to reduce the risk of recurrence. Neoadjuvant therapies can shrink the tumor before surgery, while adjuvant therapies fight any remaining cancer cells after surgery. In advanced cases, various combined chemotherapy options are available to control the disease for as long as possible and minimize symptoms. Targeted molecular therapy and immunotherapies are increasingly being used here.

Colon and rectal carcinomas

Colon and rectal cancers often arise from benign polyps that can develop into malignant tumors. The main risk factors include genetic predisposition, an unhealthy diet, alcohol consumption, tobacco use and obesity. Symptoms include blood in the stool, changes in bowel movements, unexplained weight loss and abdominal pain. Regular screening tests, such as colonoscopy and rectoscopy, are crucial for early diagnosis and treatment. Early detection and treatment significantly improve the chances of recovery.

Colon and rectal carcinomas can usually be removed endoscopically as long as they are limited to the surface of the bowel. Otherwise, surgical removal is the treatment of choice as long as the disease is localized. In certain stages of the disease, adjuvant chemotherapy is recommended after surgery to minimize the risk of recurrence. In advanced stages, neoadjuvant chemotherapy or radiotherapy may also be used to shrink the tumor before surgery.

In the metastatic situation, differentiated targeted molecular or immunotherapies are now available, which can be individually coordinated in combination with chemotherapy or in some cases even as the sole treatment.

Bile duct carcinomas

Bile duct carcinomas, also known as cholangiocarcinomas, are rare malignant tumors of the bile ducts. The main causes include chronic inflammation of the bile ducts, in particular primary sclerosing cholangitis, infections with hepatitis B and C viruses and certain parasites in Asia. Other risk factors include genetic predisposition, liver cirrhosis and certain toxic substances such as nicotine and alcohol.

Typical symptoms are jaundice, unintentional weight loss, loss of appetite and abdominal pain. Diagnosis is based on a combination of blood tests, imaging procedures and endoscopy.

The main treatment method for bile duct carcinomas is surgical removal of the tumor. In cases where surgery is not possible, local ablative measures and chemotherapy can be used. In advanced stages, targeted therapies aimed at molecular changes in the tumor are also available

Small intestine carcinomas

Small bowel carcinomas are rare malignant tumors of the small intestine. The main causes include genetic predisposition, chronic inflammatory bowel diseases such as Crohn’s disease, and certain hereditary syndromes such as Lynch syndrome. Risk factors also include diet, smoking and alcohol consumption.

Symptoms can be non-specific and include abdominal pain, weight loss, nausea, vomiting and blood in the stool. Diagnosis is often made using imaging techniques such as CT or MRI scans as well as endoscopy and biopsy.

As long as the disease is localized, a cure can be achieved by surgical removal. Similar to colon cancer, adjuvant chemotherapy is offered in locally advanced cases.

In metastatic disease, chemotherapy can be used to slow the progression of the disease and alleviate symptoms. In some cases, targeted molecular therapies or immunotherapies can also be used.