Practice Guidelines

Assessment and management of oesophago-gastric cancer: summary of NICE guidance

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k213 (Published 29 January 2018) Cite this as: BMJ 2018;360:k213
  1. May Oo Khin, systematic reviewer1,
  2. Nathan Bromham, senior systematic reviewer1,
  3. Mark Harrison, consultant oncologist and lead clinician2,
  4. Hilary Eadon, guideline lead1
  5. on behalf of the Guideline Committee
  1. 1National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London NW1 4RG, UK
  2. 2Mount Vernon Cancer Centre, Northwood, Middlesex HA6 2RN, UK
  3. Correspondence to: H Eadon HEadon@rcog.org.uk

What you need to know

  • Nutritional support is an important part of management for people who receive treatment for oesophago-gastric cancer: tailor dietetic support to the person and their clinical situation

  • Routine clinical follow-up or routine radiological surveillance is not normally offered for detection of recurrent disease: if a person with a history of oesophago-gastric cancer presents with symptoms, refer directly to specialist services with rapid access

  • People with oesophago-gastric cancer benefit from psychosocial support, verbal and written information about their cancer and care, and other sources of advice including peer groups

Oesophago-gastric cancer is the fourth commonest cause of cancer death in the UK, with 16 000 new cases each year, and its incidence is rising.1 Those affected by the disease often undergo a complex investigative pathway as a prelude to a variety of treatments with wide ranging short term and long term effects that require continued support throughout the initial period of care and beyond. Radical treatments for oesophago-gastric cancer are carried out in specialist centres where there will be access to a range of specialist healthcare professionals, but people with oesophago-gastric cancer will also require input from primary care. People whose cancer is suitable for palliative management will also benefit from the support of professionals from various disciplines, such as cancer care dietitians and palliative care professionals.

This article summarises the most recent recommendations from the National Institute for Health and Care Excellence (NICE) on diagnosis and management of oesophago-gastric cancer.2 The guidance was developed with the aim of improving and standardising care in all disciplines that treat people with oesophago-gastric cancer, including specialist centres, but some of the recommendations will affect non-specialist services too, and these are highlighted and summarised below.

Recommendations

NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal …

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