{"slug":"gastrointestinal","tag":"gastrointestinal","variants":["gastrointestinal"],"description":"Cancers of the digestive tract.","count":25,"kinds":{"cancer":25},"related":[{"slug":"subtype-page","tag":"subtype-page","shared":19},{"slug":"rare","tag":"rare","shared":4},{"slug":"biliary","tag":"biliary","shared":1},{"slug":"hpv","tag":"hpv","shared":1},{"slug":"sarcoma","tag":"sarcoma","shared":1}],"records":[{"id":"anal","kind":"cancer","name":"Anal cancer (squamous cell carcinoma)","route":"/cancers/anal/","tldr":"An HPV-caused cancer of the anal canal that is usually cured without surgery by combined chemotherapy and radiation. Prevention (HPV vaccination, screening of high-risk groups) and immunotherapy for advanced disease are the new fronts."},{"id":"gist","kind":"cancer","name":"Gastrointestinal stromal tumour (GIST)","route":"/cancers/gist/","tldr":"GIST is a sarcoma of the gut wall driven almost always by a KIT or PDGFRA mutation. It was the proof that a pill can control a solid tumour: imatinib turned a median survival of about a year into one of eight years or more, and the mutation now dictates which drug to use."},{"id":"appendiceal","kind":"cancer","name":"Appendiceal cancer and pseudomyxoma peritonei","route":"/cancers/appendiceal/","tldr":"Rare tumours of the appendix that range from slow mucin-producing growths that fill the abdomen (pseudomyxoma peritonei) to aggressive adenocarcinomas. The slow forms are treated by extensive surgery with heated chemotherapy in the abdomen; the fast ones like colon cancer."},{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/","tldr":"Gallbladder cancer is a biliary tract cancer of the bile-storing sac under the liver, most often found by chance when the gallbladder is removed for stones. Caught early, a second operation to clear the liver bed and nodes can cure it; for advanced disease, chemotherapy now comes with an immunotherapy partner, and HER2-directed antibodies help the subset whose tumours over-express HER2."},{"id":"ampullary","kind":"cancer","name":"Ampullary cancer (ampulla of Vater)","route":"/cancers/ampullary/","tldr":"Ampullary cancer, a biliary tract cancer, starts where the bile and pancreatic ducts empty into the small bowel. Because it blocks bile flow early it is often caught while still removable, and the Whipple operation cures a good share of patients. Tumours come in two flavours, intestinal-like and pancreas-like, and chemotherapy is increasingly chosen by which one the pathologist sees."},{"id":"small-bowel","kind":"cancer","name":"Small intestine cancer (small bowel adenocarcinoma)","route":"/cancers/small-bowel/","tldr":"Cancers of the small intestine are rare and often found late because the small bowel is hard to see and symptoms are vague. Surgery cures early disease, chemotherapy borrowed from bowel cancer helps after surgery and in advanced disease, and a large minority of tumours have a repair defect that makes them respond well to immunotherapy."},{"id":"anal-hsil-precursor","kind":"cancer","name":"Anal high-grade squamous intraepithelial lesions (precursor)","route":"/cancers/anal-hsil-precursor/","tldr":"Anal high-grade squamous intraepithelial lesions are the HPV-driven precancer that anal cancer grows from, found by screening people at high risk with cytology and high-resolution anoscopy. The ANCHOR trial showed that treating these lesions, mostly by ablation in the clinic, cuts the number that become anal cancer, so screening and treatment are now recommended for people living with HIV."},{"id":"localised-anal-cancer","kind":"cancer","name":"Localised anal squamous cell carcinoma (stage I to III)","route":"/cancers/localised-anal-cancer/","tldr":"Localised anal cancer is squamous cell cancer of the anal canal that has not spread beyond the pelvis and groin, one of the few cancers cured mainly by chemotherapy and radiotherapy together rather than by surgery. Fluorouracil with mitomycin during radiotherapy has been standard since the ACT II trial; surgery to remove the anus is kept for the minority whose cancer persists or returns."},{"id":"metastatic-anal-cancer","kind":"cancer","name":"Metastatic and recurrent anal squamous cell carcinoma","route":"/cancers/metastatic-anal-cancer/","tldr":"Metastatic anal cancer is squamous cell anal cancer that has spread to the liver, lungs or distant lymph nodes, or come back where surgery can no longer remove it. Carboplatin with paclitaxel became the standard first treatment after the InterAACT trial, the PD-1 antibody retifanlimab was added to it in 2025 after POD1UM-303, and nivolumab or pembrolizumab are options after chemotherapy."},{"id":"low-grade-appendiceal-mucinous-neoplasm","kind":"cancer","name":"Low-grade appendiceal mucinous neoplasm and pseudomyxoma peritonei","route":"/cancers/low-grade-appendiceal-mucinous-neoplasm/","tldr":"Low-grade appendiceal mucinous neoplasm is a slow-growing appendiceal cancer that makes mucus, and when it bursts it spreads jelly through the abdomen as pseudomyxoma peritonei. It rarely spreads through blood or lymph, so it is treated by stripping all visible disease from the abdomen and washing the cavity with heated chemotherapy, an operation that gives most patients many years of life."},{"id":"appendiceal-adenocarcinoma","kind":"cancer","name":"Appendiceal adenocarcinoma (mucinous and non-mucinous, including signet ring cell)","route":"/cancers/appendiceal-adenocarcinoma/","tldr":"Appendiceal adenocarcinoma is the invasive, gland-forming form of appendix cancer that behaves more like bowel cancer than the jelly-producing low-grade tumours, spreading to lymph nodes and the abdominal lining. It is treated with right hemicolectomy and bowel-cancer chemotherapy, and peritoneal spread with cytoreductive surgery and heated intraperitoneal chemotherapy in fit patients."},{"id":"goblet-cell-adenocarcinoma","kind":"cancer","name":"Goblet cell adenocarcinoma of the appendix","route":"/cancers/goblet-cell-adenocarcinoma/","tldr":"Goblet cell adenocarcinoma is a rare appendix cancer whose cells mix mucus-filled goblet cells with neuroendocrine features, once called goblet cell carcinoid but now classed and treated as an adenocarcinoma. It is removed by right hemicolectomy, given bowel-cancer chemotherapy when it is high grade or has spread, and not treated with the somatostatin drugs used for true neuroendocrine tumours."},{"id":"localised-small-bowel-adenocarcinoma","kind":"cancer","name":"Localised small bowel adenocarcinoma (stage I to III, resected)","route":"/cancers/localised-small-bowel-adenocarcinoma/","tldr":"Localised small bowel adenocarcinoma is cancer of the duodenum, jejunum or ileum that has not spread beyond nearby lymph nodes and can be removed by surgery, the only cure. Duodenal tumours need a Whipple operation and tumours further along a segmental resection; chemotherapy afterwards is offered for node-positive disease by analogy with colon cancer while the BALLAD trial tests whether it helps."},{"id":"advanced-small-bowel-adenocarcinoma","kind":"cancer","name":"Advanced and metastatic small bowel adenocarcinoma","route":"/cancers/advanced-small-bowel-adenocarcinoma/","tldr":"Advanced small bowel adenocarcinoma is cancer of the small intestine that has spread to the liver, peritoneum or elsewhere, treated with the chemotherapy used for bowel cancer, oxaliplatin with a fluoropyrimidine, then taxanes or irinotecan. The exception is the sizeable minority with mismatch-repair-deficient tumours, for whom the immunotherapy pembrolizumab works far better than chemotherapy."},{"id":"resectable-pdac","kind":"cancer","name":"Resectable pancreatic ductal adenocarcinoma","route":"/cancers/resectable-pdac/","tldr":"Resectable pancreatic cancer is the minority of pancreatic cancer that the surgeon can remove with clear margins because it has not wrapped around the main arteries or spread. Treatment is an operation, usually a Whipple procedure, followed by six months of combination chemotherapy, which is what turns surgery alone into a real chance of cure."},{"id":"borderline-resectable-pdac","kind":"cancer","name":"Borderline resectable pancreatic ductal adenocarcinoma","route":"/cancers/borderline-resectable-pdac/","tldr":"Borderline resectable pancreatic cancer touches the big blood vessels behind the pancreas, so an operation straight away would probably leave cancer behind. Chemotherapy first, usually FOLFIRINOX for several months and sometimes radiotherapy, shrinks the edge of the tumour, and patients whose disease has not spread go on to surgery with a better chance of a clean removal."},{"id":"locally-advanced-pdac","kind":"cancer","name":"Locally advanced unresectable pancreatic ductal adenocarcinoma","route":"/cancers/locally-advanced-pdac/","tldr":"Locally advanced pancreatic cancer has grown around the arteries or veins behind the pancreas so that it cannot be removed, but it has not spread to other organs. Chemotherapy is the main treatment, joined in 2026 by a device that delivers electric fields to the tumour; radiotherapy controls pain and local growth, and a minority of tumours shrink enough to be operated on after all."},{"id":"metastatic-pdac","kind":"cancer","name":"Metastatic pancreatic ductal adenocarcinoma","route":"/cancers/metastatic-pdac/","tldr":"Metastatic pancreatic cancer has spread beyond the pancreas, usually to the liver, and is treated with chemotherapy rather than surgery. Three combination regimens lengthen life, a minority of patients qualify for targeted drugs chosen by tumour or inherited mutations, and in 2026 the pan-RAS inhibitor daraxonrasib became the first drug against the KRAS mutation that drives almost every case."},{"id":"kras-g12c-pdac","kind":"cancer","name":"KRAS G12C-mutant pancreatic ductal adenocarcinoma","route":"/cancers/kras-g12c-pdac/","tldr":"KRAS G12C pancreatic cancer is the small slice of pancreatic cancer whose KRAS mutation happens to be the one that the first KRAS drugs were built for. Sotorasib and adagrasib, approved for lung cancer, shrink a share of these tumours after chemotherapy and are listed as options, and newer inhibitors such as elironrasib, olomorasib and the pan-RAS drug daraxonrasib are being tested in this group."},{"id":"kras-wild-type-pdac","kind":"cancer","name":"KRAS wild-type pancreatic ductal adenocarcinoma","route":"/cancers/kras-wild-type-pdac/","tldr":"KRAS wild-type pancreatic cancer is the one in ten pancreatic cancers without the KRAS mutation that drives the rest. Instead many carry a different switched-on gene, often a fusion involving NRG1, NTRK, ALK, ROS1, FGFR2 or RET, or a BRAF change, and several of these have approved pills or antibodies, so these tumours must be sequenced with a test that detects fusions."},{"id":"brca-palb2-pdac","kind":"cancer","name":"BRCA or PALB2-mutant pancreatic ductal adenocarcinoma","route":"/cancers/brca-palb2-pdac/","tldr":"BRCA or PALB2-mutant pancreatic cancer is pancreatic cancer in someone who inherited a faulty copy of a gene that repairs broken DNA. These tumours respond better to platinum chemotherapy, and the POLO trial showed that the PARP inhibitor olaparib, taken after platinum has held the disease, delays its return; that made it the first targeted drug approved for a pancreatic cancer subgroup."},{"id":"msi-high-pdac","kind":"cancer","name":"Mismatch repair deficient (MSI-high) pancreatic ductal adenocarcinoma","route":"/cancers/msi-high-pdac/","tldr":"Mismatch repair deficient pancreatic cancer is the rare pancreatic cancer whose cells cannot fix spelling errors in DNA and so carry thousands of mutations. That makes it one of the few pancreatic cancers that immunotherapy works against, and pembrolizumab is approved for it, though fewer of these tumours respond than in bowel cancer; testing every pancreatic cancer for the defect is the point."},{"id":"pancreatic-acinar-cell-carcinoma","kind":"cancer","name":"Pancreatic acinar cell carcinoma","route":"/cancers/pancreatic-acinar-cell-carcinoma/","tldr":"Pancreatic acinar cell carcinoma is a rare pancreatic cancer that grows from the enzyme-making cells rather than the ducts. It forms large soft masses, can pour lipase into the blood and cause fat lumps under the skin and joint pain, usually lacks the KRAS mutation, often carries DNA repair faults or BRAF fusions, and responds better to bowel-cancer-style chemotherapy than to gemcitabine."},{"id":"ipmn-cystic-precursors","kind":"cancer","name":"Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","route":"/cancers/ipmn-cystic-precursors/","tldr":"Intraductal papillary mucinous neoplasms are fluid-filled growths in the pancreatic ducts that make mucus and can slowly turn into pancreatic cancer, one of the few chances to catch pancreatic cancer before it starts. Most are watched with scans for years, and surgery is reserved for the ones with warning signs such as a widened main duct, a solid nodule inside the cyst or jaundice."},{"id":"pancreatoblastoma","kind":"cancer","name":"Pancreatoblastoma","route":"/cancers/pancreatoblastoma/","tldr":"Pancreatoblastoma is the pancreatic cancer of young children, a tumour of immature pancreatic cells that behaves quite unlike adult pancreatic cancer. It grows as a large abdominal mass, often raises the blood marker alpha-fetoprotein, and is treated like the childhood liver cancer hepatoblastoma: chemotherapy to shrink it, then surgery, which cures most children whose tumour has not spread."}]}