• Barrett's oesophagus: A change in the lining of the lower oesophagus caused by acid reflux that can, in a minority, progress through dysplasia to adenocarcinoma.
• Squamous cell carcinoma vs adenocarcinoma of the oesophagus: Oesophageal cancer is two different diseases in one organ: squamous cell carcinoma (upper/mid oesophagus, tobacco and alcohol, dominant in Asia) and adenocarcinoma (lower oesophagus, reflux and obesity, dominant in the West).
• FLOT regimen (perioperative chemotherapy for gastric cancer): Four cycles of chemotherapy before and four after surgery for stomach and junction cancer, using fluorouracil, leucovorin, oxaliplatin and docetaxel.
• Oesophagectomy: Surgery that removes most of the food pipe (oesophagus) and rebuilds it by pulling the stomach up into the chest.
• Dysphagia (difficulty swallowing): Trouble swallowing, either because a tumour narrows the food pipe or throat, or because radiotherapy and surgery to the head, neck or chest have damaged the muscles and nerves that coordinate swallowing.
• Gastrectomy: Removing part (subtotal) or all (total) of the stomach for stomach cancer, with the bowel joined to what remains.
• Gastro-oesophageal junction (GEJ): Where the food pipe meets the stomach.
• Feeding tube (gastrostomy, PEG, jejunostomy): A tube placed into the stomach (gastrostomy, PEG) or small bowel (jejunostomy) so a patient who cannot swallow enough can still be fed through the gut.
• Mediastinum: The space in the middle of the chest between the two lungs, containing the heart, great vessels, windpipe, food pipe and the lymph nodes that lung cancer spreads to first.
• Siewert classification (GEJ tumours): A way of classifying cancers at the junction of the oesophagus and stomach by where their centre sits, which decides whether they are treated as oesophageal or gastric.

Biomarker results to ask for: PD-L1, HER2 (adenocarcinoma), EGFR (squamous), Histology (squamous vs adenocarcinoma) determines the pathway, PD-L1 (CPS for adenocarcinoma/pembrolizumab; TAP score for tislelizumab in ESCC), HER2 IHC/ISH in adenocarcinoma, MSI/dMMR, CLDN18.2 in GEJ adenocarcinoma (gastric trials), Pathologic response after neoadjuvant therapy (residual disease → adjuvant nivolumab), Clinical complete response assessment (endoscopy, biopsy, PET-CT) for surveillance, EGFR and HER3 expression (not required for iza-bren).

Scans and tests linked to this cancer: Active surveillance, Companion diagnostics, Endoscopic resection (EMR / ESD), Endoscopic ultrasound and EBUS systems, Gastric cancer endoscopic screening (East Asia), Histopathology & immunohistochemistry.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

• Prevention and screening: Tobacco and alcohol control; endoscopic screening of high-risk populations in China and Japan (Lugol chromoendoscopy); surveillance of Barrett's oesophagus with ablation or resection of dysplasia; non-endoscopic capsule-sponge screening in trials (BEST4). (Endoscopic resection (EMR / ESD), Barrett's oesophagus, Non-endoscopic screening for Barrett's oesophagus and early adenocarcinoma)
• Localised: Neoadjuvant chemoradiation (CROSS) or perioperative FLOT → surgery → nivolumab if residual disease. (Nivolumab, IMRT / IGRT (modern external beam))
• Early (T1a, high-grade dysplasia): Endoscopic resection (EMR/ESD) with radiofrequency ablation of residual Barrett's; oesophagectomy for T1b with high-risk features. (Endoscopic resection (EMR / ESD))
• Resectable locally advanced (cT2-4a or N+): CROSS chemoradiation (carboplatin/paclitaxel + 41.4 Gy) then oesophagectomy for squamous and adenocarcinoma; perioperative FLOT for adenocarcinoma/GEJ (ESOPEC). Adjuvant nivolumab for residual disease after chemoradiation (CheckMate 577). (CROSS, CheckMate 577, FLOT (5-FU, leucovorin, oxaliplatin, docetaxel), Nivolumab, CROSS chemoradiation → surgery → adjuvant nivolumab if residual disease)
• Unresectable locally advanced or cervical: Definitive chemoradiation (50-50.4 Gy with cisplatin/5-FU or carboplatin/paclitaxel); PD-1 blockade added in trials. (IMRT / IGRT (modern external beam), Platinum agents)
• Advanced: Chemotherapy + pembrolizumab/nivolumab; iza-bren in trials. (Pembrolizumab, Izalontamab brengitecan)
• Clinical complete response after chemoradiation: Active surveillance with surgery on regrowth is a non-inferior option (SANO); requires intensive endoscopic and PET surveillance. (SANO, Active surveillance, Clinical complete response (cCR))
• Advanced squamous cell carcinoma, first line: Chemotherapy + pembrolizumab (KEYNOTE-590), nivolumab (CheckMate 648), or tislelizumab (RATIONALE-306, PD-L1 ≥1%); nivolumab + ipilimumab chemotherapy-free option; camrelizumab/sintilimab/toripalimab in China. (KEYNOTE-590, CheckMate 648, RATIONALE-306, ESCORT-1st, Pembrolizumab, Nivolumab, Ipilimumab, Tislelizumab, Camrelizumab)
• Advanced adenocarcinoma, first line: As for gastric cancer: chemotherapy + pembrolizumab or nivolumab (PD-L1 CPS ≥5 or ≥1); trastuzumab-based therapy if HER2-positive; zolbetuximab if CLDN18.2-positive (GEJ eligible in SPOTLIGHT/GLOW). (KEYNOTE-590, CheckMate 649, Trastuzumab, Zanidatamab, Zolbetuximab)
• Palliation of dysphagia: Self-expanding metal stent, brachytherapy, or external beam radiation; nutritional support; early palliative care. (Brachytherapy, IMRT / IGRT (modern external beam))
• Second line, squamous cell carcinoma: Izalontamab brengitecan after PD-(L)1 + platinum (PANKU-Esophagus01, OS and PFS benefit, 2026; approval pending); otherwise taxane or irinotecan; nivolumab/pembrolizumab if IO-naive. (PANKU-Esophagus01 (BL-B01D1-305), Izalontamab brengitecan)
• Second line, adenocarcinoma: T-DXd if HER2-positive (DESTINY-Gastric04); ramucirumab + paclitaxel; CLDN18.2 ADC after CLARITY-Gastric 01. (DESTINY-Gastric04, Trastuzumab deruxtecan, Ramucirumab, CLARITY-Gastric 01)

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.