Nutritional studies in upper gastrointestinal cancer

Abstract

Carcinoma of the oesophagus, gastro-oesophageal junction and stomach represent aggressive diseases with a poor prognosis even in patients undergoing curative resection. Where squamous cell histology once predominated, the incidence of oesophageal adenocarcinoma has risen dramatically in Western countries over the past three decades. Nutrition plays a key role in both the epidemiology of upper GI cancers and throughout the cancer journey. It is a key risk factor, with obesity thought to be fuelling the dramatic increase in incidence observed recently in the Western World. It also impacts on Gastro-oesophageal reflux disease and Barrett’s Oesophagus, and the metabolic abnormalities found in obesity are thought to be responsible for this. Once diagnosed with Upper GI cancer, profound changes occur to the patients’ nutritional status. Again nutritional therapy plays a key role on patients’ performance status, quality of life and immunological and physical well-being. This thesis describes several studies of the impact of nutrition on upper GI cancer -from its aetiology to treatment outcomes.