Oncology

Upper GI Oncology

Upper GI cancers involve the oesophagus, stomach, pancreas and biliary system.

Treatment is tailored to stage, to anatomy and to overall health, often combining therapeutic endoscopy, minimally invasive surgery, and oncology care (chemotherapy/radiotherapy) within a multidisciplinary team.

I was one of the only surgeons in NSW using endoscopy to treat early oesophageal and gastric cancers. Endoscopy used to be mainly for diagnosis. Now we can diagnose and treat early cancers during the same procedure.

Oesophageal Cancer

Early oesophageal tumours can often be treated endoscopically:

EMR (Endoscopic Mucosal Resection)
ESD (Endoscopic Submucosal Dissection)
Radiofrequency ablation (RFA/HALO) for selected precancerous or superficial lesions

More advanced disease may require oesophagectomy (removal of part or most of the oesophagus):

Performed laparoscopically or robotically where appropriate
Delivered within a multi-disciplinary team alongside chemotherapy and/or radiotherapy

Gastric (Stomach) Cancer

Very early lesions may be suitable for EMR/ESD, otherwise, surgery is the cornerstone:

Gastrectomy (partial or total), performed open, laparoscopic or robotic, depending on the case
Minimally invasive approaches aim to reduce pain, shorten stay and support faster recovery

Pancreatic Cancer

Management focuses on safe restoration of bile/pancreatic drainage and tumour control:

Pancreatectomy (e.g., distal pancreatectomy or pancreaticoduodenectomy / “Whipple”)
Selected steps may be laparoscopic or robotic; some cases require open surgery due to anatomy and involvement of adjacent organs
ERCP can help diagnose and relieve obstruction (e.g., stent placement) as part of the overall plan

Modern training, expertise and peri-operative care have significantly reduced risks compared with historical figures.

In a tertiary referral environment, we have all the modern tools and the full suite of specialists - including chemotherapy - working together.”

Biliary (Cholangiocarcinoma) & Obstructive Jaundice

Biliary cancers arise in the bile ducts and may present with pain, jaundice or abnormal liver tests.

Care typically includes:

Advanced imaging and endoscopy
ERCP to diagnose and place stents to restore bile flow
Surgical resection in selected cases, coordinated within the MDT

What To Expect

You’ll undergo streamlined staging (endoscopy, targeted imaging and MDT review).

If endoscopic therapy is suitable, it’s usually day-only. For surgery, most patients have laparoscopic or robotic approaches where appropriate, a short hospital stay, and an enhanced recovery plan covering pain control, nutrition, and return to activity.

Risks & Considerations

All treatments carry risk (bleeding, infection, leaks, cardiopulmonary complications).

Specific risks vary by procedure (e.g., ERCP-related pancreatitis; anastomotic leak after oesophagectomy/gastrectomy). A/Prof Talbot will discuss individual risk-benefit and the role of adjunct therapies (chemo/radiotherapy) in your plan.

Endoscopy has helped us manage some of the more unpleasant complications that can occur after cancer surgery… techniques we developed here are now used across Australia and New Zealand.”

Why Choose Upper GI Surgery?

Therapeutic endoscopy + surgery in one team - ERCP, EMR/ESD and RFA alongside minimally invasive oesophagectomy, gastrectomy and pancreatic surgery -the right treatment at the right time.
Minimally invasive focus - high-volume laparoscopic and robotic experience for upper GI cancer operations.
Early-lesion expertise - among the earliest NSW surgeons to adopt endoscopic therapy for early oesophageal and gastric cancers, providing organ-sparing options when suitable.
Multidisciplinary care - managed within a tertiary referral network with specialist oncology, radiology, pathology and ICU support.
Personalised pathways - treatment plans tailored to stage, fitness and patient goals, with clear communication at every step.

Ready to take the next step?

If you’ve been diagnosed with, or are being investigated for an upper GI cancer, book a consultation to review your scans, confirm staging and map the most effective, least invasive plan for you.

Upper GI Surgery
Suite 3 Level 5 1 South St,
Kogarah NSW 2217

P: 02 9553 1120
F: 02 9553 7526
E: info@uppergisurgery.com.au

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