The foregut is the upper section of the digestive tract.

• Esophageal cancer
• Stomach cancer (gastric cancer)

We partner closely with Providence Digestive Health Institute for the diagnosis and treatment of many foregut conditions. Our foregut surgeons work with gastroenterologists to treat:

• Gastroesophageal reflux disease (GERD)
• Barrett’s Esophagus
• Hiatal hernias
• Paraesophageal hernias
• Motility and swallowing disorders

Learn More at Providence Digestive Health Institute

Some people with foregut cancers may experience signs and symptoms. If you experience any of the following, tell your doctor. These may be due to cancer or could be a sign of another medical condition.

• Difficulty and pain with swallowing, especially when eating or drinking
• Pressure or burning in your chest
• Frequent choking on food
• Heartburn or indigestion
• Vomiting
• Unexplained weight loss
• A lingering cough that won’t go away
• Pain behind the breastbone or in your throat

• Unexplained weight loss
• Loss of appetite
• Stomach pain
• Feeling full after eating small meals
• Heartburn or indigestion
• Nausea and vomiting
• Blood in the stool

There are some risk factors that can make people more likely to develop esophageal cancer. These include:

• Tobacco use
• Alcohol use
• Personal history of Gastroesophageal Reflux Disease (GERD)
• Personal history of Barrett’s Esophagus
• Being overweight
• Personal history of Achalasia
• Inherited conditions, such as Tylosis and Plummer-Vinson syndrome
• HPV infection

Risk factors that may increase the likelihood of developing stomach cancer include:

• Gender; men are more likely to develop stomach cancer
• Helicobacter pylori infection may lead to pre-cancerous changes in the stomach lining
• Being overweight
• Diets high in processed or grilled meats, high in salt-preserved foods, and low in fruit
• Tobacco use
• Alcohol use
• Previous stomach surgery
• Stomach polyps, such as adenomas
• Pernicious anemia
• Inherited cancer syndromes, such as Hereditary diffuse gastric cancer (HDGC), Lynch syndrome, GAPPS, Li-Fraumeni syndrome and PJS

We have a range of diagnostic procedures to accurately diagnose cancers of the esophagus and stomach. These include:

• Upper endoscopy (EGD)
• Endoscopic ultrasound
• Barium swallow study
• Confocal laser endomicroscopy: This procedure uses a high-powered microscope at the end of an endoscope to give real-time information that can help diagnose cancer.
• Endoscopic Mucosal Resection (EMR) & Endoscopic Submucosal dissection (ESD): These endoscopic procedures are advanced therapeutic techniques that precisely remove small growths, such as cancers or other tumors, from the lining of the esophagus or stomach before they grow larger and require major surgery.
• Comprehensive imaging with PET scans, CT scans and MRI

If you have been diagnosed with esophageal or stomach cancer, your treatments may include:

Our foregut surgeons use many methods to treat cancers. They often use minimally invasive techniques that help you recover sooner. These include:

• Endoscopic removal of small tumors
• Minimally invasive procedures such as esophagectomy and gastrectomy
• Reconstructions, including colon interpositions and photodynamic therapy or stenting. These may be used for large tumors that obstruct organ function.

Our medical oncologists also conduct cancer research. They offer a broad range of therapies and clinical trials. The most common treatments include chemotherapy, immunotherapy and targeted therapies. These can be used separately or together to target your cancer.

Providence Molecular Genomics Lab uses gene sequencing to determine the unique traits of your cancer. This information gives your doctor insights about what treatments will be most successful.

Radiation is often used in combination with medical oncology and surgery to further shrink your cancer. Providence offers multiple types of radiation therapy, including MRI guided stereotactic body therapy (MR Linac). MR Linac precisely targets the tumor and reduces the damage to healthy tissue. Soon, foregut cancer trials with MR Linac will be available at Providence Portland, the only center in the Pacific Northwest with this cutting-edge technology.

Nutrition is an important part of care for people with esophageal and stomach cancer. Your ability to eat may be affected by surgery or other treatments. Our oncology dietitians are specially trained to support your healing and nutritional needs.

Our oncology nurse navigator will act as your advocate throughout your cancer treatment. Nurse navigators help you understand your diagnosis and treatment. They will help coordinate your care, provide education, and connect you with support services when needed.

To learn more about available treatments for conditions such as GERD, Achalasia and Barrett’s Esophagus, please visit the Providence Digestive Health Institute website.

At Providence, you’ll have access to support resources that can complement and enhance your treatment. Our support teams can also connect you with resources to address the emotional, physical and financial stressors that come with a cancer diagnosis.

Our care and support services include:

• Oncology social work
• Financial counseling
• Support groups and wellness classes
• Integrative medicine (acupuncture, naturopathy, massage)
• Oncology palliative care
• Peer support

See Our Full List of Support Services