Overview
Gastroesophageal junction (GEJ) cancer is a malignancy that occurs where the esophagus meets the stomach. It is an aggressive cancer type often diagnosed at an advanced stage due to subtle early symptoms. Early detection and comprehensive treatment significantly improve outcomes. South Korea is recognized for its advanced cancer care, including specialized surgical techniques and multidisciplinary treatment approaches for GEJ cancer.
What is Gastroesophageal Junction Cancer?
GEJ cancer arises at the area where the esophagus transitions into the stomach. This cancer can be classified based on its location relative to the junction: tumors centered in the esophagus, the stomach, or precisely at the junction. It often includes adenocarcinoma, which originates from glandular cells lining this region.
Symptoms
Early symptoms may be mild or nonspecific, but as the tumor grows, symptoms include:
- Difficulty swallowing (dysphagia)
- Unintentional weight loss
- Persistent heartburn or acid reflux
- Chest or upper abdominal pain
- Vomiting, sometimes with blood
- Fatigue and anemia due to bleeding
- Regurgitation or sensation of food stuck in the throat
Causes
- Chronic gastroesophageal reflux disease (GERD) causing Barrett’s esophagus
- Smoking and alcohol consumption
- Obesity
- Dietary factors, including high salt intake and processed foods
- Genetic predisposition
- Infection with Helicobacter pylori (in some cases)
Risk Factors
- Male gender (higher prevalence)
- Age over 50
- Long-standing GERD and Barrett’s esophagus
- Tobacco use
- Obesity and metabolic syndrome
- Family history of upper gastrointestinal cancers
Complications
- Local tumor invasion causing obstruction of the esophagus or stomach
- Metastasis to lymph nodes, liver, lungs, or bones
- Bleeding and anemia
- Malnutrition due to difficulty eating
- Pain and decreased quality of life
Prevention
- Manage and treat GERD effectively
- Avoid tobacco and limit alcohol intake
- Maintain healthy weight and diet
- Regular medical checkups, especially if GERD or Barrett’s esophagus is present
- Early endoscopic screening for high-risk individuals
Treatment Options in Korea
South Korea offers cutting-edge treatment for GEJ cancer with a multidisciplinary approach involving surgery, chemotherapy, radiation, and targeted therapies.
- Diagnosis and Staging
- Upper endoscopy with biopsy for definitive diagnosis
- Endoscopic ultrasound (EUS) for tumor depth and lymph node assessment
- CT scan and PET scan for metastasis detection
- Surgical Treatment
- Minimally invasive esophagectomy or gastrectomy depending on tumor location and extent
- Lymph node dissection to reduce recurrence risk
- Chemotherapy and Radiation
- Neoadjuvant (pre-surgery) chemoradiation to shrink tumors
- Adjuvant (post-surgery) therapy to eliminate residual cancer cells
- Targeted therapies for specific genetic markers
- Advanced and Palliative Care
- Treatment to relieve symptoms in advanced stages, including stenting for obstruction
- Pain management and nutritional support
- Follow-Up and Survivorship
- Regular imaging and endoscopy to monitor for recurrence
- Rehabilitation services for swallowing and nutritional support
