In order for us to schedule your patients into the appropriate consultation hours, please send us the completed registration form for new patients and existing diagnostic findings by fax or e-mail in advance. The registration form contains additional information for your patients and can be downloaded as a PDF file. After receiving your fax or e-mail, we will contact your practice or the patient directly.

Information on studies that are currently in the recruiting phase can be found on our website (also available at www.nct-heidelberg.de/studien). In addition, the senior physicians responsible for the entity are happy to provide information on further study details.

General information

In Germany, approximately 23,000 patients are diagnosed with esophageal carcinoma or carcinoma of the stomach every year. Due to lack of early symptoms, a great majority of these diseases is discovered at an advanced stage.

Tumors of the esophagus are differentiated as squamous cell carcinoma, which is usually located in the upper two thirds of the esophagus, and adenocarcinoma, which arises in the lower third of the esophagus or at its junction to the stomach (gastroesophageal junction). Risk factors for esophageal cancer include alcohol consumption and smoking, possibly with concomitant nutritional deficits, especially vitamin deficiencies. Reflux disease plays an important role in tumors of the gastroesophageal junction.

Besides nutrition factors (low fruit and vegetable consumption, excessive consumption of cured and smoked foods), smoking, and excessive alcohol consumption, the bacterium Helicobacter pylori is known to be a mediator of secondary inflammation with secondary malignant transformation into stomach cancer. At a localized stage, surgical excision of the esophagus/stomach is the treatment of choice. At a locally advanced stage, a neoadjuvant (preoperative) chemotherapy/radiation therapy (irradiation and chemotherapy) is recommended. If surgery cannot be performed due to the extent of the tumor or because of accompanying diseases, for example, of the heart or lungs, then definitive radiochemotherapy (concurrent irradiation and chemotherapy) of the tumor is performed.

In metastastic disease, i. e., when metastasis to distant lymph nodes or organs has already occurred, the therapy of choice consists of tumor-specific system therapy. In addition to classical chemotherapy, immunotherapy or targeted therapy are increasingly used.

When patients with a newly diagnosed tumor of the esophagus or stomach present to our department, depending on which tests have already been done, further diagnostic examinations such as gastroscopy and/or endosonography (endoscopic ultrasound), CT examination, or bronchoscopy are performed and an assessment of accompanying diseases of the cardiac and circulatory system is made. Subsequently the findings are discussed in the interdisciplinary tumor board meeting by the medical oncology, gastroenterology, visceral surgery, radiation therapy, and radiology departments and, where appropriate, also with specialists from other disciplines; and a treatment recommendation is made. Further treatment then takes place in the different departments at Heidelberg University Hospital. If tumor-specific drug therapy is required, this is carried out in the NCT day care unit. The department also has a ward in which patients are monitored after having undergone endoscopic procedures, for example. In addition to those patients with a newly diagnosed disease, patients already being treated somewhere else can present themselves to our outpatient clinic for a second opinion.

Current clinical trials

Numerous studies on a wide range of tumor types and tumor stages are offered by the involved specialist disciplines. Several clinical studies are ongoing and open to participation in phases I/II/III at the Department of Medical Oncology at NCT for patients with esophageal and stomach cancer both in localized stages (as so-called perioperative treatment) and in metastatic disease.

Consultation sessions

Special consultation sessions are held several times a week in the Department of Medical Oncology at NCT for patients with tumors of the upper gastrointestinal tract (tumors of the esophagus and stomach). Where the findings indicate it is appropriate, referral is made to the colleagues in the Department of Radiation Oncology and Radiation Therapy or the Department of General, Visceral and Transplantation Surgery. In addition, dieticians, psycho-oncologists and colleagues from social services provide comprehensive support in coming to terms with the tumor diagnosis.