Questions Patients Ask Most

• Gallstones (cholelithiasis) — hardened deposits of bile or cholesterol
• Biliary sludge — microscopic cholesterol and bile particles
• Cholecystitis — inflammation of the gallbladder, usually caused by gallstones
• Adenomyomatosis — non-cancerous thickening of the gallbladder wall
• Gallbladder polyps — small benign growths in the lining
• Functional gallbladder disorder (biliary dyskinesia) — abnormal function without stones

• Gallstones and sludge — imbalance in bile composition, genetics, obesity or rapid weight loss
• Cholecystitis — blockage of the cystic duct, usually by a stone
• Adenomyomatosis and polyps — exact cause unclear, possibly linked to chronic inflammation
• Functional disorders — abnormal gallbladder motility or hypersensitivity

• Persistent pain in the upper right abdomen, especially after meals (biliary colic)
• Nausea or vomiting
• Indigestion, bloating or intolerance of fatty food
• Fever and chills, which may mean inflammation or infection
• Yellowing of the skin or eyes (jaundice), which may mean bile duct obstruction

Diagnosis: history and examination, ultrasound (to find stones, polyps or thickened walls), a HIDA scan to assess function, CT or MRI for complex cases, and blood tests for liver function, infection and obstruction.

Treatment:

• Lifestyle — a low-fat diet eases mild symptoms
• Medication to dissolve small stones — rarely effective
• Laparoscopic cholecystectomy — gallbladder removal, the most common treatment for symptomatic stones or cholecystitis
• Endoscopic procedures to clear stones from the bile duct
• Monitoring for small asymptomatic polyps or adenomyomatosis

Yes. Most people live normal, healthy lives after removal — the liver keeps producing bile for digestion. Fatty meals may need some dietary adjustment at first.

To prevent gallbladder problems in the first place: keep a healthy weight and avoid rapid weight loss, eat a balanced diet with moderate fat and plenty of fibre, stay active and drink enough water.

A malignant tumour beginning in the cells of the gallbladder — most commonly adenocarcinoma, starting in the epithelial cells of the lining.

It is rare overall, but noticeably more common in India, Pakistan, South America and Eastern Europe. Women are affected more often than men, usually in their 60s or 70s.

• Gallstones — chronic inflammation is a significant risk factor
• Porcelain gallbladder — calcification of the wall from long-term inflammation
• Chronic infections of the bile ducts
• Gallbladder polyps larger than 1 cm
• Obesity, which raises the risk of stones and inflammation
• Family history and exposure to certain industrial toxins

No. Gallstones are present in 80–90% of gallbladder cancer patients, which makes them the most strongly associated risk factor — but only a tiny fraction of people with gallstones ever develop the cancer.

The link is chronic inflammation: persistent stones irritate the gallbladder wall, repeated injury alters the DNA of the lining cells, and prolonged inflammation can calcify the wall into a porcelain gallbladder. Larger stones and long-standing disease carry more risk than small, recent ones.

Yes. Cholecystectomy is the most effective way to eliminate the risk in patients with symptomatic stones or high-risk features:

• Large gallstones
• Porcelain gallbladder
• Gallbladder polyps larger than 1 cm

For asymptomatic gallstones, surgery is usually not recommended unless other risk factors are present.

Symptoms are usually absent early. Later: upper right abdominal pain, nausea and vomiting, jaundice, weight loss and loss of appetite, fever and fatigue, or a lump in the abdomen.

Diagnosis: ultrasound first, then CT or MRI, PET scans for spread; ERCP and endoscopic ultrasound for detailed imaging and biopsy; liver function tests and tumour markers such as CA 19-9 and CEA; and biopsy for confirmation.

Stages run from Stage 0 (limited to the inner lining) through Stage I (confined to the wall), Stage II (nearby tissue), Stage III (lymph nodes or nearby organs) to Stage IV (distant metastasis).

Treatment: cholecystectomy for early-stage disease; extended surgery including part of the liver and lymph nodes for advanced local disease; chemotherapy; radiation therapy; and palliative care where the disease is inoperable. It is curable when detected early and removed surgically — unfortunately many cases present late.

Non-cancerous conditions of the bile ducts or gallbladder:

• Cholelithiasis — stones in the gallbladder or bile ducts
• Choledocholithiasis — stones lodged in the common bile duct
• Cholangitis — inflammation of the bile ducts, usually from infection after an obstruction
• Biliary strictures — narrowing after injury, surgery or chronic inflammation
• Biliary dyskinesia — dysfunctional bile duct or gallbladder motility
• Primary biliary cholangitis (PBC) — a chronic autoimmune disease damaging the small bile ducts

Symptoms range from right upper abdominal pain after fatty food to jaundice, dark urine and pale stools, nausea and vomiting, fever and chills, and persistent fatigue.

Diagnosis: liver function tests, bilirubin, ALP and GGT; ultrasound as first-line imaging; MRCP for non-invasive imaging of the ducts; ERCP for both diagnosis and treatment; and biopsy where PBC is suspected.

Treatment depends on the condition:

• Gallstones — cholecystectomy if symptomatic; asymptomatic stones may need nothing
• Cholangitis — antibiotics and bile duct drainage via ERCP
• Strictures — endoscopic stenting or balloon dilation
• Biliary dyskinesia — cholecystectomy if symptoms are severe
• Primary biliary cholangitis — ursodeoxycholic acid (UDCA) to slow progression

Left untreated, these can lead to biliary colic, acute cholangitis (life-threatening), pancreatitis and biliary cirrhosis.

Surgery restores bile flow from the liver to the intestine, prevents infection, leaks, strictures and liver damage, and relieves jaundice and pain. Early repair by an experienced hepatobiliary surgeon has success rates of 85–95%.

A poorly performed repair can cause:

• Biliary strictures — scar tissue narrowing the ducts, in 25–40% of suboptimal repairs
• Persistent bile leaks — infection, peritonitis or abscess
• Recurrent cholangitis — up to 10% mortality if untreated
• Liver damage or failure — chronic obstruction can lead to cirrhosis and, in some cases, transplantation

Low-experience centres report failure rates up to 50%, against 5–10% in high-volume specialised centres. Timing matters too: early repair within 72 hours gives the best outcomes; delayed repair after 6–8 weeks is workable; repair during active inflammation carries the highest risk.

Cancer forming in the ducts that carry bile from the liver to the small intestine:

• Intrahepatic — inside the liver
• Perihilar — where the ducts enter the liver
• Extrahepatic — outside the liver, near the gallbladder or small intestine

Risk factors include cirrhosis and hepatitis, primary sclerosing cholangitis, liver fluke infection, gallstones and bile duct abnormalities, and age over 65 (more common in men). Symptoms are vague — jaundice, upper right abdominal pain, itchy skin, unexplained weight loss, dark urine and pale stools, fever and chills.

Treatment: surgical resection of part of the bile duct, liver or gallbladder is the most effective option, with liver transplant for a very selected group. Where surgery is not possible, stenting relieves blockage, and chemotherapy, radiation, targeted therapy and immunotherapy help control the disease. Prognosis depends heavily on how early it is found.

Conditions affecting the liver that do not involve cancer or immediate risk of liver failure. They may change the structure of the liver or how it functions, but are usually treatable and do not progress to liver cancer. Common ones:

• Fatty liver disease (NAFLD / NASH)
• Liver cysts
• Hepatic hemangiomas
• Liver adenomas
• Benign biliary lesions
• Hemochromatosis

They are not cancerous, but some can cause complications, so monitoring still matters.

Non-alcoholic fatty liver disease is fat building up in liver cells without significant alcohol intake, usually linked to obesity, type 2 diabetes and poor diet. NASH (non-alcoholic steatohepatitis) is the more severe form, where the fat causes inflammation and tissue damage.

It often causes no symptoms but can damage the liver over time. Early-stage disease is managed with weight loss, a better diet and more physical activity; medication may be added for related problems such as high cholesterol or diabetes.

Fluid-filled sacs in the liver, usually benign and symptom-free, most often found by chance during imaging for something else. Two main types:

• Simple cysts — the most common, and usually harmless
• Polycystic liver disease — a genetic condition where multiple cysts form over time

Most need only regular monitoring. If a cyst grows large or becomes painful, it may be drained or, rarely, surgically removed.

Hepatic hemangiomas are the most common benign liver tumour — clusters of blood vessels, usually symptom-free and found incidentally. Treatment is normally unnecessary unless they cause abdominal pain or bleeding, in which case surgical removal may be needed.

Liver adenomas form from liver cells and are more common in women, particularly those who have used oral contraceptives or anabolic steroids. They are generally harmless, but can rupture, bleed or (rarely) turn malignant. Large or symptomatic adenomas are usually removed; small, silent ones are monitored.

Many cause nothing at all, especially early. Some people notice:

• Abdominal pain, especially in the upper right side
• Fatigue
• Nausea or loss of appetite
• Jaundice, in rare cases
• Itchy skin

The prognosis is generally excellent. Most of these conditions cause no long-term liver damage and are managed with lifestyle changes or minor interventions. Regular monitoring catches the rare complication early.

• Primary liver cancer — starts in the liver itself. The most common form is hepatocellular carcinoma (HCC), arising from liver cells. Others include cholangiocarcinoma (bile duct cancer) and angiosarcoma
• Secondary (metastatic) liver cancer — has spread to the liver from elsewhere, such as the colon, lungs or breast

• Chronic liver disease — long-term hepatitis B or C infection
• Cirrhosis — scarring from alcohol, fatty liver disease or hepatitis
• NAFLD — fat accumulation unrelated to alcohol
• Aflatoxins — toxins from moulds on badly stored grain and nuts
• Heavy alcohol use
• Diabetes and obesity
• Family history

Early liver cancer often causes nothing. As it progresses: unexplained weight loss, loss of appetite, fatigue and weakness, abdominal pain or swelling in the upper right side, jaundice, nausea or vomiting, dark urine and pale stools.

Diagnosis:

• History and physical examination, reviewing risk factors
• Blood tests — liver function and alpha-fetoprotein (AFP)
• Imaging — ultrasound, CT and MRI to find tumours and assess size and location
• Liver biopsy to confirm cancer cells
• Screening — regular ultrasound and AFP for people with cirrhosis or chronic hepatitis B/C

Surgery — the most effective treatment in early disease:

• Liver resection (hepatectomy) — removes the part of the liver containing the tumour; suitable when liver function is good and the cancer is localised
• Liver transplant — replaces the diseased liver, often for early-stage cancer with underlying disease such as cirrhosis

Ablative therapies: radiofrequency or microwave ablation (heat) and cryoablation (freezing) to destroy cancer cells.

Chemoembolisation and radioembolisation: TACE delivers chemotherapy directly into the tumour's blood supply; SIRT delivers radiation through tiny beads injected into it.

Drug therapy: targeted drugs such as sorafenib or lenvatinib, and immunotherapy such as atezolizumab with bevacizumab.

Radiation therapy for advanced cases or where surgery is not possible, and palliative care focused on symptom control and quality of life.

• Listen — let them express fear and frustration without being fixed
• Help with appointments — transport, notes, company
• Learn about the disease so you understand what they are facing
• Encourage healthy habits — diet, activity where possible, and sticking to the treatment plan
• Find support — for them, and for yourself as a caregiver

Non-cancerous conditions affecting the colon (large intestine) and rectum:

• Colon polyps — growths on the inner lining, some of which can become cancerous if not removed
• Diverticular disease — small pouches in the colon wall that can become inflamed or infected (diverticulitis)
• Irritable bowel syndrome (IBS) — a functional disorder causing pain, bloating and changed bowel habits
• Inflammatory bowel disease (IBD) — ulcerative colitis and Crohn's disease, causing chronic inflammation

These are not life-threatening, but some — polyps in particular — need timely management to prevent progression to colorectal cancer.

• Abdominal pain or cramping
• Changes in bowel habits — diarrhoea, constipation, or both
• Rectal bleeding or blood in the stool
• Mucus in the stool
• Bloating or excessive gas
• Unexplained fatigue, from anaemia caused by chronic bleeding

• History and examination — symptoms, family history, risk factors
• Colonoscopy — direct visualisation of the colon and rectum to find polyps or inflammation
• Imaging — CT, MRI or barium enema X-rays for structural problems
• Lab tests — stool tests for blood, infection or inflammation; blood tests for anaemia and inflammatory markers

Surgery becomes necessary when:

• Symptoms persist and significantly affect quality of life
• Complications develop — obstruction, perforation or severe bleeding
• Diverticulitis is recurrent or complicated
• A polyp cannot be removed at colonoscopy or carries a high cancer risk
• Medical management of inflammatory bowel disease fails

Procedures: polypectomy during colonoscopy; laparoscopic surgery to remove affected sections; segmental colectomy preserving the rest of the tract; total colectomy in severe IBD or familial polyposis; and rarely a colostomy or ileostomy to reroute waste temporarily or permanently.

Recovery: 3–7 days in hospital after major surgery; light activities within a few weeks and full recovery in 4–6 weeks; a gradual return to normal eating starting with a low-fibre or soft diet; and regular follow-ups.

Prevention:

• Eat a high-fibre diet — whole grains, fruit and vegetables
• Stay hydrated to keep stools soft
• Exercise regularly
• Avoid smoking and heavy alcohol
• Get screened, especially over 45 or with a family history

Cancer developing in the colon or rectum. It typically begins as a small, non-cancerous polyp that gradually turns cancerous over time.

Risk factors:

• Age — most cases occur after 50, though younger people are affected too
• Family history of colorectal cancer or polyps
• Lifestyle — diets high in red and processed meat, obesity, smoking, heavy alcohol
• Medical conditions — IBD such as Crohn's and ulcerative colitis, and genetic syndromes like Lynch syndrome or familial adenomatous polyposis (FAP)

Early-stage disease often has none, which is exactly why screening matters. When symptoms do appear:

• Changes in bowel habits — diarrhoea, constipation or narrowed stool — lasting more than a few weeks
• Rectal bleeding or blood in the stool
• Persistent abdominal pain or cramping
• Unexplained weight loss
• Fatigue or weakness from anaemia

Surgery:

• Polypectomy during colonoscopy for very early cancers
• Partial colectomy — removes the cancerous section, usually reattaching the healthy ends
• Abdominoperineal resection (APR) — for rectal cancers close to the anus, removing the rectum and anus and creating a colostomy

Plus chemotherapy before or after surgery, radiation therapy often combined with chemotherapy for rectal cancers, targeted therapy for advanced disease and immunotherapy for some genetic subtypes.

After surgery, expect 3–7 days in hospital and 4–6 weeks to full recovery, with dietary adjustment starting on soft or low-fibre food. Chemotherapy or radiation may run over weeks or months.

• Early-stage cancers have a high survival rate — up to 90% of patients survive five years or more after treatment
• Advanced cancers that have spread are harder to treat, though targeted therapies and immunotherapies are improving outcomes

Regular screening and early treatment give the best chance of a successful recovery.

• Local excision — for small, early tumours near the anus, removed through the anus without major incisions
• Low anterior resection (LAR) — for tumours in the upper or middle rectum; the colon is reconnected to the remaining rectum to keep normal bowel function
• Abdominoperineal resection (APR) — for cancers in the lower rectum close to the anus; the rectum, anus and surrounding tissue are removed and a permanent colostomy created
• Total mesorectal excision (TME) — a precise technique removing the rectum and surrounding lymph nodes, often combined with LAR or APR
• Laparoscopic or robotic surgery — smaller incisions, quicker recovery, less pain afterwards

• Neoadjuvant therapy (before surgery) — radiation and/or chemotherapy for locally advanced rectal cancer, to shrink the tumour, make it easier to remove and reduce recurrence
• Adjuvant therapy (after surgery) — used if cancer cells are found in the lymph nodes or the margins of removed tissue are positive

A colostomy is an opening (stoma) created in the abdominal wall so waste can leave the body into a bag. It may be:

• Temporary — to let the rectum heal after surgery
• Permanent — when the anus and rectum are removed, as in APR

Your surgeon will tell you whether one is needed for your case. If it is, specialised stoma nurses will teach you how to manage it.

• Bleeding or infection at the surgical site
• Leakage where the colon and rectum are reconnected
• Changes in bowel function — diarrhoea or incontinence
• Nerve damage affecting bladder or sexual function
• Adhesions or bowel obstruction

Early-stage rectal cancer confined to the rectum with no lymph node involvement may be cured by surgery alone. Advanced stages do best with surgery, chemotherapy and radiation combined.

• Gastritis — inflammation of the stomach lining, often from Helicobacter pylori infection, heavy alcohol use or NSAID medicines
• Peptic ulcers — open sores in the lining of the stomach or upper small intestine, usually from H. pylori or prolonged NSAID use
• Gastric polyps — small growths, usually harmless, sometimes removed if symptomatic or suspicious
• Gastroparesis — the stomach empties too slowly, often related to diabetes or nerve damage

• Upper abdominal pain or discomfort
• Nausea or vomiting
• Loss of appetite or unintentional weight loss
• Bloating, or feeling full after small meals
• Heartburn or indigestion
• Black or tarry stools, which may mean a bleeding ulcer

• Endoscopy — a flexible camera examines the lining and finds ulcers or polyps
• Biopsy during endoscopy, to rule out infection, inflammation or malignancy
• Imaging — X-rays, CT scans or barium swallow studies for structural problems
• Lab tests — blood, stool or breath tests for H. pylori

Medication: antibiotics to eradicate H. pylori; proton pump inhibitors (PPIs) to cut acid and heal ulcers; antacids for heartburn; prokinetic agents to speed stomach emptying in gastroparesis.

Diet and lifestyle: avoid spicy, acidic or greasy food; cut alcohol and caffeine; eat smaller, more frequent meals.

Procedures: polypectomy during endoscopy; surgery for ulcers (rarely needed, but used for perforation or severe bleeding); gastric pacing or partial stomach removal for severe gastroparesis.

Surgery becomes necessary for persistent or recurrent ulcer bleeding, perforation, obstruction from scarring or polyps, and severe gastroparesis that does not respond to medical management.

Most do not. However, chronic H. pylori infection, long-standing gastritis and large gastric polyps can raise the risk of gastric cancer over time. Regular monitoring and timely treatment reduce that risk substantially.

To protect your stomach: eat a balanced diet of whole grains, lean protein and vegetables; avoid smoking and limit alcohol; use NSAIDs cautiously and with food; manage stress; and treat underlying conditions such as diabetes.

Cancer developing in the inner lining of the stomach, which can spread elsewhere if untreated. The most common type is adenocarcinoma, starting in the glandular cells of the lining. Rarer types include lymphomas and gastrointestinal stromal tumours (GISTs).

Early gastric cancer often causes no symptoms. Later ones include persistent indigestion or heartburn, loss of appetite or weight, nausea or vomiting (sometimes with blood), abdominal pain, feeling full quickly, and black tarry stools.

• H. pylori infection — linked to chronic gastritis and ulcers
• Diet — high intake of salted, smoked or pickled food
• Smoking and alcohol
• Family history
• Chronic inflammation — pernicious anaemia, chronic gastritis
• Previous stomach surgery, such as for ulcers

• Subtotal (partial) gastrectomy — removes the cancerous part of the stomach, usually for tumours in the lower or middle stomach; the remainder is reconnected to the small intestine
• Total gastrectomy — removes the whole stomach with nearby lymph nodes, and sometimes parts of the esophagus or small intestine; the esophagus is joined directly to the small intestine
• Endoscopic resection — for very early cancers confined to the lining, removed through an endoscope with no major incisions
• Lymphadenectomy — removal of nearby lymph nodes to check and limit spread
• Palliative surgery — in advanced cases, to relieve blockage or bleeding rather than to cure

Minimally invasive laparoscopic or robotic techniques are used where appropriate, shortening recovery and reducing complications.

• Neoadjuvant therapy (before surgery) — chemotherapy or chemoradiation to shrink the tumour and make surgery more effective
• Adjuvant therapy (after surgery) — to kill remaining cancer cells and reduce recurrence
• Targeted therapy — drugs such as trastuzumab for cancers with specific markers (e.g. HER2-positive)
• Immunotherapy — boosts the immune response in advanced disease

Risks: bleeding or infection; anastomotic leak from surgical connections; blood clots or deep vein thrombosis; nutritional deficiencies; and dumping syndrome, where food moves too fast into the small intestine causing nausea, dizziness or diarrhoea.

Eating afterwards: the stomach holds less, so smaller and more frequent meals are necessary. Total gastrectomy can cause deficiencies in iron, calcium and vitamin B12 that need supplements. Diarrhoea, bloating and dumping syndrome are managed with dietary changes and medication, guided by a dietitian.

Yes, if detected and treated early. Prognosis depends on the stage at diagnosis, the patient's overall health and response to treatment, and whether the cancer has spread. Advances in surgical technique, chemotherapy and targeted therapy have improved survival rates.

Recovery: usually 7–10 days in hospital; liquids first, then soft food, with long-term dietary adjustment; light activity such as walking encouraged, with no heavy lifting for several weeks; and regular follow-up with imaging, blood tests and endoscopy.

Preparation before surgery helps: pre-surgical testing, quitting smoking and alcohol, optimising nutrition, and emotional preparation through counselling or support groups.

Non-cancerous conditions affecting the structure or function of the esophagus:

• Gastroesophageal reflux disease (GERD) — stomach acid flows back up, causing heartburn and irritation
• Achalasia — the lower esophageal sphincter (LES) fails to relax, so food struggles to pass into the stomach
• Esophageal strictures — narrowing, often from scarring after acid reflux or injury
• Hiatal hernia — part of the stomach pushes up into the chest through the diaphragm
• Esophageal diverticula — pouches in the lining that can trap food

• Heartburn or acid reflux
• Difficulty swallowing (dysphagia)
• Regurgitation of undigested food
• Chest pain or discomfort
• Chronic cough or hoarseness, common in GERD
• A feeling of food getting stuck in the throat or chest

• Endoscopy — a camera examines the esophagus for inflammation, strictures and other abnormalities
• Barium swallow test — X-rays after swallowing barium to highlight the esophagus
• Esophageal manometry — measures muscle contractions, used especially for achalasia
• pH monitoring — assesses acid levels for GERD
• CT or MRI — for structural issues such as hiatal hernia or diverticula

Lifestyle (mainly for GERD and hiatal hernia): avoid spicy, fatty and acidic food; eat smaller meals and stay upright afterwards; stop smoking and cut alcohol; keep a healthy weight.

Medication: antacids, PPIs or H2 blockers to reduce acid and heal the esophagus; prokinetic agents to improve motility.

Endoscopic procedures: dilation of strictures with a balloon or dilator; Botox injections to temporarily relax the LES in achalasia.

Surgery: fundoplication to strengthen the LES in GERD or hiatal hernia; Heller myotomy to relieve LES pressure in achalasia; diverticulectomy to remove diverticula.

Surgery is considered when medication and lifestyle changes fail, when narrowing or motility problems are significant, when complications such as perforation or recurrent aspiration pneumonia arise, or when GERD leads to Barrett's esophagus or severe esophagitis.

The benign conditions themselves are not cancerous. However, chronic GERD can increase the risk of developing Barrett's esophagus, which may progress to esophageal cancer if left untreated. Regular monitoring and treatment reduce that risk significantly.

A malignant growth in the esophagus, the tube connecting throat to stomach. Two main types:

• Squamous cell carcinoma — affects the upper or middle esophagus
• Adenocarcinoma — more common in the lower esophagus, often linked to chronic acid reflux or Barrett's esophagus

Symptoms include difficulty swallowing, unexplained weight loss, chest or back pain, persistent heartburn or indigestion, vomiting or regurgitation of food, and chronic cough or hoarseness.

• Endoscopy — to view the esophagus and take biopsies
• Barium swallow test — highlights abnormalities on X-ray
• CT or PET scans — assess spread to nearby organs or lymph nodes
• Endoscopic ultrasound (EUS) — determines how deep the tumour has invaded and checks nearby lymph nodes

Surgery is recommended for early-stage cancer that is localised and has not spread, and for locally advanced cancer, usually after chemotherapy or radiation has shrunk the tumour. It may not be an option with significant metastasis or where other health conditions make major surgery unsafe.

During an esophagectomy:

• The cancerous portion of the esophagus and nearby lymph nodes are removed
• The stomach is reshaped into a tube and connected to the remaining esophagus
• Sometimes part of the colon or small intestine is used to reconstruct it
• Incisions may be made in the neck, chest or abdomen depending on tumour location

• Leakage at the surgical connection (anastomotic leak)
• Infection or bleeding
• Respiratory complications such as pneumonia
• Difficulty swallowing or reflux after surgery
• Nutritional challenges requiring dietary adjustment

Recovery: 7–10 days in hospital with close monitoring; a liquid or soft diet at first, with solids reintroduced gradually; medication for pain; light activity encouraged but no heavy lifting or strenuous exercise for 4–6 weeks; and regular follow-up with imaging.

Eating and digestion: the stomach holds less, so meals need to be smaller and more frequent; swallowing can be temporarily difficult; reflux or dumping syndrome may cause nausea, diarrhoea or bloating; and nutritional deficiencies may need monitoring and supplements. A dietitian will guide you through it.

Treatment usually combines several approaches: neoadjuvant therapy (chemotherapy or radiation before surgery to shrink the tumour), adjuvant therapy afterwards to kill remaining cells, and targeted therapy or immunotherapy for advanced cases.

Surgery offers the best chance of cure when the cancer is found early and is localised. Advanced-stage cancers usually need additional therapies to control the disease, and regular follow-up is essential to detect recurrence.

To prepare: pre-surgical tests including imaging, blood work and nutritional assessment; quitting smoking and alcohol; optimising nutrition; and emotional readiness through counselling or support groups.

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