Blog

Gastrointestinal tumors remain among the most common and challenging forms of cancer. Despite major technological and pharmacological advances, many patients are still diagnosed when the disease is already locally advanced or metastatic, which explains why mortality has not decreased as much as we would expect. The crucial message is twofold: first, the need for timely endoscopic investigation with gastroscopy and colonoscopy; and second, the implementation of a “precision” therapeutic strategy, based on molecular control of the tumor and the close collaboration of an experienced, multidisciplinary team. 

Molecular control

In modern oncology, molecular characterization is not an “additional” examination, but the compass of the therapeutic strategy. It reveals the tumor’s immunobiology, potential gene mutations, and therapeutic targets, determining whether the patient may benefit from immunotherapy, targeted therapies, or specialized combinations with chemotherapy. Ideally, this analysis is performed at the time of diagnosis and reevaluated whenever necessary, so that each decision is based on truly personalized data. 

Esophageal & Stomach Cancer

In recent years, there has been a clear shift towards preoperative therapeutic strategies in esophageal and stomach cancer. The combination of chemotherapy with radiotherapy and, where indicated, the addition of immunotherapy or biological agents contributes to reducing the disease burden and increases the chances of radical (R0) resection. 

In the surgical field, the robotic approach has been established as a benchmark in specialized centers, as it offers greater precision, less morbidity and faster recovery. Postoperatively, adjuvant therapies are individualized based on pathoanatomical response and molecular markers, ensuring targeted and customized care for each patient. 

Hepatobiliary tract cancer

Progress in liver and biliary tract tumors has been particularly substantial in recent years. In hepatocellular carcinoma, combinations of immunotherapy with targeted biological agents have significantly improved overall survival, even in advanced stages of the disease. 

In parallel, locoregional therapies such as chemoembolization and radioembolization are powerful tools in selected patients, often in combination with systemic treatments. 

Regarding cholangiocarcinoma, a form with a traditionally poor prognosis and a “silent” clinical course, the widespread application of molecular testing is now paving the way for targeted therapies to specific genetic mutations or rearrangements. At the same time, immunotherapy is gradually gaining ground in selected subgroups of patients, offering new therapeutic possibilities.

Pancreatic cancer

Pancreatic cancer remains one of the greatest challenges. Here, the key is resectibility: whether the tumor can be radically removed. We often start with neoadjuvant therapies, seeking to convert a marginally or initially inoperable tumor into an operable one. Successful surgical resection, in specialized centers with high experience, remains the strongest factor in long-term survival. In addition, stereotactic radiotherapy can provide effective local control in well-selected cases.

Colorectal cancer

In colorectal cancer, the most powerful “weapon” remains prevention: an early colonoscopy can detect and remove polyps before they develop into malignancy.

Once the disease is diagnosed, we now have effective combinations of chemotherapy and biological agents. In tumors with high microsatellite instability or DNA repair deficiency, immunotherapy has the potential to transform the course of the disease, offering prolonged responses. In oligometastatic stages, aggressive local treatment such as surgical removal of metastases, ablation or focused radiotherapy can lead to impressive and long remissions. 

Rectal cancer

In rectal cancer the paradigm shift is impressive. The so-called “total neoadjuvant therapy” transfers the entire planned systemic and radiotherapy before surgery. In this way we seek better local control and, where possible, avoidance of permanent colostomy, an issue of enormous importance for quality of life. The decision to operate is made after new staging, through close collaboration between oncologist, radiation therapist and surgeon. In anal cancer, after two decades of stable radiochemotherapy protocols, immunotherapy is now making its presence felt in selected profiles.

Radiotherapy& interventional radiology

Radiotherapy has evolved into a highly precise science. Modern techniques such as IMRT/VMAT, imaging-guided radiotherapy and stereotactic radiosurgery, allow for maximum tumor destruction with minimal burdenon healthy tissues. At the same time, interventional radiology offers minimally invasive locally targeted solutions to localized foci, particularly useful in oligometastatic disease or when an extensive surgical approach is not possible. 

Robotic surgery

Robotic surgery, finally, is not a “luxury” but a means for better oncological precision with fewer complications, where experience and indications exist. From the esophagus and stomach to the colon and selected hepatopancreatic procedures, minimally invasive technology improves hospitalization, postoperative pain and, very often, functional outcomes. 

A new era in Oncology is marked by the opening of theInternational Oncology Center of the Athens Medical Group in Thessaloniki. The model International Oncology Center operates with standards comparable to the leading oncology centers worldwide, offering holistic care to each patient, from early diagnosis, personalized treatment and continuous monitoring, in state-of-the-art, specially designed spaces, with high security and aesthetics.