Gachon University Gil Hospital

Stomach cancer is the second largest cancer outbreak. From cancer screening recommendation, adults over age of 40, who have an increased rate of gastric cancer, are required to be screened once every two years without any symptoms. When diagnosed with stomach cancer, the degree of disease progression (stage) is determined to establish treatment plan. Stomach cancer treatment includes endoscopic resection, surgery, and chemotherapy. Anti-cancer chemotherapy is performed when metastasis is accompanied as well as to prevent recurrence even if it is determined as stage 2 or 3 after surgery.

Colorectal cancer is the third most common cancer and the fourth cause of cancer death. Surgery is the main treatment, but chemotherapy or radiation therapy is performed before and after surgery depending on the location and progress of the tumor. In the fourth stage, genetic tests are conducted to provide customized chemotherapy.

Liver cancer refers to cancer that occurs in liver cells, and if it developed in other organs and spread to the liver, it is not regarded as liver cancer. It usually occurs when you have viral hepatitis or liver cirrhosis of any cause. Treatment is decided by considering the liver function, systemic condition, and stage comprehensively. In case of disease occurred only in the liver, localized treatments such as liver resection, liver transplantation, radiofrequency treatment, transarterial chemoembolization and radiation therapy are used. If there are metastases in other areas, systemic treatment is performed as a targeted treatment.

Bile duct cancer (biliary tract cancer) is cancer that occurs in the bile duct (biliary tract), which is a way to discharge bile made from the liver into the duodenum, and includes biliary tract cancer, hepatobiliary tract cancer and gallbladder cancer depending on its location. When biliary tract cancer occurs, biliary obstruction is common and bile is not discharged, resulting in jaundice, itching, and biliary tract infection. Symptoms such as pain and anorexia occur as the lesion progresses. Cancer stages are established through tests such as CT, MRI, biliary endoscopy, and surgery is performed if surgical treatment is possible. If surgery is not possible, chemotherapy using cytotoxic anticancer drugs is the standard treatment. Also, in order to improve biliary obstruction, symptom improvement must be performed through endoscopic/imaging medical procedures, so multidisciplinary consultation is essential.

Pancreatic cancer occurs in pancreas where secretes hormones such as digestive enzymes and insulin. Pancreatic cancer is often a condition with severe symptoms such as jaundice, weight loss, loss of appetite, abdominal pain and ascites, and is often diagnosed in later stages. Tests such as CT, MRI, endoscopic ultrasound or pancreatic endoscopy are used to identify the stage, and if surgery is possible, adjuvant therapy (chemotherapy or radiation therapy) will be added after surgery. Otherwise, chemotherapy using cytotoxic drugs will be done. Yet side effects are often severe, so you must control symptoms.

Lung cancer is a cancer that occurs in the parenchyma of the bronchus or lungs, and it is a cancer with a very high mortality rate, which is the number one death cause from cancer in Korea. Smoking is the leading cause, but it has been recently increasing among non-smokers and women. In non-small cell lung cancer stage 1 and 2, surgery is the main treatment, and in some cases of 1 and 2, chemotherapy is performed to reduce the recurrence rate after surgery. However, more than a half of lung cancer patients are diagnosed with stages 3 and 4 at time of diagnosis. In stage 3, it is recommended that the optimal combination of chemotherapy, radiotherapy, and surgery be considered through multidisciplinary treatment. In stage 4, anticancer chemotherapy is performed to delay disease progression and improve the quality of life, and various characteristics of lung cancer tissues such as EGFR, ALK, KRAS, ROS1 gene mutation and PD-L1 expression are investigated, and the most appropriate customized chemotherapy or immunotherapy will be advised. In case of small cell lung cancer, only chemotherapy or radiation therapy is performed depending on the degree of disease progression.

The thymus is an organ located behind the chestbone that involved with immune function. Thymus cancer is a rare cancer that occurs within 450 cases a year in Korea. When surgery is possible, surgery is the primary treatment, and for the purpose of reducing recurrence rate after surgery or surgery is too difficult to perform, chemotherapy is performed.

Pleural cancer (pleural mesothelioma) is a cancer that occurs in the membrane (pleura) that surrounds the lung, and asbestos is known to be the main cause. It is a very rare cancer that occurs within 30 cases a year in Korea. If surgery is possible, surgery is the main treatment, and chemotherapy is performed when surgery is difficult.

Breast cancer is the most common cancer among women in Korea, except for thyroid cancer. Part of stage 1 and stage 2 & 3, chemotherapy is performed to reduce the recurrence rate after surgery, and chemotherapy is also performed to reduce the size of the tumor before surgery for stage 4, which is difficult to cure. In breast cancer, targeted chemotherapy suitable to the hormone receptor and HER2 protein expression will be performed.

In Korea, breast cancer occurs relatively frequently in young patients. At Gil Medical Center, we provide necessary care for young patients, including weekend chemotherapy, genetic testing for risk assessment, consultation with gynecology for preservation of fertility and skin management.

Gynecological cancer refers to cancer that occurs in female reproductive organs, such as cervical cancer, ovarian cancer, endometrial cancer and vaginal cancer. Recently, the incidence of cervical cancer has decreased in Korea, but ovarian and endometrial cancer are increasing due to westernized food. Early detection of gynecological cancer is important, and the basic treatment for diagnosis is surgery.

Depending on the type and progress of gynecological cancer, chemotherapy and radiotherapy can be done.

Urinary cancer refers to cancer of the urinary system, such as kidney cancer, bladder cancer, and prostate cancer.

Kidney filters and excretes waste products of the body, and when cancer is formed in kidney, it is called kidney cancer. The most common type is transparent cell carcinoma, but there are various types of tissues, such as papillary carcinoma, small cell carcinoma, and sarcoma renal cancer. If it is found early, it can be cured through resection, and if metastasis occurs, the treatment is chosen according to the tissue type, and a targeted treatment is generally used. Recently, immuno-cancer drugs have been developed and showed good results.

Bladder cancer is a cancer that occurs in the bladder that collects and discharges urine, and is sometimes referred to as urinary tract epithelial cancer. Urinary tract epithelial cancer includes not only bladder cancer, but also renal and ureteral cancer. Bladder cancer is often found as the first symptom of hematuria, which is not accompanied by pain, and if it is found early and has very shallow lesions inside the bladder, good treatment outcome can be expected through cystoscopy. If the bladder cancer has penetrated into the bladder wall but stayed within the bladder, totall bladder resection is performed. Adjuvant chemotherapy before or after bladder resection improves survival rate, so chemotherapy is often combined. If bladder cancer has spread outside the bladder, chemotherapy is the standard treatment.

The prostate exists only in men and is an organ of the size of a chestnut just below the bladder. Prostate cancer is a cancer that can be cured through surgery or radiation treatment if it is detected early, but if it is found in advanced conditions, it is difficult to cure, but there are various treatment methods that can increase the survival time. Prostate cancer is known to be affected by testosterone, a male hormone, and attempts to deprive testosterone as the first treatment method can be considered. If it becomes resistant to testosterone deprivation (castration resistant prostate cancer), the latest treatments such as next-generation hormone therapy and cytotoxic chemotherapy are available alternatives. Because bone metastasis is common together with pain and fractures, treatment for metastatic sites and prevention of bone-related complications are also important, so multidisciplinary approach to treatment is very important.

Head and neck cancer refers to cancers that occur in the oral cavity (lips, gums, tongue, etc.), tonsils, pharynx, larynx, nasal cavity, sinuses, and salivary glands. Smoking is the most common cause and some are related to viruses. If surgery is possible, surgery is the main treatment, but if the range is too wide to remove by surgery, chemotherapy and radiotherapy are performed simultaneously, or chemotherapy is performed to reduce the tumor size before surgery. In stage 4 with metastasis, chemotherapy is usually given to slow the progression of the disease.

Most of thyroid cancers are differentiated thyroid cancers, and surgery and radioactive iodine therapy are the main treatments. However, in some cases where metastasis is accompanied and radioactive iodine treatment is no longer difficult, targeted therapies are taken to slow the disease. In case of undifferentiated cancer (an anaplastic cancer), surgery is often impossible and the prognosis is poor, so general chemotherapy and radiotherapy are performed.

Risk factors for esophageal cancer are smoking, drinking alcohol, hot tea or especially those who enjoy both alcohol and tobacco. Treatment methods for esophageal cancer include surgery, radiation therapy and chemotherapy. Surgical resection is possible. If the general condition is good, surgery is performed to remove the cancer, and esophageal reconstruction is performed using the stomach or large intestine. In advanced cases, chemotherapy-radiation therapy may be combined first, or chemotherapy may be performed after radiation therapy. When metastasis is accompanied, chemotherapy is usually done.

A gastrointestinal stromal tumor is a cancer that occurs in muscles or nerve cells located in the middle layer of the gastrointestinal tract wall. Surgery is the priority choice of treatment and targeted therapy may be taken to reduce the recurrence rate after surgery or if metastasis is observed.

Neuroendocrine tumor of the digestive system is a relatively rare cancer that occurs in neuroendocrine cells, such as the gastrointestinal tract, biliary tract, and pancreas. If surgery is the main treatment, but if metastasis is observed, chemotherapy is performed.

Small intestine cancer is a relatively rare cancer that occurs only hundreds of cases a year in Korea.