Treatment options

First-line therapy is surgical if active treatment is appropriate. Intravenous fluids and nasogastric suction are usually instigated but are not normally necessary if surgery is not an option. The patient may not wish surgery or, due to the extent of disease, surgery may not be appropriate. Laser therapy may be useful to debulk obstructing oesophageal, gastric, and rectal carcinomas. However, this approach requires repeated treatments. Plastic tubes or expandable metal stents can also be considered and are generally of use in oesophageal or oesophago-gastric lesions.

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