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March 2025 Virtual Session Recap: Gastrointestinal Oncology Case Discussions

In March 2025’s session it focused on cases in gastrointestinal oncology. The session provided valuable insights into the challenges faced in treating advanced gastrointestinal cancers, particularly within resource-limited settings.

Session Highlights

The session’s first speaker, Dr. Karishma Singh, is a medical oncologist from Chris Hani Baragwanath Hospital.

Case Presentations:

1. Squamous Cell Carcinoma of the Esophagus:
   • Dr. Singh presented a case of a 54-year-old female patient diagnosed with advanced squamous cell carcinoma of the esophagus.
   • The discussion highlighted the challenges imposed by limited access to therapies and diagnostic tools in sub-Saharan Africa.
   • The patient had completed chemoradiation but displayed stable disease without operability, leading to a discussion on potential subsequent treatment options.
2. Adenocarcinoma of the Gastroesophageal Junction (GOJ):
   • The second case focused on a 64-year-old male with a history of significant weight loss and dysphagia due to an obstructive mass. Initial investigations suggested a T4 lesion with complex staging considerations.
   • Despite the prognosis, the patient showed a remarkable response to chemotherapy, prompting further deliberation on surgical options and additional therapies.

Panel Discussion:

Following the case presentations, a panel facilitated an engaging discussion among participants regarding treatment options, palliative care considerations, and the implications of emerging therapies in the management of these cases.

Notable Points from the Discussion:

• The value of multidisciplinary team collaboration was emphasized, along with innovative approaches to patient management, including prehabilitation strategies.
• The panelists also discussed the challenges of performing surgeries in patients who have undergone chemoradiation therapy.
• It was highlighted that consistent monitoring and tailored treatment plans based on patient responses are critical.

Conclusion:

The session was rich in content, providing a platform for knowledge exchange between oncologists from diverse backgrounds and settings. The discussions underscored the necessity for collaborative efforts to enhance treatment strategies for patients with gastrointestinal cancers.

For those who missed the live session, a recording is available to 🎥 Watch the Full Session:: Watch Session Recording.

Stay tuned for future sessions as we continue to explore advancements and strategies in oncology care.

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November 2024 AFROC & ICI Virtual MDT

Exploring Aggressive Gastric Cancers Across Continents

The third virtual Multidisciplinary Team (MDT) session, jointly hosted by the African Forum for Research and Oncology Collaboration (AFROC) and the International Cancer Institute (ICI), took place in November 2024. This session dove deep into the complex world of gastric cancer, highlighting aggressive presentations and unique diagnostic challenges across Africa and Europe.

Clinical Case Spotlight

A case was presented involving a patient with poorly cohesive gastric carcinoma — a notoriously aggressive and elusive form of stomach cancer. The patient underwent endoscopy, but frustratingly, there were no obvious macroscopic lesions. This immediately sparked reflection across the panel.

“They go for endoscopy, but there is nothing macroscopically obvious. Do you also see this kind of patient with poorly cohesive carcinoma in your clinical practice?”

The case reflected a broader concern around late presentation and rapid progression of gastric cancer, particularly in under-resourced regions.

Discussion Highlights

• Tumor Biology and Aggression
  Remarks on the fast-moving nature of this disease: “There’s something about the aggression of this disease… once it starts, it progresses quickly.”
• Diagnostic Challenges
  The lack of visible lesions during initial exams led the team to question early detection approaches. There was consensus that gastric cancers are often missed in initial screenings, especially in countries lacking routine surveillance. “By the time we see the patients, most of the time they already have lesions you can see.”
• HIPEC and Treatment Pathways
  The discussion also touched on HIPEC (Hyperthermic Intraperitoneal Chemotherapy), used in select cases of peritoneal spread. Panelists noted limited use in Africa, often due to cost or infrastructure constraints. “We’ve done HIPEC in a few patients with peritoneal carcinomatosis, but outcomes haven’t been great. It’s about tumor biology and aggression.”
• Global Perspectives
  Participants from Europe noted that advanced gastric cancer is not rare in their setting either, especially among underserved populations. This emphasized the global need for earlier intervention and standardized treatment pathways. “Here in Europe, we also see advanced gastric cancers, especially since there’s no screening in rural communities.”

Key Takeaways

• Gastric cancer often presents late, and poorly cohesive subtypes are particularly difficult to detect early.
• Multidisciplinary perspectives are crucial for tailoring care to aggressive cases.
• There’s a need for regional cancer screening programs and early endoscopic diagnostics, especially in rural settings.

🎥 Watch the Full November Session:
Click here to view the session

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October 2024 MDT Session by AFROC and ICI

Held Virtually – October 2024

Building on the momentum from its inaugural session, the African Forum for Research and Oncology Collaboration (AFROC), in partnership with the International Cancer Institute (ICI), convened its second virtual Multidisciplinary Team (MDT) meeting in October 2024. The session brought together oncologists, surgeons, and clinicians across Africa and Europe to discuss upper gastrointestinal and hepatopancreatobiliary (HPB) cancers.

Panel and Speaker

The expert panel included leaders in oncology and surgery:

• Dr. Michael, Consultant Surgeon and Endoscopist at Avenue Healthcare (Nairobi), Vice President of the Surgical Society of Kenya, and Chair of the Education & Research Committee of the College of Surgeons of East, Central, and Southern Africa.
• Prof. Florian Lodic, Director of Medicine at the University of Leipzig, Germany, and Head of Oncology, Gastroenterology, Hepatology, and Pulmonology at Leipzig Medical Center.

Featured Presentation

The clinical spotlight was on Dr. Leanne Prado, an Upper GI and HPB Surgeon at Charlotte Maxeke Johannesburg Academic Hospital and the University of the Witwatersrand. She delivered a presentation titled “Surgery After Neoadjuvant Chemotherapy.”

Case Summary

Patient: 54-year-old male with progressive dysphagia and weight loss.
Findings: Diagnosed with lower esophageal cancer and regional lymph node involvement.
Treatment Path:

• Underwent neoadjuvant chemoradiation.
• Post-treatment imaging showed significant tumor response.
• The MDT evaluated surgical timing, lymph node clearance, and long-term outcomes.

“The question now becomes — what is the optimal time to operate and what surgical margins can we realistically aim for?” – Dr. Prado

The discussion emphasized the importance of patient selection and intraoperative planning after chemoradiotherapy, especially in resource-variable settings.

Key Takeaways

• Multidisciplinary collaboration is essential for personalized cancer care.
• The session encouraged adapting global protocols to African contexts.
• Attendees praised the value of real-world case presentations and cross-border expertise.

“The regional insights are so valuable — they show how we can adapt protocols effectively on the ground.”

🎥 Watch the Full October Session:
Click to View Recording

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Inaugural MDT Session by AFROC & ICI

Held Virtually – September 2024

In September 2024, the African Forum for Research and Oncology Collaboration (AFROC), in partnership with the International Cancer Institute (ICI), hosted its first-ever MDT meeting. Held virtually, this inaugural session brought together healthcare professionals and oncologists from across Africa and beyond to discuss complex cancer cases and improve collaborative care practices.

Dr. Muahammed Bapeekee delivered the first presentation, discussing the diagnosis and management of a complex oncology case involving a metastatic gastrointestinal tumor.

“We initially suspected a GIST [Gastrointestinal Stromal Tumor], but further biopsy and imaging confirmed it was a poorly differentiated adenocarcinoma. This significantly changed the treatment pathway.”

His presentation emphasized the importance of multidisciplinary collaboration when diagnostic clarity is elusive, and multiple organ systems are involved.

Following this, Prof. Radka Obermannova shared a comparative perspective from the Czech Republic, discussing best practices in staging and treatment sequencing for esophageal cancers.

“The sequencing of chemo-radiation followed by surgery remains standard, but we see growing interest in definitive non-surgical approaches, especially in high-risk surgical patients.”

She also highlighted the value of MDTs in optimizing patient-centered care.

“What works in one country may need to be adapted elsewhere — MDTs help us interpret international guidelines in context.”

Clinical Case Discussions

Two detailed cases were presented and discussed:

1. Case 1: Metastatic GI Tumor with Atypical Presentation
   • A 47-year-old male with diffuse abdominal pain, misdiagnosed initially as gastritis.
   • Imaging revealed liver lesions and thickened stomach wall.
   • Multidisciplinary review led to updated staging and treatment with targeted therapy, based on HER2 status.
2. Case 2: Recurrent Esophageal Cancer in a Low-Resource Setting
   • A female patient previously treated with chemo-radiation developed recurrence after 14 months.
   • The team debated salvage surgery versus second-line chemoradiotherapy.
   • Key discussion points included nutritional support, accessibility of palliative care, and patient preference.

As one attendee commented in the chat:

“This is exactly why these MDTs are needed. In real life, these cases are rarely textbook.”

🎥 Watch the full recording here:
Click to View Session