Objective	To be able to perform specialist assessment, guide systemic therapy in the context of multidisciplinary treatment and counselling of patients with gastro-oesophageal (GE) junction cancer along the cancer continuum
Key Concepts	Distinguish which tumours are considered oesophageal v GE junction v gastric and the potential differences in treatment Describe the histologic and molecular subtypes of GE junction cancer Distinguish hereditary syndromes and understand of how to counsel these patients and their families and when to refer for genetic assessment Evaluate diagnostic and staging methodologies including endoscopy, computed tomography (CT), endoscopic ultrasound, positron emission tomography CT, laparoscopy and the TNM staging system to determine operative candidates Recognise the importance of the contribution of the multidisciplinary team in management of GE junction cancer including medical oncology, radiation oncology, surgery, pathology, radiology, nutrition, and palliative care Recognise that for curative treatment, patients with operable GE junction cancer require surgery, but that the addition of chemotherapy, chemoradiotherapy and immunotherapy may be needed for most patients Recognise the impact of surgery for GE junction cancer on patient nutrition and well-being, and the need for appropriate follow-up after surgery Explain the implications of biomarker testing in GE junction tumours including microsatellite instability or mismatch repair deficiency, human epidermal growth factor receptor 2 (HER2), and PD-L1 on the choice of systemic therapy Define the available lines of systemic therapy including chemotherapy, targeted therapy and immunotherapy, and how to sequence these Determine the potential complications resulting from disease progression or treatment including dysphagia, nutritional challenges and the benefits of early nutritional intervention Recognise that early palliative care support for symptom burden alongside oncology treatment is recommended
Skills	Demonstrate the ability to: Perform a history and physical examination and assess performance status for treatment in patients diagnosed with GE junction cancer Use the commonly available molecular tests (mismatch repair deficiency/microsatellite instability, HER2, PD-L1) to prescribe appropriate targeted or immunotherapy for patients Participate in multidisciplinary team meetings where the multidisciplinary treatment of GE junction cancer is discussed to understand why specific treatments are indicated for each patient Prescribe and discuss systemic therapy and understand their potential interactions with other therapeutic modalities including radiation Predict and manage side effects from cytotoxic chemotherapy, monoclonal antibodies or other targeted therapies, and immunotherapy Manage patients from their initial diagnosis to end-of-life and supportive care including referring for or initiating nutritional and palliative interventions