Managing metastatic disease is complex and should therefore involve all the appropriate specialties in a multidisciplinary team including palliative care. Treatment of recurrent, residual or metastatic oesophagogastric cancer is rarely curative; metastatic oesophagogastric cancer usually has a poor prognosis. For most patients, treatment is given with palliative rather than curative intent.

From the time of diagnosis, the team should offer patients appropriate psychosocial care, supportive care, advance care planning and symptom-related interventions as part of their routine care. The approach should be personalised to meet the patient’s individual needs, values and preferences. The full complement of supportive care measures as described throughout the optimal care pathway and in Appendices A and B, and in the special population groups section should be offered to assist patients and their families and carers to cope. These measures should be updated as the patient’s circumstances change.

Many people live with metastatic oesophagogastric cancer for up to 12 months, or sometimes longer. Health professionals should therefore be ready to change and adapt treatment strategies according to disease status, prior treatment tolerance and toxicities and the patient’s quality of life, in addition to the patient’s priorities and life plans.