What are Gastrointestinal (GI) Cancers?
The gastrointestinal tract pertains to the part of the body which helps in digestion, assimilation, and excretion of the eaten food materials. It starts from the esophagus, goes onto the stomach, small intestine, large intestine, rectum, and ends at the anus (the anal opening or the excretory orifice). Its approximate length is 6 meters. It also involves other accessory organs that aid in digestion like the liver, gallbladder, and biliary system, and pancreas.
Gastrointestinal (GI) cancer is the term given to cancer affecting any of these organs.
What are the general features of GI Cancers?
- The majority of these cancers are lifestyle-related. They are the result of one or more lifestyle-related problems such as
So, it implies that the majority of these cancers can be prevented by the adoption of a healthy lifestyle.
- These cancers are very much amenable to screening. For colorectal cancers – Colonoscopy can be easily performed. Similarly, in some countries like Japan, there is a screening program for esophageal and stomach cancers by the use of Upper GI Endoscopy.
- Certain infections are known to cause cancers in the GI System like Hepatitis B and Hepatitis C for liver cancer. These infections are treatable now and Hepatitis B infection is preventable by the use of vaccines available.
- The risk of these cancers increases with age especially after 50 years of age. But, recently the incidence is increasing rapidly in the younger age group. It may be lifestyle-related or genetically modulated.
What are the different GI Cancers?
The major types of cancers are:
- Esophageal (food pipe) Cancer
- Stomach Cancer
- Colorectal Cancer
- Gallbladder cancer
- Pancreatic Cancer
- Liver Cancer
What are the symptoms of GI Cancers?
Unfortunately, these cancers do not cause many symptoms early or cause symptoms that are easily ignored. The symptoms depend upon the location of cancer. The major symptoms of GI Cancers are:
- Abdominal pain is a common feature for Gallbladder and Pancreatic Pain can be there in colonic cancers also.
- Esophageal cancers patients have difficulty in swallowing.
- Stomach cancer patients have symptoms of indigestion or hyperacidity or vomiting after meals.
- Gallbladder cancer presents with right upper abdominal pain and sometimes jaundice.
- Pancreatic cancers can have pain and jaundice.
- Colorectal cancers present with either bleeding from an anal orifice or recent-onset constipation or black-coloured stools or sometimes even as appendicitis pain.
- Loss of appetite and loss of weight.
How are GI Cancers diagnosed?
The diagnosis of the disease. If your doctor suspects GI cancer depending upon your symptoms, he may advise one or more of the following investigations:
- Endoscopy to look for any change in the lining of the esophagus, stomach, or early small intestine.
- Colonoscopy to check for polyps, cancers into the large intestine.
- Imaging like CT scan, MRI, PET Scan depending upon the disease as prescribed by the doctor.
- Biopsy of the lesions seen during endoscopy or lesions seen on imaging as the case may be.
- Blood Investigations involving routine blood tests and certain tumor markers like CEA, CA19-9, and others.
What is the treatment of GI Cancers?
The treatment of the GI Cancers involves surgery, chemotherapy, and radiation being applied in different combinations. The treatment is dependent upon the clinical stage of the disease. If the tumor is early diagnosed surgery maybe what all is needed. But in certain scenarios, chemotherapy and radiation are required to be given before the surgery. Similarly, chemotherapy and radiation may also be required after the surgery.
Surgery performed can be open or Laparoscopic (keyhole or Minimally Invasive). Surgery aims at complete removal of the tumor along with a margin of normal tissue and then restores the normal GI Function. For the liver, cancer transplantation is also possible in certain cases.
At Dharamshila Narayana Superspeciality Hospital (DNSH), GI Cancers are treated in a holistic way. It is the integrated TEAM approach involving the surgery, radiation, and medical oncology teams. Each tumor is discussed in the TUMOR BOARD and a treatment plan is made.
At DNSH, the GI Oncology is taken care of by the specialized team (GI Surgery) of doctors. The team is well-experienced in treating all kinds of GI Cancers with both open surgery and minimal invasive surgery (Laparoscopic).
We strive for the best management and early recovery of the patient.
Dr. Neeraj Goel, Clinical Lead & Senior Consultant – Gastrointestinal, Minimal Access, HPB and Bariatric Surgery, Dharamshila Narayana Superspeciality Hospital, Delhi