As a gastrointestinal surgeon, one of the most difficult aspects of my clinical practice is explaining to unfortunate cancer patients that it’s too late and nothing much can be done. It is heart-breaking for them and for their near and dear ones. They often remark in despair “but he or she was fine till fifteen days back” or, “we ignored this small symptom” or, “we went to the doctor with this symptom and weren’t investigated”.
As a group gastrointestinal cancers are the most common cancers globally. Common cancers of the gastrointestinal system include cancers of the esophagus (food pipe), stomach, colon and rectum (large intestine), Gall bladder diseases , bile duct, pancreas, liver and gastrointestinal stromal tumors (GISTs).
Oesophagus (food-pipe) | Stomach | Colon and rectum (large intestine) | Gall bladder | Bile duct | Pancreas | Liver |Gastrointestinal stromal tumors (GISTs)
The gastrointestinal system is encased in a protective abdominal wall; similarly, the esophagus is seated deep inside the chest. This is important for their safety and function. But that puts them in a disadvantageous position – diagnosing gastrointestinal diseases and cancers become difficult.
Symptoms are our body’s way of alerting us that something is wrong with us. Each of these GI cancers present with their distinctive signs and symptoms. But unfortunately, often these symptoms occur when it’s already too late. Many of these symptoms also occur in mild to moderate common ailments which affect us from time to time. Moreover, the likelihood of a minor disease being the cause of your symptom is much more. It is less likely that your symptom will be due to a serious illness like cancer. The end result is that these cancers are diagnosed at an advanced stage most of the time.
Symptoms of gastrointestinal diseases including cancer are difficulty in swallowing, pain abdomen, recurrent vomiting, unexplained weight loss, loss of appetite, blood in vomitus, blood in stool, altered bowel habits (change in frequency or consistency of stools), persistent abdominal discomfort, feeling of incomplete evacuation, weakness or fatigue, worsening indigestion or heartburn, Jaundice, clay-colored stools, itching, recent onset diabetes, lump in the abdomen and/or change in voice.
Warning signs of GI Cancers
Difficulty in swallowing | Abdominal pain | Recurrent vomiting | Unexplained weight loss | Loss of appetite | Blood in vomitus
Blood in stool | Altered bowel habits (change in frequency or consistency of stools) | Narrow stools | Persistent abdominal discomfort | Feeling of incomplete evacuation | Weakness or fatigue | Worsening indigestion or heartburn | Jaundice | Clay colour stools
Itching | Recent onset diabetes | Lump in the abdomen | Low red blood cell count (anemia) | Change in voice
If you have any of these symptoms the chance of having cancer depends upon the risk factors. More the number of risk factors – higher the likelihood. Risk factors are circumstances which increase your risk of developing cancer. The risk factors vary depending upon the organ in question but generally includes increasing age, family history of gastrointestinal cancer, smoking and alcoholism, a diet deficient in fruits and vegetables and obesity.
There is possibly not much harm in ignoring an occasional mild abdominal discomfort or gastric trouble. However, you should be worried, if any of these symptoms occur regularly. In addition, they seem to be getting worse and they don’t go away. Consult your physician or a credentialed GI surgeon immediately. Based on these symptoms and physical examination he or she will order investigations which will help diagnose these cancers at a stage where they can still be cured.
Be alert and stay healthy. Happy living!
Dr. Nikhil Agrawal I Senior Consultant – Gastrointestinal, HPB and G. I. Onco Surgery I Dharamshila Narayana Superspeciality Hospital, Delhi