Gastrointestinal Oncology
Cancer is one of the leading causes resulting in deaths, disorders, and disabilities, worldwide. Among all the organ cancers, gastrointestinal tract cancer follows a peculiar distribution pattern all over the world. They are responsible for more deaths than any other cancers. Also referred to as stomach cancer, these malignant gastric tumors are majorly found in people aged between 50 to 70 years. However, they are more common among male individuals.
Narayana Health provides advanced, comprehensive care for the early diagnoses and treatment of
- Colon cancer
- Pancreatic cancer
- Stomach cancer
- Liver cancer
- Neuroendocrine cancer
- Esophageal cancer
Patients can get ontologically sound surgeries for Colorectal and Liver Cancers with minimal access technique, thus ensuring faster recovery & quick return to normal life.
Our team of specialists includes radiation oncologists, surgeons, and medical oncologists who work together to develop a comprehensive treatment plan for our patients.
At Narayana Health network Hospitals, our Gastrointestinal Oncology division exclusively focuses on handling such complications. We ensure the diagnosis and treatment of gastric malignancies through foremost experts from the field. Our center offers advanced treatment facilities and expertise for a range of Gastrointestinal Cancers including Esophagectomies, Pancreatic and Gallbladder Cancer, Colon and Rectal Cancer, and Liver Resection. With an exceptional depth of knowledge, innovative research and technology, and a compassionate approach, NH gastrointestinology experts can facilitate comprehensive care and personalized evaluation for each patient.
To offer the broadest possible range of treatment options, oncologists and dedicated professionals at NH are consistently investing efforts in bringing advancements in:
- Endoscopic procedures
- Laparoscopy and other minimally invasive surgeries
- Pain management
- Interventional radiology
- Functional imaging
- Novel chemotherapy drugs
- Molecular therapies and immunotherapies
- Risk assessment, early detection, screening, and prevention methods
What Is Gastrointestinal Cancer?
Gastrointestinal (GI) Cancer is a collective term that comprises a group of cancers that affect the gastrointestinal tract and digestive system. These cancers develop through the formation of a lump or ulcer within the stomach and spread diffusely throughout the other parts of the stomach.
The GI cancer includes cancers of the:
- Oesophagus
- Liver
- Gallbladder
- Stomach
- Biliary tract
- Small intestine
- Pancreas
- Colon
- Anus
- Rectum
Symptoms of Gastrointestinal Cancer
The signs and symptoms of gastrointestinal cancer may vary according to the type of cancer a person has. It may include:
- Abdominal pain and discomfort.
- Sudden variation in bowel habits, such as consistency, frequency or shape
- Rectal bleeding or blood in the stool
- Unusual weight loss
- Bloating
- Nausea/vomiting
- Fatigue
- Indigestion
- Loss of appetite
- Swelling in your stomach
- Heartburn
- Constipation or diarrhea
- Weakness or feeling tired
- Yellowish eyes or skin
Gastrointestinal Cancer Diagnosis
To diagnose and identify the spread of cancer your GI oncology doctor may conduct several tests including:
- Endoscopic examinations: In this process, a tiny camera attached to a thin tube is passed down to the stomach, through the throat. If any malignant area is found the tissue is sent for analysis (biopsy). This may be conducted using the following endoscopic methods:
I. Upper GI Endoscopy
II. Colonoscopy - Imaging Studies: Imaging techniques identify stomach cancers using computerized process and special X-ray examinations including:
I. CT Scan
II. MRI Scan
III. PET Scan
IV. Contrast Studies - Diagnostic Laparoscopy
- Barium Studies
Risk Factors Involved in Gastrointestinal Cancer
The major risk factors responsible for Gastrointestinal Cancer are:
- Smoking and excessive alcohol consumption
- Increasing age
- Epstein-Barr virus infection
- Animal fat-rich diet
- Chronic pancreatitis
- Type-A blood group
- Stomach surgery for an ulcer
- Certain genes
- Exposure to asbestos
- Obesity
- Diets with a high amount of salt or poorly preserved foods.
- Working in coal, metal, timber, or rubber industries
Treatments for Gastrointestinal Cancer
There are several treatment options for curing cancers in the digestive tract and nearby areas. These may comprise therapies, surgical processes, or a combination of both.
Surgical Processes: Gastroesophageal cancer that has not yet spread to other parts (metastasized) can be treated using surgical processes. The affected areas having malignancy with a margin of healthy tissues are removed along with lymph nodes. The range of surgical treatments available is:
- Endoluminal Laser Process: This process involves removing cancer tumors of an early-stage found in the digestive tract.
- Open Surgery: This technique involves treating cancer-affected areas using conventional methods.
- Laparoscopic Surgery: This is a minimally invasive surgery that involves less operational morbidity and downtime.
Radiation therapy: This is a widely used process for treating gastrointestinal tumors. It involves using high powered energy radiations to treat cancer cells and inhibit its recurrence. The process uses high-intensity energy beams such as protons and X-rays to destroy cancerous cells. The radiation therapy is also used prior surgery (neoadjuvant radiation) to diminish the size of the tumor for its easy removal. Additionally, it is also used after surgery to destroy cancer cells that might have been left out.
In the case of gastroesophageal junction cancer, radiation and chemotherapy are directed at the same time, they are referred to as chemoradiotherapy. This is commonly performed before surgery. However, in most advanced cases, radiation therapy may be used to alleviate the side effects caused by large tumors.
Chemotherapy: Chemotherapy is a drug-based treatment that involves using chemicals to kill cancer cells. In chemotherapy drugs circulate throughout your body and kill cancer cells that may spread to surrounding tissues and vital organs. Through the chemotherapy process, local recurrence of cancer cells can be prevented.
This process is used before surgery (neoadjuvant chemotherapy) to reduce the size of the tumor for easy removal. Post-surgery chemotherapy (adjuvant chemotherapy) is used to destroy the remaining cancer cells in the body.Immunotherapy: This process involves using medicines for building the body’s immunity or natural defense against cancer developing cells. By using specific drugs it restores a patient’s immune system to address abnormalities or direct them to kill cancer cells. Immunotherapy targets specific proteins, genes, and tissue environments responsible for the growth of cancer.
Targeted drugs that your GI Oncology doctor may recommend you include:
- Herceptin
- Cyramza
- Gleevec
- Sutent
- Stivarga
A gastrointestinal oncology specialist may recommend you Chemotherapy, immunotherapy, or radiation therapy along with surgery. This multidisciplinary approach helps doctors to treat the residual cancer cells comprehensively, inhibiting their further growth.
Gastrointestinal Oncology FAQs
What disease can be treated with gastrointestinal oncology?
Gastrointestinal oncology is a broad term that refers to the treatment of several malignant conditions pertinent to digestive organs and the gastrointestinal tract.
The diseases Treatable with Gastrointestinal oncology include:
- Anal cancer
- Esophageal Cancer
- Gallbladder Cancer
- Pancreatic Cancer
- Bile Duct Cancer
- Colorectal Cancer
- Primary Liver Cancer
- Gastrointestinal Carcinoid Tumors
- Stomach (Gastric) Cancer
What are the stages of Gastric cancer?
There are mainly four stages of stomach cancer which include:
- Stage I: At stage one, the cancerous mass is only limited to the top layer of tissues lining the stomach or esophagus. The tumor may also spread to a few neighboring lymph nodes.
- Stage II: At this stage, the cancer tumor spreads deeper and reaches to the stomach or esophagus’s muscle layer. Moreover, the cancer cells may also advance to more lymph nodes.
- Stage III: At this stage, cancer cells grow to all layers of the stomach or esophagus. They may also reach extensively to lymph nodes and nearby organs.
- Stage IV: This is an advanced stage where cancer has spread to all distant areas of the body.
Can gastric cancer be prevented?
Early detection and attention to ongoing symptoms such as bleeding, abdominal pain, ulcers or H.pylori may help alleviate the risks associated. However, documentation revealing the healing of gastric cancers is rare. But one can definitely limit its risk by following certain measures. Consumption of proper diet including leafy vegetables, fresh fruits, beta-carotene, and ascorbic acid may reduce the risk of developing gastric cancer.
Furthermore, recent researches have revealed that families with hereditary gastric cancer issues may benefit from prophylactic gastrectomy treatment if they are in mutation in the E-cadherin gene.
What are the side effects of GI oncology?
Whilst the GI oncology process aims to treat cancer, it can often lead to some side-effects. These side-effects may vary depending on the type of treatment a patient is undergoing and their stage of cancer. Nevertheless, you have to note that not everyone will experience the same kind of side-effects.
- Side effects due to surgery may depend on the body organ that’s being treated, the patient’s general health, and, type of surgical procedure used.
- Side effects that are caused due to radiation therapy may include loss of appetite, tiredness, skin reactions, and reduction in the number of white blood cells.
Side-effects of chemotherapy also include nausea/vomiting, loss of appetite, hair loss, and mouth sores.
How is gastrointestinal cancer staged?
Staging is a process used by oncologists to determine the extent of malignancy. The factors responsible for determining the stage include:
- The size and location of the tumor
- Speed of cell growth.
- Whether or not the cancer has spread to lymph nodes or other organs.
What are the signs and symptoms of gastrointestinal cancer?
Gastrointestinal cancer, in its early stages, rarely produces any symptoms. Therefore, it is quite hard to detect early. Some of the signs and symptoms of stomach cancer may include:
- Poor appetite
- Abdominal or belly pain
- Weight loss without trying
- Heartburn or indigestion
- A sense of fullness in the upper abdomen even after eating a small meal
- Nausea
- Vague discomfort in the abdomen, usually above the navel
- Vomiting, sometimes with blood
- Blood in the stool
- Low blood cell count or anaemia
What are the risk factors of pancreatic cancer?
The causes of pancreatic cancer are yet to be found out. However, there are certain factors including lifestyle habits and medical conditions that can increase the chances of getting cancer. Some of the risk factors include:
- Age - Elderly people are more likely to develop pancreatic cancer.
- Diet – A diet that has a high proportion of red meat, saturated fat and low proportions of fresh fruits and vegetables is known to increase the risk of pancreatic cancer.
- Smoking – People who smoke tobacco twice or thrice a week significantly raise their chances of pancreatic cancer.
- Alcohol – Heavy alcohol consumption over the long term can cause chronic pancreatitis that further increases the risk manifold.
- Medical conditions – diabetes, long term infection of hepatitis B and previous surgery, including the partial removal of the stomach or gallbladder.
- Family history of pancreatic, ovarian or colon cancer
- Inherited conditions that may increase the risk are Familial Atypical Multiple Mole melanoma, Peutz-Jeghers syndrome, hereditary non-polyposis colorectal cancer and hereditary pancreatitis.
How is stomach cancer diagnosed?
As stomach cancer rarely shows any symptoms in the early stages, the disease often stays unidentified until it has become more advanced.
Generally, the diagnosis begins with a physical exam to check for any abnormalities. Your doctor may also ask you to get a blood test including a test to check the presence of H. pylori bacteria. More diagnostic tests may be ordered if your doctor suspects the signs of stomach cancer.
The following tests can help your doctor look for suspected tumours and other abnormalities in the oesophagus and stomach.
- A biopsy may be conducted by taking a small tissue sample and checking it for the presence of cancer cells.
- Abdominal ultrasounds MRIs and CT scans can help create a clearer picture of the organs for possible cancer diagnosis.
- Endoscopic ultrasound may be performed to find out if there are any tumours.
What are the treatment options for stomach cancer?
The common treatment option for stomach cancer is surgery, which may include one or more of the following procedures.
- Chemotherapy
- Radiation therapy
- Immunotherapy, such as vaccines and medication
The exact plan of treatment will depend on the location of cancer and whether it has reached an advanced stage. If the cancer is detected early, the cancerous tissue can be surgically removed from the stomach. If the cancer is at its advanced stage and surgery is no longer possible, chemotherapy and radiotherapy is the only option.
The goal of treatment is to prevent the cancerous cells from spreading as well, because when left untreated, they may spread to the lungs, liver, lymph nodes and bones.
