Gastrointestinal Cancer

Gastrointestinal cancer is cancer that affects the organs in the digestive system

including the esophagus, stomach, pancreas, gallbladder, liver, small and large intestine, anus and rectum. Gastrointestinal cancer is characterized by the uncontrolled growth of normal cells that make up the digestive tract.

Causes

The exact cause of gastrointestinal cancer is not clear. However, certain risk factors such as excessive alcohol intake, smoking, advanced age, diet rich in animal fat and salt, poorly preserved food and obesity may increase your risk of developing gastrointestinal cancer.

Impact

Gastrointestinal cancer significantly impacts your quality of life. It not only affects you physically, but also emotionally. Pain, fatigue, stress and the side effects of treatment become a part of your life.

Anatomy

The gastrointestinal system is a long tube running right through the body, with specialized sections that are capable of digesting and extracting useful components entering the mouth and expelling waste products from the anus. Once food has been chewed and mixed with saliva in the mouth, it is swallowed and passes down the esophagus (food pipe), a long, narrow tube. The food pipe is lined by muscles that expand and contract, pushing food into the stomach.

The stomach secretes acid and other digestive enzymes for digestion and stores food before it enters the intestine. The liver is the main organ of metabolism and energy production. It produces bile, which is stored in the gallbladder, and also stores iron, vitamins and trace elements. The pancreas, located behind the stomach, produces enzymes and hormones that aid in digestion and metabolism. Once food has been mulched and partially digested by the stomach, it is pushed into the duodenum (first part of the small intestine). Secretions of the gallbladder and pancreas empty into the small intestine, the site where most of the chemical and mechanical digestion and virtually all of the absorption of useful materials takes place. The large intestine is the last part of the digestive tube and the location of the terminal phases of digestion, where waste is processed and stored in the rectum, and excreted through the anus.

Symptoms

Symptoms of gastrointestinal cancer may include abdominal pain, discomfort or tenderness, change in shape, frequency or consistency of bowels, blood in stool, bloating, vomiting, nausea, fatigue, loss of appetite and unintentional weight loss.

Diagnosis

Your doctor diagnoses gastrointestinal cancer by performing a thorough physical examination and reviewing your medical history. Certain tests may be ordered to assist and confirm the diagnosis, which includes:

  • Blood tests: The tests include full blood count and tumor marker tests.
  • Upper endoscopy: Upper endoscopy is a procedure in which a long, thin flexible tube with a tiny camera is passed through your mouth and down your throat to examine the lining of the esophagus, stomach and duodenum.
  • Fecal test: Fecal samples are examined under the microscope for abnormalities.
  • Barium swallow: You are given a liquid that contains barium to swallow. X-ray imaging can detect this barium, which coats the walls of the esophagus and stomach, making abnormalities visible more clearly.
  • Biopsy: A small sample of tissue is removed and examined under the microscope for abnormal cells.
  • Colonoscopy: A colonoscope, a long narrow tube with a camera is inserted from the rectum to examine your colon.

These tests help identify the location and stage (stage 0 to stage 4, in order of severity) of cancer, which is important for designing the treatment plan.

Treatments

Treatment depends on the stage of the cancer, location, your age and general health. Several treatment options are available for treating gastrointestinal cancers. The standard approaches include surgery, radiation therapy, chemotherapy and target therapy.

  • Surgical procedures vary depending upon the size and site of the cancer. Some of the common surgeries include:
    • Fulguration: use of electric current to kill tumor cells
    • Cryosurgery: involves freezing the cancer cells to destroy them
    • Resection: removal of the cancerous growth
    • Radio frequency ablation: use of high energy radio waves to kill cancer cells
  • Radiation therapy is a procedure where high-energy rays are targeted at the cancer cells to destroy them.
  • Chemotherapy involves the use of anti-cancer drugs given intravenously (through the veins) or orally (by mouth). This type of treatment is extremely useful in cases where the cancer has spread to different parts of the body. These drugs work against the cells that divide quickly; thereby, slowing down the growth of cancer.
  • Target therapy stops new blood vessels from developing in the cancer cells. With no blood supply, the growth of cancer cells slows down.

If left untreated, cancer usually spreads to other areas of the body, eventually leading to death.

The endoscopic mucosal resection (EMR) procedure is indicated to treat gastrointestinal cancer that has spread to the lining of the tract. Your surgeon inserts an endoscope (a thin long tube with a light source and camera) through the mouth to the cancerous growth present in the esophagus, stomach or upper small intestine. Cancers in the colon are reached by an endoscope inserted through the anus. Surgical tools are passed through the EMR to remove the cancerous tissue. The surgery is non-invasive as it does not involve any cuts on the body.

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