Gastrointestinal Cancer - Know More About Them!

Below are some most common types of gastrointestinal cancers, know more - 

1. Esophagus cancer (cancer of food pipe): Cancer of food pipe presents as difficulty in swallowing food (Dysphagia) and is usually seen in elderly patients. Gastroenterologists will perform Endoscopy to look for any growth or cancer. High-resolution endoscopy with Narrowband imaging helps in detection of Superficial early squamous cell cancer (SESCC) of esophagus. Biopsies are taken for microscopic evaluation. Treatment depends on stage of the disease and is multimodality, means it involves GI Surgeons, cancer doctors(Oncologists), Radiotherapy specialists, and Gastroenterologists. Early cancer can be treated by Endoscopy (Endoscopic submucosal dissection). Definitive treatment involves surgery and chemotherapy or radiotherapy or both. Advanced stage cancers require palliative treatment by esophageal metal stenting (SEMS for Esophageal cancer).

2. Stomach cancers: Stomach cancer usually presents with vomiting after food, abdominal pain, anemia, or can be symptomless. Occasionally it just presents with Gas or acidity where on endoscopy a cancer growth is found. High-resolution endoscopy with Narrowband imaging helps in the detection of early gastric cancer. The treatment is multimodality and involves GI Surgeons, cancer doctors (Oncologists), Radiotherapy specialists, and Gastroenterologists. Early cancer can be treated by Endoscopy (Endoscopic submucosal dissection). Definitive treatment involves surgery and chemotherapy or radiotherapy or both. Advanced stage cancers require palliative treatment by Metal stenting (SEMS for stomach cancer) for palliation of gastric outlet obstruction.

3. Cancer of Large intestine and rectum (colorectal cancer): Large intestine cancer presents with altered bowel habits such as recent onset loose motions or constipation, Anemia, Bleeding in the motions. Screening colonoscopy helps in detection of polyps which are the precursors of cancer. If any polyp is found during the colonoscopy, it is usually removed by polypectomy. This reduces the risk of large intestine cancer. The treatment is multimodality and involves GI Surgeons, cancer doctors (Oncologists), Radiotherapy specialists, and Gastroenterologists. Surgery is the best management of large intestine cancer. Advanced stage cancers with obstruction require metal stenting (SEMS for large intestine cancer) across the growth to relieve the obstruction.

4. Liver cancer: Chronic Hepatitis B or chronic hepatitis C, Alcohol intake and fatty liver are the main causes of liver cancer. The treatment is multimodality and involves GI Surgeons, cancer doctors (Oncologists), Radiotherapy specialists, and Interventional Radiologists. Early cancers less then 5 cm are usually treated by Liver transplantation, radiofrequency ablation or Surgical resection if there is no portal hypertension. Advanced liver cancers are treated by Transarterial chemoembolisation (TACE) or Transarterial radioembolisation (TARE) if there is portal vein thrombosis. Liver cancers with metastasis are usually treated by medicines such as Sorafenib with palliative intention.

5. Pancreas Cancer:  Pancreas cancer can present with Acute pancreatitis, severe abdominal pain or Jaundice. The treatment is multimodality and involves GI Surgeons, cancer doctors (Oncologists), Radiotherapy specialists, and Gastroenterologists. Early cancers can be treated by Whipple’s surgery or distal pancreatectomy. Late-stage cancers with Jaundice can be treated by Metal stenting (SEMS for pancreas cancer), where the metal stent is inserted in common bile duct for relieving jaundice. Patients who have severe pain are treated by Endosonography guided Celiac plexus Neurolysis ( EUS guided CPN).