Q1. What are gastrointestinal cancers?

A1. These are cancers that affect the gastrointestinal tract. These include cancers of esophagus, small and/or large intestine, stomach, pancreas, liver, gallbladder, rectum and anus.

Q2. How are these cancers detected?

Endoscopy is done to establish diagnosis. Biopsy of the affected/damaged tissue is carried out.
Barium swallow test is done for cancers of the upper gastrointestinal tract.
Sigmoidoscopy and colonoscopy is done to detect colon cancers.
CT scan may be required for detailed view of the tissues and organs.

Q3. What are the symptoms?

A3. Esophageal cancer does not have any early symptoms. It does not present any symptoms till has progressed to an advanced stage. Patients report of pain on swallowing and indigestion and there is unexplained weight loss.

In case of pancreatic cancer, patients have severe abdominal pain which may radiate to the back. There is weight loss and diarrhea. Jaundice is also reported. Symptoms are seen in the advanced stages.
In patients of liver cancer, jaundice and ascitis (fluid filled up in the abdomen) are seen. There is weight loss, loss of appetite, upper abdominal pain and abdominal swelling, weakness and fatigue.
In gallbladder cancer, weight loss, loss of appetite and jaundice are seen. There is a pain in an upper right portion of the abdomen.
In case of stomach cancer, there will be severe heartburn and indigestion, stomach pain, persistent nausea and vomiting, a feeling of fullness and bloating of the stomach.
In bowel cancer, blood will be seen in the stools, there is pain in the abdomen and stools are frequent and loose.

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Q4. What are the risk factors for the development of gastrointestinal cancer?

A4. The risk factors are increased age, low fiber and high salt, chronic gastritis, smoking, alcohol abuse and family history of gastric cancer. These cancers are more common in men.

Q5. How can we prevent gastrointestinal cancers?

A5. They can be prevented if a person focuses on taking a nutritional, balanced, high fiber diet. Smoking and alcohol consumption should be stopped. Controlling obesity by following a healthy lifestyle is also very important.

Q6. How are gastrointestinal cancers treated?

A6. Treatment mainly involves Surgery, Chemotherapy, Radiotherapy, Chemoradiation and targeted therapy.

The team of specialists includes medical oncologists, gastrointestinal surgeons and radiation oncologists.

Cancers detected in the early stage can be managed by surgical treatment alone.

If cancers are detected at a later/advanced stage, then treatment will involve chemotherapy &/or radiotherapy and surgical removal.

For stomach cancers, subtotal gastrectomy (removal if cancerous portion and nearby lymph nodes and tissues) or total gastrectomy (removal of whole stomach, nearby lymph nodes and adjoining tissues and organs) is done.

In colon cancer, colectomy is done and the remaining ends of the digestive system may be sutured to allow stool to leave the body as before. An opening called stoma may be created on the abdomen to which the small intestine or the remaining colon will be attached and stool leaves through this opening and is to be collected in a bag. When both colon and rectum are removed, the small intestine is attached to the anus.

In cases of liver cancer, hepatectomy is done wherein a portion of the diseased liver is removed. Liver transplantation may be an option when cancer has not spread outside the liver.