Track 5 : Gastrointestinal Cancer

Gastrointestinal cancer refers to a group of cancers that affect the digestive system. This includes cancers of the stomach, liver, pancreas, gallbladder, esophagus, small intestine, large intestine (colon), rectum, and anus. These cancers can vary significantly in terms of symptoms, diagnosis, treatment, and prognosis depending on the specific location and stage of the cancer.

Treatment options available?

Treatment options for gastrointestinal (GI) cancer vary depending on the type, location, stage of the cancer, and the overall health of the patient. Here's an overview of the common treatments:

1. Surgery

Curative Surgery: Removes the cancerous tumor completely. It's the primary treatment for many GI cancers, especially when detected early.

Examples: Partial or total gastrectomy (stomach), colectomy (colon), pancreatectomy (pancreas), esophagectomy (esophagus).

Palliative Surgery: Performed to relieve symptoms or complications like obstruction, even when cancer cannot be completely removed.

2. Chemotherapy

Uses drugs to kill cancer cells or stop them from growing. Chemotherapy can be used before surgery (neoadjuvant) to shrink tumors or after surgery (adjuvant) to eliminate remaining cancer cells.

Often used in combination with other treatments, especially in cancers like pancreatic or colorectal cancer.

3. Radiation Therapy

High-energy radiation is used to target and destroy cancer cells. It can be used alone or in combination with surgery and/or chemotherapy.

External beam radiation is the most common form, though internal radiation (brachytherapy) is sometimes used.

4. Targeted Therapy

Minimally invasive procedures performed using an endoscope to remove or treat small tumors or early-stage cancers within the GI tract.

Examples: Endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD)

7. Ablation Therapy

Techniques like radiofrequency ablation (RFA) or microwave ablation use heat to destroy cancer cells. Often used for liver or pancreatic cancers.

8. Palliative Care

Focuses on improving quality of life by managing symptoms and reducing pain for patients with advanced cancer. This can include pain management, nutritional support, and other supportive therapies.

9. Clinical Trials

Participation in clinical trials may offer access to new and emerging treatments not yet widely available. Clinical trials are a key part of cancer research and may provide options when standard treatments are not effective.

10. Nutritional Support and Rehabilitation

Essential for patients undergoing treatment for GI cancers. Proper nutrition can help manage treatment side effects and improve overall well-being. Rehabilitation may also involve physical therapy, psychological support, and other services to aid recovery.

Side effects?

1. Surgery

Post-Surgical Pain: Pain at the site of the incision or where organs were removed.

Infection: Risk of infection at the surgical site.

Bleeding: Potential for significant blood loss during or after surgery.

Digestive Issues: Changes in bowel habits, difficulty digesting food, or nutritional deficiencies depending on the extent of the surgery.

Fatigue: General tiredness due to the body’s recovery process.

Scar Tissue: Formation of scar tissue which may cause complications like bowel obstruction.

2. Chemotherapy

Nausea and Vomiting: Common but often manageable with anti-nausea medications.

Fatigue: Persistent tiredness that can impact daily activities.

Loss of Appetite: Reduced desire to eat, which can lead to weight loss.

Hair Loss: Often temporary and related to the drugs used.

Mouth Sores: Painful sores in the mouth or throat.

Diarrhea or Constipation: Digestive changes due to the effects on the GI tract.

Increased Risk of Infection: Due to a decrease in white blood cells (neutropenia).

Skin Changes: Rashes or sensitivity.

3. Radiation Therapy

Skin Irritation: Redness, dryness, or blistering in the area being treated.

Fatigue: Common as treatment progresses.

Nausea and Vomiting: Especially if the stomach or abdomen is treated.

Diarrhea: If the pelvic or abdominal area is irradiated.

Difficulty Swallowing: If the chest or throat area is treated.

Hair Loss: Limited to the area being irradiated.

4. Targeted Therapy

Diarrhea: Common with some targeted drugs.

Skin Rash: May occur with certain drugs.

Fatigue: General tiredness.

Liver Function Changes: Elevated liver enzymes may require monitoring.

Blood Pressure Changes: Some drugs can affect blood pressure.

5. Immunotherapy

Flu-Like Symptoms: Fever, chills, and body aches.

Skin Rash: May appear as a result of the body’s immune response.

Digestive Issues: Diarrhea or colitis.

Endocrine Problems: Effects on hormone-producing glands, potentially causing issues like thyroiditis or adrenalitis.

Fatigue: General tiredness or weakness.

6. Endoscopic Treatments

Discomfort: Mild discomfort or cramping after the procedure.

Bleeding: Minor bleeding at the treatment site.

Infection: Risk of infection at the site where the endoscope was inserted.

7. Ablation Therapy

Pain: Localized pain at the site of treatment.

Fever: Temporary fever can occur as a reaction to the treatment.

Skin Changes: If the treatment is near the surface, there may be changes in skin texture.

8. Palliative Care

Side Effects Depend on Specific Interventions: Pain management and other supportive measures aim to alleviate side effects rather than cause them. However, certain medications or interventions might have side effects that need to be managed.

9. Nutritional Support and Rehabilitation

Digestive Issues: May arise as part of adjusting to new eating habits or managing side effects.

Fatigue: Ongoing fatigue might be addressed through nutritional support and physical rehabilitation.

Managing side effects often involves a combination of medication, dietary adjustments, and supportive care. It’s essential for patients to communicate openly with their healthcare team about any side effects they experience so that appropriate measures can be taken to alleviate discomfort and maintain quality of life.

SUB TRACK:

Abdominal discomfort, Unintentional weight loss, Vomiting and nausea, Acid reflux, Diarrhea, constipation, Fecal incontinence, Fatigue, Loss of appetite, Irritable Bowel Syndrome, Hemorrhoids, Diverticulitis, Hepatitis A, Hepatitis B, Liver Disease, Colonoscopy, Esophagogastroduodenoscopy, Liver transplant service, Complex endoscopy, Nutrition, Hepatobiliary Clinic, Pancreas Clinic, Esophageal Clinic, Colorectal Neoplasia, Motility, Miscellaneous GI testing, Inflammatory Bowel Disease, General GI, Cholera, Enteric duplication cyst, Giardiasis, Pancreatitis, Peptic ulcer disease, Yellow fever, Hepatitis Virus, Hepatitis treatment