Gastrointestinal cancers refer to cancers that affect the digestive system. This includes cancers of the esophagus, liver, pancreas, stomach, small intestine, large intestine, colon, rectum, gallbladder, biliary tract, and anus. GI cancers grow in diagnosis every year, with more cases on the rise. Many Americans live with gastrointestinal cancer and find treatment that works to help regain their quality of life. Certain gastrointestinal cancers are treatable, while others can be fatal. Men and women both get GI cancer for a myriad of reasons, in any culture or at any age.
The survival rates for gastrointestinal cancers are ever changing. In 2018, the World Health Organization stated that over twenty-thousand people would die from gastrointestinal cancers. The five-year survival rate of people with cancer of the stomach lingers between 27% and 32%; bowel cancer from 67% to 72%; and only around 9% of those diagnosed with pancreatic cancer will reach the five-year survival rate.
What are the main types of gastrointestinal cancers?
The main types of gastrointestinal cancers are:
Esophageal cancer occurs in the tissues of the esophagus where malignant cancer cells have formed. The esophagus is the tube that transports food from your mouth to your stomach. This type of cancer can occur anywhere in the esophagus. Cancers that are found in the upper and mid-section of the esophagus are normally a form of squamous cell carcinoma. If the lesions are found in the lower part of the esophagus, these are more than likely adenocarcinomas.
In the early stages of esophageal cancer, there can be no visible symptoms. In some cases, the beginning symptoms often mimic other, less-invasive illnesses. Many times, esophageal cancer is diagnosed in the later stages of the disease. Symptoms may include any or all of the following:
- Vomiting up blood and abdominal pain.
- New or worsening heartburn or acid reflux or abnormal burning in the chest.
- Bloody or black-colored, tarry stools that might look like coffee grounds. In this case, blood could be a range of colors from bright red (new, fresh blood) to maroon or dark brown colors.
- Hoarseness or a chronic cough with throat discomfort.
- Difficulty or pain while swallowing or inability to swallow.
- Episodes of choking on food or fluids coming back up after “being caught” in the throat.
- Unexplainable weight loss that is sudden or continues over a period of time.
- Unexplainable fatigue and excessive sleep.
- Development of upper abdominal discomfort especially while eating.
Stomach cancer occurs anywhere inside the walls of the stomach when malignant cancer cells form. These malignant cells grow uncontrollably and, in the stomach, can also spread to other organs. The most common forms of stomach cancer growth in the lining and mucosa, which holds the glands that secrete fluids to aid in our digestion and the breakdown of food. This type of cancer is called gastric adenocarcinoma. The stomach is the organ in the upper abdomen that helps to digest food and absorb any important nutrients before the food moves into the intestines. There are different tissues in the stomach that help with different stages of absorption. Other types of stomach cancer can affect this function. Carcinoid tumors in the stomach wall and connective tissues can delay stomach emptying. Linitis plastica is a rare type of adenocarcinoma which can cause the stomach lining to become thick and rigid. This is slow-growing cancer, and if not detected early, can spread to other organs in the body, and lymph nodes.
These are commonly noticed symptoms of those who were then diagnosed with stomach cancer. If you are experiencing any or all of these symptoms, schedule a consult appointment with your gastroenterologist to discuss possibilities and begin pre-testing to determine what is causing your trouble.
- Indigestion, or other digestion problems such as vomiting, diarrhea or constipation with no cause.
- Feeling of bloating and lower abdominal discomfort.
- Difficulty swallowing or feeling that what you are trying to swallow is being ‘trapped’ in your throat.
- Swelling of the abdomen in any area.
- Frequent burping with heavy sulfur or decaying smells.
- Heartburn or reflux that does not go away with over-the-counter solutions.
- Unexplainable loss of weight or appetite, or both, for days or more at a time.
- Unexplainable fatigue or excessive exhaustion.
- Vomit containing blood more than twice.
- Bloody or black –colored or tarry stools with anything else abnormal affecting it.
Pancreatic cancer develops in the pancreas when malignant cells form and grow. Over 90% of pancreatic cancers are born from exocrine cells, which are the cells that help the pancreas aid the body with digestion of foods. The pancreas is a small gland that is located behind the stomach and is connected to the small intestine or duodenum. The pancreas’ role in the body is to help regulate blood sugars and enzymes for digestion. The pancreas has both endocrine and exocrine functions, which are also responsible for the production of insulin and glucagon. This type of cancer usually begins in the lining of the pancreatic duct and spreads into the actual pancreas gland. Cancerous cells can then spread throughout the body and into the bloodstream and lymphatic systems if left untreated.
Depending on where this tumor and cancer is located will depend on your symptoms. Any of these symptoms could be present if you have pancreatic cancer.
- -Jaundice, such as yellowish skin and eyes, pale bowel movements, itchiness of the skin and dark urine.
- -Pain in the upper abdomen, stomach or back that does not cease with moving or over-the-counter medications.
- -Loss of appetite that rolls on for days at a time.
- -Nausea and vomiting that lasts for more than two days.
- -Unexplained weight loss for any period of time.
- -New onset of diabetes, change in bowel behavior or habits, such as diarrhea or severe constipation. Almost 20% of people diagnosed with pancreatic cancer end up with diabetes as well.
Small Bowel cancer is also referred to as small intestine cancer and it is a rare cancer that grows in the small intestine. The intestines are part of the body’s digestive system and is a long tube that connects the stomach with the large intestine. The small intestine is the absorber, in that its main job is to absorb nutrients and minerals from foods. Overtime, this type of cancer could grow and block off the small intestine. The most common types of this cancer are the carcinoid tumor and adenocarcinomas. Most often these tumors are present in the duodenum. Less common types of small bowel cancers are sarcomas, lymphomas, stromal tumors.
Early stage symptoms of small bowel cancer often mimic other illnesses. Usually, symptoms are not fully noticed until they become prominent, which is a sign that the cancer is most likely growing or spreading. If you are experiencing any or all of these symptoms, meet with your medical care team to discuss testing and treatment for whatever is causing the ailments.
Small bowel cancer symptoms may include:
- Blood in stool or on the toilet paper after wiping, or dark, tarry like stools being passed.
- Unexplained weight loss for any period of time.
- A lump in the abdomen or abdominal swelling.
- Pain, cramps or swelling in the middle of the abdomen with no known cause or reason.
- Anemia or low-blood iron levels that are out of character for your body.
- Nausea and vomiting without reason or cause.
Liver cancer can occur in two manners. First as a primary liver cancer when cancer cells form and spread into the liver. Secondary liver cancer happens when cancer cells spread from another part of the body, and eventually make their way into the liver. The liver is the second largest organ in the body and part of the digestive system. Located in the upper right side of the abdomen, next to the stomach. The liver acts as a filter, removing waste products from the blood and breaking down any foreign or unknown substances like alcohol or medications. The liver also produces bile which helps to dissolve fats so they can be more easily digested. The two main types of primary liver cancer are:
- Hepatocellular carcinoma is the most common type of liver cancer and starts in the main cell type of the liver called hepatocytes.
- Cholangiocarcinoma begins in the cells of the bile duct and is also known as bile-duct cancer.
In the early stages of liver cancer, symptoms are often hidden and do not surface until the cancer has grown or has begun to spread. Liver cancer symptoms include:
- Unexplained loss of weight and appetite without explanation.
- Unexplained nausea and vomiting.
- Fatigue with weakness or exhaustion.
- Pain in the upper right side of the abdomen
- Jaundice which is the yellowing of the skin and whites of the eyes.
- Pale bowel motions or loose stools with no change.
- Severe pain or swelling of the abdomen without reason.
- Fever of 100.4 or higher.
Colorectal cancer or large bowel cancer happens when malignant cancer cells grow in the wall of the large bowel. This can include the large intestine, rectum, and any other part of the lower digestive tract. Cancers that affect the small bowel are quite rare. Colorectal cancers occur when the cancerous cells grow uncontrollably and turn in to polyps or adenomas. Most polyps are benign and not cancerous however, they can be cancerous and spread. The most common type of this cancer is adenocarcinoma, which develops in the lining of the bowel where cancer first develops. Other rare types of colorectal cancers are hamartomas, mesenchymal tumors, neuroendocrine tumors, and lymphomas.
Symptoms can be present for early stage colorectal cancer and could be any or all of the following:
- Blood in stool or on the toilet paper.
- Change in bowel habits. This includes more frequent bowel movements, constipation or diarrhea without reason.
- Change in appearance and consistency of bowel movements.
- Changes in bowel function, such as feeling bowel has not emptied completely even after a bowel movement.
- Feeling of bloating in the abdomen.
- Unexplained weight loss over any period of time.
- Unexplained weakness or fatigue with extreme exhaustion.
- Rectal or anal pain that does not go away.
- A lump in the abdomen with or without pain.
- Pain, cramps or swelling in the abdomen.
- Iron deficiency anemia, or low red blood cell count.
Gallbladder and Biliary Duct cancers occur in the gallbladder and biliary tract ducts, respectively. While gallbladder cancer is rarer, biliary tract cancer or cholangiocarcinoma cancer does occur more frequently.
The gallbladder is a small pear-shaped organ that rests in the body next to your liver. The gallbladder holds bile, which is produced by the liver to help absorb fats. There are multiple types of gallbladder cancers that are named by the type of cancer cell that caused the issue. More than 80% of gallbladder cancers are adenocarcinomas that start in the gland cell lining. Non-papillary adenocarcinomas make up almost 75% of diagnosed cancers of the gallbladder. More uncommon gallbladder cancers include squamous cell cancer and mucinous adenocarcinomas, which make up only 1% of cases.
The biliary tract ducts transport bile from the liver. There are two bile ducts that come from the liver and one from the gallbladder. These tubes form the common bile duct that connects to the small intestine. When food is eaten, and digestion begins, bile stored in the gallbladder is released and helps to move the mass in to the intestines. This type of cancer can form anywhere along the bile duct tract, and multiple types of bile duct cancers may be present.
In the early stages of these two types of cancers, these symptoms could be present:
- Jaundice which is the yellowing of the skin and whites of the eyes.
- Unexplained nausea and vomiting lasting longer than two days.
- Unexplained weakness and extreme exhaustion.
- Unexplained loss of appetite and weight loss.
- Fevers and chills that do not let up.
- Pain in the right side of the abdomen or radiating pain in the same area.
- Darkened urine or more frequent bathroom breaks with little output.
- Pale bowel movements or other change in color.
- Itchy skin anywhere on the body that lasts.
Anal cancer occurs when malignant cells grow and settle around the anus and within the tissues in the area. This cancer can occur where the anal canal meets the rectum, or in the skin and tissue around the anal opening. The anus is a 4cm section located at the end of the colon that opens to the outside of the body. This canal connects the anus to the rectum or the final section of the large intestine. The anus has an important role of controlling the bowel movements and motions of the body. The anal sphincter muscles help to control the contractions and releases of muscles for defecation. The most common form of anal cancer is squamous cell carcinoma and is found on the surface of the anal tissue. A rare form of anal cancer would be melanoma, which develops first on the skin and the cells move into the anal canal.
Early stages of anal cancer do not always appear as troublesome issues, and many people are diagnosed after it is too late. Symptoms that may be experienced with anal cancer are:
- Blood in stool or on the toilet paper. Darker blood can look like coffee grounds.
- Bleeding from the rectum. Nearly half of individuals diagnosed with anal cancer have had symptoms of rectal bleeding or blood in their stool prior to diagnosis.
- Bowel changes such as difficulty controlling bowel movements or feeling the need to go after one has already gone.
- Discharge of mucus from the anus occurring during or after a bowel movement.
- Pain, itching or discomfort in the area around the anus.
- Feeling full, pressure and discomfort or pain in the rectum.
- Feeling a lump near the edge of the anus. Not all lumps are cancerous, and some may just be hemorrhoids.
- Ulcers around the anus that seep or bleed or become too painful to sit.
If you suspect you may be dealing with some sort of gastrointestinal cancer, do not wait to make an appointment with your doctor to get some of the basic testing out of the way. The earlier you can begin treatment for these types of cancers, the better. Do not begin treating any new conditions without consulting with your medical care team to ensure that you are on the right path for the type of illness or disease you are facing.
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