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Gastrointestinal Cancer Diagnosis and Treatment - A Detailed Guide

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The diagnosis of gastrointestinal cancer begins with a physical examination and a medical history assessment. If the findings from these are alarming, further tests may be recommended. Upon arriving at a conclusive diagnosis and staging the cancer, personalized care plans are devised, which are going to treat the disease effectively and help patients return to the best state of health possible.

Procedures or Tests for Gastrointestinal Cancer Diagnosis

Since many of the symptoms of GI cancer overlap with those of other less serious GI conditions, doctors will initially perform a physical examination to understand the causes of the symptoms. The following are the most commonly recommended tests for gastrointestinal cancer diagnosis:

Medical History and Physical Examination

The doctor performs a detailed physical examination of the patients and discusses their symptoms. The doctor also asks the patient about the symptoms' initiation, progression, and severity.


The patient's medical history is also an important consideration when evaluating the possibility of gastrointestinal cancer. Certain conditions, such as obesity, diabetes, inflammatory bowel disease, and certain inherited conditions, increase the risk of gastrointestinal cancer. A family history of gastrointestinal cancer also increases the risk of this condition.


If the results of the physical examination and medical history assessment are found to be alarming, that patient is advised to undergo further tests.


Imaging Tests

Several imaging tests are recommended for gastrointestinal cancer diagnosis. These include ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography. Along with the diagnosis, imaging tests are also recommended for GI cancer staging, treatment planning, monitoring, and relapse evaluation.


Ultrasound

Ultrasound is an important technique for detecting gastrointestinal tumors and is combined with traditional endoscopic methods. Advanced ultrasound techniques help evaluate the gastrointestinal walls and assist oncologists in detecting surrounding metastases.

CT Scan

Computed tomography, or CT scan, helps detect the lesions in the gastrointestinal tract and allows the staging of the disease.

MRI Scan

Magnetic resonance imaging, or MRI, provides detailed and high-quality images of the gastrointestinal tract by using radio waves and magnetic fields.

PET Scan

Positron emission tomography, or PET scan, uses radioactive glucose derivatives. This technique provides detailed information about cancer metastasis by scanning the body.

Blood Tests

Blood tests for certain tumor markers may be recommended during a gastrointestinal cancer diagnosis. Elevation in the levels of certain markers may indicate the presence of GI cancer. That said, other medical conditions can also cause the levels of these biomarkers to increase, and therefore, blood tests alone cannot be used to diagnose GI cancer.


Blood tests are also used to obtain vital information about the body's overall health and the functioning of the kidneys and liver. Liver function tests are important to determine the spread of cancer to the liver. In patients with colon cancer, blood tests may detect anemia, as there may be frequent blood loss in colon and rectal cancer.


Barium Swallow

The barium swallow method is used for detecting abnormalities in various gastrointestinal tract organs, such as the esophagus, stomach, colon, and rectum. The test involves the oral administration of barium. Barium is a white liquid that outlines the abnormal tissues in the gastrointestinal tract. After administering barium liquid, the patient undergoes a series of X-ray scans to obtain images of the gastrointestinal tract. The upper GI tract evaluation is called the upper GI series, and the lower GI is evaluated through the lower GI series.


Endoscopy

Upper endoscopy is also known as endoscopic gastroduodenoscopy. It helps determine the presence of cancer in the esophagus, stomach, and upper small intestine regions. The techniques use an endoscope, which is a thin, long tube with a camera at the end. The procedure is performed under sedation. The images are displayed on the screen. The doctor examines various parts of the upper GI tract for the presence of cancer.


Colonoscopy

Lower endoscopy is also known as colonoscopy. A colonoscopy is used to detect abnormalities in the colon. The colon is the initial and longest section of the large intestine. The procedure is performed with the help of a colonoscope, which is a thin, elongated tube with a light and camera source. A colonoscopy is recommended to examine the colon completely for the presence of polyps or lesions. This procedure may be performed under sedation or anesthesia. The doctor may also obtain the tissue sample for further examination if any abnormal tissue is detected.


Endoscopic ultrasound (EUS)

EUS is a non-invasive method used to detect cancer of the gastrointestinal tract. It involves the use of an endoscope and ultrasound. It not only provides images of the GIT but also of the nearby organs, such as the pancreas, liver, lymph nodes, gallbladder, and lungs.


Biopsy

A biopsy is a method that involves obtaining a sample of abnormal tissues and sending it to the laboratory for further examination. A biopsy may be done through different procedures. It includes a biopsy through colonoscopy or endoscopic ultrasound. During endoscopic ultrasound, the endoscope has small needles to collect samples of abnormal tissues. A biopsy often helps in arriving at a conclusive diagnosis.

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What are Effective Gastrointestinal Cancer Treatments?

Gastrointestinal cancer treatment often involves a comprehensive approach, wherein a multidisciplinary team carefully goes through the case information and takes the patient’s overall health condition into consideration before devising a personalized treatment plan. The following are the commonly recommended approaches for gastrointestinal cancer treatment:

Surgical Treatment

Different types of surgical interventions are available for treating different gastrointestinal cancers. As a GI cancer treatment, surgery involves the removal of the tumor along with a small portion of healthy tissue. Depending on the case, the specialists may also recommend partial or complete removal of the cancer-affected organ.


Cancer surgery for GI cancer is often recommended along with other treatment approaches like chemotherapy, radiation therapy, immunotherapy, and targeted therapy. The following are the different surgical procedures recommended for different types of gastrointestinal cancers.


Surgical techniques for esophageal cancer include partial and total esophagectomy. Techniques for esophagectomy include open surgery and minimally invasive esophagectomy.


Stomach cancer surgeries include endoscopic resection, endoscopic submucosal dissection, gastrojejunostomy, endoluminal stent placement, partial gastrectomy (proximal or distal gastrectomy), total gastrectomy, laparoscopic gastrectomy, and robotic-assisted laparoscopic gastrectomy.


Surgical interventions for colon cancer include local excision, polypectomy, colectomy, and colostomy. The techniques used for performing colectomy include open colectomy and laparoscopic-assisted colectomy.


Surgery is also effective in managing gastrointestinal stromal tumors.


Lymph node dissection

If the doctor suspects the cancer’s spread to the surrounding lymph nodes, lymph node dissection may be performed along with the main surgery. The lymph nodes are examined for the presence of cancer cells. It helps in determining the stage of cancer. Cancer in the lymph nodes suggests the progression of cancer. In such cases, the gastrointestinal cancer treatment strategy may include other treatments like chemotherapy or radiation therapy along with surgery.

Palliative surgical treatment

Palliative care is recommended for advanced-stage GI cancers. Palliative care aims to manage cancer symptoms to improve the patient's quality of life. In patients with esophageal and stomach cancer, palliative surgery helps prevent bleeding from the tumor and avoids obstruction in the esophagus and stomach due to tumor growth.

Non-Surgical Treatment

Chemotherapy

Chemotherapy is one of the GI cancer treatment approaches. It involves the oral or injectable administration of anti-cancer drugs that kill the cancer cells. These drugs interfere with the vital cellular pathways of cancer cells and stop them from growing further. These drugs destroy cancer cells throughout the body. Thus, the patients experience several systemic side effects, like vomiting, loss of appetite, nausea, and hair loss. Chemotherapy may be used in combination with surgery and/or radiation therapy.

Radiation Therapy

Radiation therapy is another important GI cancer treatment approach, wherein high-energy radiation beams are used to kill cancer cells. The technique is used in combination with surgery and/or chemotherapy. Radiation therapy for gastrointestinal cancer is usually delivered through external beam radiation therapy, wherein the tumor is targeted with an external radiation source, a linear accelerator. It may be used before the surgery to shrink the tumor size or after the surgery to kill the remaining cancer cells.

Immunotherapy

Immunotherapy is an advanced option for GI cancer treatment. It works by enhancing the ability of the immune system to identify and attack cancer cells in the body. Cancer cells use numerous molecular mechanisms to hide themselves from the immune system. Immunotherapy drugs block these mechanisms and allow the immune system to identify and attack the cancer cells.

Immunotherapy is usually used in cases of non-response to traditional therapies or in advanced gastrointestinal cancers. In some cases of stomach cancer, a combination of immunotherapy and chemotherapy is recommended.

Targeted Therapy

Some proteins, genes, or tissue environments enhance the growth of cancer cells and their proliferation. Targeted therapy interferes with the working of these genes and proteins and prevents the cell division and proliferation of cancer cells. Before recommending this GI cancer treatment, the oncologists comprehensively evaluate the cytology of the cancer cells to identify the cancer-specific genes and proteins.

Why Choose HCG for Gastrointestinal Cancer Diagnosis and Treatment?

HCG Cancer Hospital is an advanced and highly sophisticated institute for managing all gastrointestinal cancers, such as esophageal, stomach, colorectal, and anal cancers. The center has ultra-modern diagnostic facilities to differentiate between cancer and other underlying medical conditions. Further, the center has the facilities to perform all types of cancer-related surgeries to improve outcomes. The facilities for radiation therapy, immunotherapy, chemotherapy, and targeted therapy are also available at the center.

Conclusion

The gastrointestinal cancer diagnosis is made through blood tests, medical history assessment and physical examination, imaging tests, biopsy, barium swallow, and endoscopic ultrasound. The gastrointestinal cancer treatment options include surgery, immunotherapy, targeted therapy, chemotherapy, and radiation therapy.

For timely diagnosis and treatment, it is important for one to be mindful of different symptoms and promptly report them to a specialist.

Frequently Asked Questions

How is the stage of gastrointestinal cancer determined?

The stage of gastrointestinal cancer is determined through TNM classification. This classification includes tumor extent (T), the number of lymph nodes affected (N), and whether the cancer metastasized to other organs (M).

It is important to note that the staging parameters may slightly vary for different types of gastrointestinal cancer. For accurate information on the stage of GI cancer, patients must have a discussion with their specialists.

Imaging techniques for gastrointestinal cancer staging include computed tomography (CT), magnetic resonance imaging (MRI), and PET scans.

No blood tests assist in diagnosing gastrointestinal cancer. However, blood tests may help determine the overall health of the patient.

Several factors are considered while developing the most suitable treatment approach for gastrointestinal cancer. These factors include the type of GI cancer, the disease’s stage at the time of diagnosis, the patient’s underlying medical conditions, cancer-related complications, and the overall patient's health.

Procedures most commonly used for diagnosing gastrointestinal cancer include endoscopy, imaging tests, the barium swallow method, and biopsy.

The cancer is said to be in remission if the patient does not have any cancer in the body and remains symptom-free for a specific period. Specialists recommend various tests like physical examination, blood tests, imaging tests, and biopsy.

Gastrointestinal cancers are generally diagnosed in advanced stages because most symptoms of the cancer overlap with the symptoms of other non-serious conditions and are ignored by the patients.

Being mindful of various symptoms and seeing a doctor when something is not normal aids in early detection and timely treatment.

Surgery is one of the best GI cancer treatment options for all types of GI cancer. In some cases, early-stage GI cancers may be treated with surgery alone. In most cases, surgery is combined with other treatment options to enhance the overall effectiveness of the treatment.