Diagnosis, staging and management.

Gastrointestinal cancer is a term for the group of cancers that affect the digestive system. This includes cancers of the oesophagus, gallbladder, liver, pancreas, stomach, small intestine, bowel (large intestine or colon and rectum), and anus. 

• Stomach cancer

Cancer of the stomach, also called gastric cancer, is the fourth-most-common type of cancer and the second-highest cause of cancer death globally. Eastern Asia (China, Japan, Korea, Mongolia) is a high-risk area for gastric cancer, and North America, Australia, New Zealand and western and northern Africa are areas with low risk. The most common type of gastric cancer is adenocarcinoma, which causes about 750,000 deaths each year. Important factors that may contribute to the development of gastric cancer include diet, smoking and alcohol consumption, genetic aspects (including a number of heritable syndromes) and infections (for example, Helicobacter pylori or Epstein-Barr virus) and pernicious anaemia

• Liver cancer

People get liver cancer (also called hepatocellular carcinoma, HCC or hepatoma) typically from a prolonged Hepatitis B or C infection or as a result of cirrhosis from chronic alcoholism. Liver cancer may bring about yellowing of the skin and eyes (jaundice), itching (pruritus), or cause a buildup of fluid in the abdomen (ascites). A person may feel an enlarging mass, or the cancer might be revealed by abnormal liver function tests.
An attending practitioner might order a biopsy, an MRI or a CT scan, and a patient might be monitored through blood tests (including alpha-fetoprotein, liver-function tests or ultrasound. These cancers are typically treated according to their TNM stage and whether or not cirrhosis is present. Options include surgical resection, embolisation, ablation or a liver transplant.

• Gallbladder cancer

It is a relatively uncommon cancer. It has peculiar geographical distribution being common in central and South America, central and Eastern Europe, Japan and Northern India; it is also common in certain ethnic groups e.g. Native American Indians and Hispanics. If it is diagnosed early enough, it can be cured by removing the gallbladder, part of the liver and associated lymph nodes. Most often it is found after symptoms such as abdominal pain, jaundice and vomiting occur, and it has spread to other organs such as the liver.
It is a rare cancer that is thought to be related to gallstones building up, which also can lead to calcification of the gallbladder, a condition known as porcelain gallbladder. Porcelain gallbladder is also rare. Some studies indicate that people with porcelain gallbladder have a high risk of developing gallbladder cancer, but other studies question this.

• Stomach Cancer

Most stomach cancers develop in cells that line the mucosa and are called adenocarcinoma of the stomach.  Stomach cancer (also known as gastric cancer) develops slowly – it may take many years before any symptoms are felt.
Just over 2,000 people are diagnosed with stomach cancer each year. This figure includes a small number of people diagnosed with gastrointestinal stromal tumours (GIST) or neuroendocrine tumours (NETs) – relatively rare cancers that are found mostly in the stomach but can occur elsewhere in the digestive system. Their symptoms and progress vary widely.

• Anal cancer

Anal cancer is a cancer (malignant tumor) which arises from the anus, the distal opening of the gastrointestinal tract. It is a distinct entity from the more common colorectal cancer.
Anal cancer is typically an anal squamous cell carcinoma that arises near the squamocolumnar junction, often linked to human papillomavirus (HPV) infection. It may be keratinizing (basaloid) or non-keratinizing (cloacogenic). Other types of anal cancer are adenocarcinoma, lymphoma, sarcoma or melanoma.