Understanding Treatment Options for
Gastrointestinal Cancers

Once diagnosed, gastrointestinal cancer can be treated in various ways. Whether you have been newly diagnosed, or have been undergoing treatment for a while, it is normal to be confused and have a lot of questions. An important first step is to understand your disease better. 

Any cancer that starts in the organs and tissues of the human digestive system is called gastrointestinal cancer, or cancer of the digestive system. There are different types of gastrointestinal cancers, which are named based on their place of origin.

OESAPHAGEAL CANCER

This type of cancer begins in the oesophagus –the hollow, muscular tube that helps transport food and liquid from the throat to the stomach. The wall of the oesophagus is made up of several layers of tissue, including membranes and muscle. Read more about the risks, symptoms, diagnosis and treatment of oesophageal cancer.
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STOMACH CANCER

Stomach cancer is a type of gastrointestinal cancer that originates in the stomach – an essential organ in the human digestive system. It helps process nutrients in foods that are consumed, and also helps pass waste material out of the body. Read more about the risks, symptoms, diagnosis and treatments of stomach cancer. Read more

LIVER CANCER

Liver cancer is a type of cancer that begins in the liver, one of the largest organs in the body. The liver has two lobes and fills the upper right side of the abdomen, inside the rib cage. Read more about the risks, symptoms, diagnosis and treatments of liver cancer. Read more

GALLBLADDER CANCER

The gallbladder is a small pear-shaped organ located in your upper abdomen, next to the liver. Read more about the risks, symptoms, diagnosis and treatments of gallbladder cancer.
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PANCREATIC CANCER

The pancreas is a small gland located behind the stomach and attached to the small intestine. It is an essential organ in the human body. Read more about the risks, symptoms, diagnosis and treatments of pancreatic cancer. Read more

Colorectal CANCER

The colon (also called the large bowel) is the first part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine. Read more about the risks, symptoms, diagnosis and treatments of colorectal cancer. Read more

ANAL CANCER

The anus is the opening at the end of the large bowel. It helps us pass bowel movements out of the body. Read more about the risks, symptoms, diagnosis and treatments of anal cancer.
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Next, it can be helpful to understand your diagnosis and the stage of your cancer. This information is critical, as it helps determine the treatment options that are available to you. Refer to this section to understand your cancer diagnosis and for more information about how cancer is staged.

Treatments for Gastrointestinal Cancer

Once you have met with your primary physician and clinical care team, it can help to learn more about each of the treatment options they have prescribed for you. There are a variety of methods used to treat gastrointestinal cancer. Some (such as surgery, radiation therapy and chemotherapy) are currently being used for treatment, and some (such as clinical trials) are experimental in nature. Treatments for gastrointestinal cancer can be either:

  • Localized (targeting cancerous cells in one area of the body), or
  • Systemic (targeting cancerous cells throughout the body)
Type of Treatment Nature of Treatment Nature of Treatment
Localized
Invasive
Generally performed once
Localized
Can be invasive or non-invasive
Typically administered over many sessions
Systemic
Can be invasive or non-invasive
Typically administered over many cycles
Systemic
Non-invasive
Typically administered over many cycles
Depends on the trial
Depends on the trial
Depends on the trial
Localized Treatment Options
Surgery

What to expect

Surgery is the most common form of treatment for gastrointestinal cancer. Prior to surgery, your doctor will perform a biopsy to confirm the presence of cancerous cells. Once confirmed, the cells are removed through certain surgical procedures, as detailed below. It is advisable to have an in-depth discussion with your primary physician and cancer care team to find the course of treatment that is best suited for you. 

  • Endoscopic resection: Endoscopic resection is a procedure done in the early stages of cancer. During this procedure, the surgeon will remove the cancer without an incision, using an endoscope. 
  • Subtotal gastrectomy: The procedure involves removal of part of the stomach, sometimes along with part of the oesophagus or the first part of the small intestine. 
  • Total gastrectomy: During this procedure, the surgeon removes the entire stomach, nearby lymph nodes, and omentum. The spleen and parts of the oesophagus, intestines, pancreas, or other nearby organs may also be removed. The end of the oesophagus is then attached to part of the small intestine.

 Some people have trouble taking in enough nutrition after surgery. Further treatment like chemotherapy with radiation can make this problem worse. In these cases, a feeding tube is added directly to the intestine to regulate nutritional intake. 

  • Lymphadenectomy: This procedure involves the removal of the lymph nodes in either a subtotal or total gastrectomy. 
  • Endoluminal laser therapy: This procedure involves the removal of cancerous tissue using a laser. 
  • Gastrojejunostomy: This procedure involves the removal of part of the stomach or small intestine to relieve signs and symptoms of a growing tumour.
Radiation Therapy

What to expect

Radiation therapy uses high-energy x-rays or other types of radiation to remove cancer cells and keep them from growing further. There are two types of radiation therapy:

  • In external radiation therapy, the radiation isadministered from outside the body using a specially designed machine, and is non-invasive.
  • In internal radiation therapy, a radioactive substance is placed directly into or near the cancer through needles, seeds, wires, or catheters. This is an invasive procedure.
Systemic Treatment Options
Chemotherapy

What to expect

Chemotherapy is a drug-based cancer treatment that deploys medication to stop the cancer from growing further, either by killing cancerous cells or by stopping them from dividing. There are two kinds of chemotherapy, depending on the way they are administered:

  • In systemic chemotherapy, the drug is administered either orally or intravenously. The drug enters the bloodstream and targets cancer cells throughout the body. This is the most commonly used type of chemotherapy for cancers.
  • In regional chemotherapy, the drug is administered directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, to ensure the drugs target the cancer cells in those areas more efficiently.

The type of chemotherapy being administered depends on the type and stage of the cancer that is being treated. It is advisable to have an in-depth discussion with your primary physician and cancer care team to find the course of treatment that is best suited for you.

Immunotherapy

What to expect

Immunotherapy readies and trains your immune system to fight cancer using substances made by the body or made in a laboratory to boost, direct, or restore the body’s natural defences against cancer. This type of treatment is also called biotherapy or biologic therapy.

Clinical Trials

What to expect

Clinical trials are medical research studies and are used to find out if new cancer treatments are safe, effective or better than the standard treatment protocol. Trials can also look at improving diagnosis or symptom management. Results from clinical trials can improve cancer treatments and help people live longer. For some people, a clinical trial may be the best treatment option. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients can enter clinical trials before, during, or after starting their cancer treatment.

Alternative Medicine

What to expect

After you have been diagnosed with cancer, you may hear about different forms of alternative medicine through your research orfrom your family, friends or colleagues. Many different areas make up the practice of alternative medicine, and some of these therapies have been practiced for centuries in many parts of the world. Some types of alternative medicine are:

  • Ayurveda
  • Homeopathy
  • Naturopathy
  • Chinese medicine
  • Acupuncture
  • Reiki
  • Hypnosis

While no alternative medicines have been found to cure cancer, they can help cope with side effects of treatment.

It is critical to inform your doctor if you intend to take any of these medicines, or are currently taking them. Sometimes, combining these remedies with the allopathic treatment prescribed by your doctor can be very dangerous. In some cases, the chemicals present in each form of treatment can interact. This can cause reduced efficacy of both types of treatments, or other harmful side effects. It is best to have an open discussion with your doctor about these therapies, and which regimens can be safely combined with your doctor’s care.

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