Gastrointestinal Cancer

Quit smoking! Skip the alcohol. Say no to sugar. Forget the relief of air fresheners. And while you are at it, ditch your cell phones and avoid going out into the sunshine too! Just don't do anything.

Any Google search you run enlisting uncomfortable symptoms will load a host of medical conditions that almost invariably ends with some form of cancer. Look into uncredited online researches and you will suspiciously feed innate fears of having contracted cancer. Rampant in headlines and almost everything seemingly leading to cancer these days, you can't be blamed for failing to separate fact from fiction. But if you are experiencing symptoms that led you down the scary abyss of online diagnoses in the first place, you are not alone.

One of the annual country cancer profiles created by the World Health Organization (WHO) specific to Bangladesh testifies that 10.8 percent (men) and 8.5 percent (women) of all newly-reported cases of cancers in 2018 were some varying form of GI cancer. The most common type out there, GI cancers affect organs stretching from the oesophagus, including the gallbladder, liver, pancreas, stomach, small and large intestine, and ending at the colon, rectum and anus.

Common complaints when it comes to GI cancers are stomach-ache, heart burns, nausea, bloating and the alarmingly constant bloody stools. "It is the fact that these symptoms are commonly associated with indigestion or a persistent case of acid reflux that possibilities of aggressive cases of cancers are dangerously shrugged off at first consultations," shares Dr Foo Kian Fong, senior consultant of medical oncology at Singapore's Parkway Cancer Centre.

Quite simply, cancer is caused by changes in the genetic blueprint, or cellular DNA. Genetic changes are only natural as reflecting upon 7th grade biology lectures will remind you of cell divisions. The problem, however, arises when abnormal cells divide uncontrollably and then go on to affect other organs and tissues of the body. The likelihood of an uncontrollable growth of such manner is often increased due to genetic or hereditary factors, a family history of cancer mortality. A familial diagnosis of colorectal cancer should be a wake-up call to prompt you to visit a doctor and get checked out for Lynch syndrome, an inherited disorder putting you at a 20-80 percent higher chance of contracting colorectal, stomach or other GI cancers. Environmental changes can also affect DNA.

Narrowed down by the International Agency for Research on Cancer (IARC), a part of WHO, substances found in alcoholic beverages, tobacco and its wisps of smoke, along with exposure to radioactive materials like plutonium and radium, are identified to be Group 1 when it comes to categorising cancer-causing agents. Group 1 is, thereby, called 'Carcinogenic to humans.' Exposure to these factors will potentially lead you to a type of cancer in your lifetime. Other common things to steer clear of are leather and wood dust, coal emissions and places such as rubber and paint manufacturing factories.

Cancer is a fight; its army forming gradually. If the foreign forces are bacterial infections, the helicobacter pylori (the pathogen causing stomach/peptic ulcers), is the one leading the siege. Burrowing itself in the lining of the stomach, the bacteria can be ingested through foods handled in unhygienic manners. It inflames the stomach, which results in blood in vomit, nausea and stomach-ache, and, eventually, an ulcer. Also, H. pylori puts you at an 8-time higher risk of getting stomach cancer.

If the darkness is all the same, it's not the end of the road just yet. Surgery, chemotherapy and radiation are the beams of light in this scenario, prolonging life with improved quality of life. Oesophageal, stomach and gallbladder cancers can be treated with the surgical removal of the cancerous tissues in the specific regions. Whole organs or parts of it may be removed or some combined form of chemo and radiation may be sought after to prolong life. Liver cancers can even be eradicated via liver transplants.

For early-stage pancreatic cancer, the most common intervention is surgery. Whipple procedure aims to remove tumours in the head of the pancreas. Next in line stands localised small bowel cancer and colorectal cancers, also, treated by surgery. In any case, the type of cancer, stage and/or other list of factors foresee suitable treatment options and changes in life expectancy. A specialist's opinion is, therefore, bar to none.

"Offering new hope and proving more and more promising when it comes to treating GI cancers is immunotherapy, although still in the early stages of development," shares Dr Foo.

Immunotherapy works by stimulating the body's own immune system so it recognises and attacks cancerous cells. Such proteins or antibodies marking the cancer cells for easier recognition can be given to the patient via pills, topical creams or IV drips. However, there's a catch.

"Such forms of therapy only work when genetic characteristics of the tumours are matched against certain drugs. Thus, immunotherapy can only treat a niche category of cancers," elaborates Dr Foo.

Before giving up and getting your affairs in order, consider some of Bangladesh's best. The National Institute of Cancer Research and Hospital boasts a multi-disciplinary cancer patient management, specialising in tertiary care. Dhaka Medical College Hospital's oncology department also has its own fleet of qualified and eminent specialists. Moreover, Square Hospital and United Hospital are other reliable options, both equipped with palliative care units of their own.

And if you are to go the extra mile, PCC's team of oncologists, radiologists, dietitians, support groups all work in harmony with a singular goal in mind; providing premier and integrated cancer service that is patient-focused, keeping comfort and compassion in mind.

"Treating cancer is very expensive and early detection is a boon here. It's imperative that you opt for regular screenings and tests like gastroscopies and colonoscopies for a longer life. And moderating dietary habits and regular exercise are ideal for prevention," Dr Foo advises.

Everything may seem to cause cancer, but that's only a myth. Contracting any form of cancer is purely biological, with mere factors increasing or decreasing chances. Cancer is a fight that must be braved, no matter the prognosis. It is not a death sentence. Even the rarest types of cancers are attached to a string of hope at the end of the road.