Surviving GI Tract Cancers: Dr. Kanchan Stresses Symptom Awareness And Regular Screenings
Home Surviving GI tract cancers: Dr. Kanchan stresses symptom awareness and regular screenings Gastrointestinal cancers (GI cancers) account for 26% of the global cancer incidence and 35% of all cancer-related deaths, according to a study published in the journal Gastroenterology. While India has historically experienced a lower incidence of gastrointestinal (GI) cancers compared to Western countries, a marked surge in cases over the last two decades, particularly concerning colorectal and pancreatic cancers, demands our attention. The intrigue of cancer lies in its ability to manipulate cellular division, coaxing cells meant to expire into a deathly process. The enigma deepens when it comes to GI tract cancers residing within the body, their telltale signs hidden from plain sight. Understanding the intricacies of GI cancer prognosis is crucial for effective management and treatment strategies. Picture this: an unusual lump forms, an accumulation of cells that might either be harmless bystanders (benign or non-cancerous tumours) or malicious infiltrators (malignant or cancerous tumours). Ulcers, sores, and bleeding, the aftermath of these cellular conglomerates wreaking havoc. However, the real challenge arises with GI tract cancers, where the symptoms often emerge stealthily in advanced stages—when the tumour has grown substantially to colonize and affect the normal functioning of the neighbouring lymph nodes, organs, or distant territories through metastasis. As the tally of cases continues its worrisome ascent, we find ourselves grappling with a question. How do we confront this situation? In a candid tête-à-tête, the CancerMitr team engaged with the eminent GI tract oncosurgeon, Dr. Kanchan Sachanandani.Dr Sachanandani, with her profound insights and surgical prowess, navigates us through the labyrinth of GI cancers, unveiling strategies to unearth the disease in its latent stages. What is India’s current status regarding the prevalence of GI tract cancer? Which is the most reported GI tract cancer in India? The most reported GI tract cancer is colorectal cancer. It is a condition characterised by the presence of cancerous cells in the colon and rectum (the large intestine region). Now, here’s the eye-opener, the number of cases is scaling up, no sugarcoating that. We’re witnessing the formidable rise of colorectal cancer, followed by liver cancer. These are those diseases that are usually recorded amongst the elderly as the result of age-related complications. But alcohol abuse and a host of other enigmatic factors are pushing more youngsters into the spotlight. Based on your experience, at what stage do patients usually come to you with GI tract cancer? You see, cancer is complex and can be challenging to explain, but allow me to simplify it. We typically categorize cancers into four stages. Stages 1 and 2 are considered early stages, characterised by small, localized tumours. Then there are stages 3 and 4, where the tumour has spread to nearby lymph nodes and distant organs respectively. A significant number of colorectal cancer patients who seek my expertise are either in their first or second stage. This indicates that the tumour is still relatively small and contained. However, the treatment process remains arduous depending on the tumour’s specific characteristics and location. Picture the colon divided into two sections: the proximal region on the right side (ascending and transverse colons) and the distal colon on the left (descending and sigmoid colon). When the tumour appears in the distal colon, it triggers noticeable symptoms such as altered bowel habits (constipation or diarrhoea) and bleeding. In contrast, a tumour in the proximal colon can lead to indicators like anaemia or unexplained weight loss. These are apparent signals that prompt patients to seek medical attention promptly. We often succeed in catching the tumour early unless it’s a particularly aggressive variety, like a high-grade adenocarcinoma. Now, when it comes to the pancreatic cancer patients I have dealt with, the majority of them were in advanced stages, marked by metastasis—meaning the tumour has spread beyond its origin. It’s a sobering reality, highlighting the need for heightened awareness and proactive medical intervention. Why do GI tract cancers, especially pancreatic cancer, have such a low prognosis? Why is pancreatic cancer known as the silent killer? You see, many of these cancers operate in stealth mode, cunningly avoiding obvious signs and symptoms. It’s a tricky terrain where misdiagnoses can easily occur even with our vigilant tools, like ultrasounds and X-rays. Pancreatic cancer is the slickest of the lot. As we’re all aware, the pancreas serves as a key player in our body’s insulin-glucagon balance. Imagine it as a three-part ensemble with the head, body, and tail. Trouble brews when a malignant tumour shows up in any of these segments. What I’ve encountered in my professional journey is that a staggering 90% of reported cases focus on the body or tail regions, often discovered when cancer has already spread. Contrastingly, should this menacing growth show up in the head, a telltale sign emerges early on – jaundice – which is characterised by the yellowing of eyes and skin. The melancholic truth is that the rest of the symptoms – the abdominal distress, the bloating, the curious stool or urine behaviours, the itchiness under the skin, and the anaemia – show up only in the later stages. Imagine this scenario: a patient in stage 1 or 2 notices abdominal pain, which is an ordinary occurrence for many. It’s easy to dismiss it. Meanwhile, the cancerous cells slowly and stealthily replace the normal workforce, those cells that should be maintaining the blood glucose levels. Let’s not forget the nature of these pancreatic tumours, often referred to as adenocarcinomas. They’re relentless, aggressive tumours. It is often the final stop for those patients with stage 3 or stage 4 adenocarcinoma. Read: From palliative care to cancer recovery: Atul Thakkar shares his father’s cancer journey A recent research showed that “excess thirst” and “dark yellow urine” are initial signs of silent-killer pancreatic cancer. What is your professional opinion on that? Yes. Absolutely. Both these symptoms together might set off an alarm, but if you ask me, we can’t entirely depend on them as definitive indicators of pancreatic cancer. It’s a tricky situation.
