Author: CancerMitr

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.

Home Cancer is a devastating condition that takes a toll on an entire family, leaving a lasting mark on their lives. Characterized by the body’s own cells turning against it through abnormal cell division, this disease disrupts the harmonious functioning of vital tissues and organs. Its unpredictability is truly unsettling, as it strikes even those who lead healthy lifestyles. In the face of such uncertainty, how do we confront a condition notorious for its enigmatic nature? In the realm of battling cancer, the words “early detection saves lives” resonate powerfully. This mantra, vehemently embraced and endorsed by medical experts worldwide, holds the key to transformative outcomes. The question that keeps coming up is how can we ensure early detection of cancer, thus gaining the upper hand in this relentless battle? In pursuit of this knowledge, we turn to the expertise of Dr. Ravi Shankar – a surgical oncologist whose passion for combating cancer shines brightly. Dr. Shankar’s invaluable insights are generously shared with the CancerMitr team, illuminating a path of hope for everyone. Why is early detection important? Which all stages are usually referred to as the early cancer stage? Cancer is a condition characterized by abnormal cell division, which can penetrate various tissues and organs. Depending on the tumour’s size and location, cancer is classified into four stages. Stages 1 and 2 are often referred to as the early stages, offering a glimmer of hope and the possibility of effective intervention. During these initial phases, the tumour is localized. It has not invaded the nearby tissues, lymph nodes, blood vessels, or organs. This is the time when targeted measures can be taken to either destroy the tumour outright or surgically remove the affected portion, mitigating the risk of further spreading. As the journey progresses into later stages, the tumour assumes a more significant presence, potentially affecting nearby structures or spreading distant sites (process known as metastasis). Navigating this phase demands an expensive, time-consuming, and comprehensive approach as treatment frequency increases. At the same time, the patient faces more complexities and damages caused by the tumour. Amidst the challenges posed by cancer, understanding the stages empowers individuals and families to make informed decisions. By fostering awareness and knowledge, people can support one another in the face of both uncertainty and adversity. What is the current prevalence of cancer in India? Is the number low or high when compared to earlier? In my expertise, oral cancer is the most prevalent, along with lung, breast and colorectal cancers. However, it’s important to note that these numbers can vary depending on the region. Currently, India is grappling with a substantial burden of Head and Neck cancer. Undoubtedly, we are witnessing a rise in cancer cases compared to earlier times, but let’s explore the two crucial aspects contributing to this trend: incidence and diagnosis. When it comes to the incidence, several factors play a role, including lifestyle habits like smoking, tobacco chewing, and more, along with environmental factors like air pollution. Acknowledging and addressing these contributors is paramount in our efforts to combat the disease. On a positive note, the increase in the number of cancer diagnoses indicates an encouraging shift. More people are becoming aware of the importance of early detection and willingly seeking tests for the disease. This proactive approach significantly impacts prognosis, as early identification paves the way for better outcomes. We should embrace the power of awareness and knowledge. By understanding the causes, fostering healthy habits, and prioritizing regular screenings, we can collectively shape a brighter future in the fight against cancer. In your experience, at what stage do patients usually come to you? Do you come across more patients who experience initial symptoms but don’t talk about it until the cancer worsens? Unfortunately, 60-70% of the patients who come to me are in their advanced stage of cancer. Many of these individuals have experienced symptoms such as persistent ulcers, sore throats, or unusual pain, which often go unnoticed or are mistakenly treated for something else, due to a lack of awareness. Regrettably, even misdiagnoses can occur, prolonging the time it takes to initiate proper investigations, ultimately leading to later-stage diagnoses. The importance of awareness cannot be overstated, as it empowers patients to recognize potential warning signs and seek timely medical attention. In that way, the patient will know where to go for timely intervention. On a more positive note, there are patients who demonstrate admirable awareness about their health. They recognize that certain symptoms might indicate something abnormal and warrant immediate investigation. Their proactive approach to seeking appropriate care can lead to earlier detection and better treatment outcomes. We are trying to instil the mantra “early detection saves lives” into people’s minds by highlighting it’s importance. So, based on your expertise, how do you compare the prognosis of stage I and stage 4 cancer patients? When it comes to cancer stages, understanding the risk of recurrence is vital. The focus of treatment revolves around preventing recurrence. By using a combination of therapies, post-surgery chemotherapy or radiation, doctors aim to target any remaining cancerous cells in the bloodstream. When it comes to stage I patients – 80 out of 100 individuals do not experience a relapse. It is because early-stage tumours are localized and haven’t spread. However, the scenario changes for stage III or IV patients. Here, 80-90% of individuals may experience a relapse, as the initial treatment didn’t completely eliminate all cancerous cells. If even a small number of cancerous cells, 100 out of 1 lakh, for example, survive treatment, they can trigger a resurgence of the disease. One thing almost all of my patients ask me is if I can guarantee that the cancer won’t come back after treatment. My honest answer is no; such guarantees are beyond my reach. Each patient’s journey is unique, and predicting individual outcomes is not possible. What I can assure them, though, is my unwavering commitment to providing the finest treatment and tailored protocols customized to their abilities and convenience. The