Gastrointestinal Cancer Awareness Month

Digestion is the complex process of turning food into energy needed for survival. The digestive system is made up of the alimentary canal, also known as the gastrointestinal (GI) tract, and other organs that play a part in digestion. The GI tract is the long tube of organs that runs from the mouth to the anus and is approximately 30 feet long (in an adult). It is responsible for releasing hormones that help regulate the digestion process.

The main organs of the digestive system are:

• Mouth
• Esophagus
• Stomach
• Small and large intestines
• Rectum
• Anus

Other organs include:

• Salivary glands
• Gallbladder
• Liver
• Pancreas

Gastrointestinal cancers include:

• Anal cancer
• Cholangiocarcinoma (cancer of the bile duct)
• Bile is produced by the liver and helps the body absorb fat.
• Colorectal cancer
• Esophageal cancer
• Gallbladder cancer
• Gastric cancer (a.k.a. stomach cancer)
• Liver cancer
• Oral cancer
• Pancreatic cancer
• Small intestine cancer

This month we will focus on oesophageal and gastric cancers.

OESOPHAGEAL CANCER

Esophageal cancer occurs when malignant cells form in the tissues of the esophagus. The esophagus is a muscular tube that connects the mouth to the stomach. It’s about 10 to 13 inches long and carries liquids and foods to the stomach. The wall of the esophagus has several layers. Cancer starts from the inner layer and grows outward.

The main types of oesophageal cancer are:

• Squamous cell carcinoma – grows in the cells that form the inside layer of the lining of the oesophagus (called the squamous cells); accounts for about half of all cancers of the oesophagus
• Adenocarcinoma- usually starts near the opening to the stomach; cannot start unless squamous cells have been changed by acid reflux

The latest global statistics for cancer of the oesophagus are:

• 6th most common cancer in men
• 9th most common cancer in women
• 5th leading cause of cancer death in men
• 7th leading cause of cancer death in women
• The Caribbean is one of the 3rd world regions most affected by the disease

The exact cause of oesophageal cancer is unknown, however, there are certain risk factors associated with the disease. A risk factor increases a person’s chances of getting a disease, however having one or more risk factors does not mean someone will get a disease. Likewise, someone with no known risk factors can still get it. Biological risk factors for this cancer include age and sex. The risk goes up with age; it is rarely found in people under age 55. Men are 3 times more likely to get it than women. Lifestyle risk factors include: diet, being overweight and the use of tobacco and alcohol products. Stay tuned, next week more risk factors will be discussed.

For more information on gastrointestinal or any cancers speak with your doctor or contact the Cayman Islands Cancer Society at 949-7618 or email victoria@cics.ky

The Cayman Islands Cancer Society is observing April as Gastrointestinal Cancer Awareness Month.

Gastrointestinal cancer (cancer of the digestive system) includes cancers of the esophagus, gallbladder, liver, pancreas, stomach, small intestine, large intestine (colon) and rectum. These cancers do not discriminate between men or women; as either gender can be afflicted by the disease.

General symptoms of all gastrointestinal cancers may include:

•  Abdominal pain
• Appetite loss
• Blood in the stool
• Unexplained fatigue or weakness
• Unexplained weight loss
• Nausea
• Vomiting

To start off our discussion we will talk about Colorectal Cancer. Colorectal is a term that refers to the colon and the rectum. The colon, which is also called the large intestine or large bowel, is about six feet long and is the part of the body’s digestive system that moves waste material from the small intestine to the rectum, the last six inches of the colon. Though we at times shy away from talking about these parts of the body and their general functions, we must be aware that a healthy colon and rectum is critical to our overall health.

Colorectal cancer is a general term for both colon cancer and rectal cancer. Colon cancer and cancer of the rectum (colorectal cancer) generally starts in the large intestine or the rectum. Cancer develops when the cells that line the colon and rectum begin to grow out of control. Nearly all colon cancers start out as a small polyp. Generally polyps are not cancerous but finding and removing them early may keep it from becoming malignant (cancerous) over a period of time. Colorectal cancer can take from 10 years to 15 years to develop to an advanced stage.

According to the American Cancer Society, colorectal cancer is the third most common cancers in both men and women and the fourth leading causes of cancer-related deaths worldwide. Colorectal cancer is highly preventable, treatable and often curable. That’s why it’s very important to make regular screening for colorectal cancer a part of your routine health checks. Screening tests are used to look for disease in people who do not have any symptoms. In many cases, these tests can find colorectal cancers at an early stage and greatly improve the chances of successful treatment.

Risk factors and signs and symptoms of colorectal cancer

No one knows exactly what causes colorectal cancer. But there are certain risk factors that can increase a person’s chances of getting and dying from this type of cancer. Having one or more risk factor doesn’t necessarily mean one will get the disease; likewise, someone with no risk factors could still get it.

Some risk factors for colorectal cancer cannot be controlled, such as:

• Age: particularly after 50.

• A personal history of polyps or colorectal cancer

• Having a history of inflammatory intestinal conditions: such as ulcerative colitis and Crohn’s disease

• Family history of polyps or colorectal cancer – especially if the relative (parent, sibling, child) developed colorectal cancer at a young age (under 55). In some cases, this connection may not be hereditary or genetic. Instead, cancers within the same family may result from shared exposure to an environmental carcinogen or from diet or lifestyle factors.

• Race or ethnic background: Some racial and ethnic groups such as African Americans and people of Ashkenazi (Eastern European Jewish) descent have a higher colorectal cancer risk.

However, some lifestyle habits that increase the risks may be managed, such as:

• Diets: A diet that is high in red meats (beef, pork, goat, lamb, or liver) and processed meats such as hot dogs, ham, salami, bologna, and lunch meat can increase risk. Cooking meats at very high heat (frying, broiling, or grilling) can create chemicals that might increase risk as well.

• Lack of exercise: Someone who is physically inactive is more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.

• Being overweight

• Smoking

• Alcohol: Heavy use of alcohol has been linked to colorectal cancer.

• Diabetes: People with type 2 diabetes have an increased chance of getting colorectal cancer. They also tend to have a worse outlook (prognosis).

Colorectal cancer can strike without any symptoms. When symptoms do occur; seen with more advanced stage of the disease, they usually consist of the following: dark stool, rectal bleeding or blood in the stool (often though the stool will look normal); change in bowel habits (such as diarrhea, constipation, narrow stool) that lasts for more than a few days; frequent abdominal discomfort such as cramps, gas, pain or feeling full or bloated; a feeling that your bowel doesn’t empty completely; unexplained weight loss; nausea or vomiting and body weakness or extreme fatigue.

Although most of these symptoms are more likely caused by something other than colorectal cancer, it is still important to see a doctor right away if any of these problems are present so the cause can be found and treated, if needed.

The Cayman Islands Cancer Society is dedicated to increasing the level of awareness of everyone on the various ways of preventing colorectal cancer through presentations. These are offered free of cost to companies and their employees, schools, clubs and church groups. To schedule a presentation call 949-7618 or email victoria@cics.ky

As mentioned last week, certain lifestyle factors are associated with the development of oesophageal cancer. A diet high in fruits and vegetables is linked to a lower risk as they provide a number of vitamins and minerals that may help prevent cancer. Overeating, which leads to being overweight, raises the risk. A diet high in processed meats may increase the risk (this claim has not yet been proven). Drinking a lot of very hot liquids might also increase risk.

Using any form of tobacco increases risk. The longer the use, the greater the risk. More than half of all squamous cell esophageal cancer is linked to smoking. Similarly, the chance of getting esophageal cancer increases the more a person drinks. Combining smoking and drinking alcohol raises the risk much more than using either alone.

Medical risk factors for cancer of the oesophagus include:

Heartburn (stomach acid and juices escaping into the esophagus): Long-standing heartburn, also called reflux (or GERD: gastroesophageal reflux disease) increases risk.

Barrett esophagus: Results from GERD and over time can change the cells at the end of the esophagus. Raises the risk of adenocarcinoma of the esophagus.

Achalasia: The muscle at the bottom of the esophagus does not open to release food into the stomach, the lower end of the esophagus expands and food collects there instead of moving into the stomach. Over time, raises the risk for squamous cell cancer.

Tylosis: A rare, inherited disease that causes extra skin to grow on the palms of the hands and soles of the feet. People with tylosis are at a very high and should be seen by a doctor regularly to watch for this cancer.

Esophageal webs: A web is an abnormal bulge of tissue that causes the esophagus to become narrow and can lead to a feeling like food gets stuck when it is swallowed. About 1 in 10 people with this problem will get oesophageal cancer.

Stomach bacteria: A certain bacteria called H. pylori can cause many stomach problems, including ulcers and even some types of cancer. Infection with these bacteria can be treated with antibiotics plus a drug to stop stomach acid. People who have had treatment to rid the stomach of H. pylori get adenocarcinoma of the esophagus more often than expected.

Other cancers: People who have had other cancers such as lung, mouth, and throat have a high risk of getting oesophageal cancer. Perhaps because of smoking.

There are often no signs or symptoms in the early stages of cancer of the oesophagus. They often appear at an advanced stage, and include:

– Trouble swallowing (dysphagia)

– Pain – especially in the mid-chest

– Unintended weight loss

– Hoarseness

– Hiccups

– Pneumonia

– High calcium levels

Gastrointestinal cancers – Part 3