GUWAHATI: Cancers are the second most common cause of death due to non-communicable diseases globally. The demography of cancer in India is as varied as the country itself. However, one fact that remains constant is that the incidence of cancer in North East is higher compared to mainland India.
Gastrointestinal (GI) system is primarily responsible for digestion and absorption of food. Anatomically it consists of a continuous series of hollow tubular structures beginning in the esophagus (food pipe) and terminating in the anal canal. Accessory organs like liver, pancreas also form a part of the gastrointestinal system playing an important role in digestion of food. They constitute a system of their own called as hepato-pancreatico-biliary (HPB) system consisting of liver, GB, biliary tract and pancreas. Gastrointestinal cancers refer to cancers that arise in the gastrointestinal system proper and the hepato-pancreatico-biliary system.
Use of tobacco (smoked and smokeless), alcohol and beetle nut are responsible for majority of GI and HPB malignancies. Obesity, excessive consumption of red meat, diet poor in fibers and vegetables are an important risk factor for lower GI (colon, rectum) malignancies. For HPB malignancies, gallbladder stones, chronic hepatitis b/c infection, alcohol use, chronic pancreatitis, are some of the known and relatable risk factors.
Apart from the above modifiable risk factors some unmodifiable factors like age, race, inherited cancer syndromes also contribute to the development of GI cancers.
Cancers from upper GI system may present with difficulty in swallowing,dyspepsia,decreased appetite, vomiting with or without altered blood. Sadly, most of these symptoms are easily interpreted as acid peptic disease or indigestion and neglected.
Lower GI cancers present with altered bowel habits, bleeding PR fresh or altered, vague pain in abdomen, unexplained anemia, mass in abdomen. Cancers of HPB system may present with unexplained jaundice, vague abdominal pain, abdominal mass or lump.
Evaluation for suspected GI cancers should always be done in a specialized center with a dedicated gastroenterology unit. Noninvasive imaging modalities like USG, CT scan or PET CT help to image these organs and provide valuable clues to the cause of the problems. Scopy (upper GI scopy/colonoscopy) are commonly employed to directly visualize UGI and LGI tract to diagnose and take biopsy to confirm cancer.
Management of GI cancers requires a multidisciplinary team consisting of medical and surgical gastroenterologists, medical oncologist, radiation oncologist, dietician, amongst others. Each expert brings to the table his vast experience and updated knowledge pertaining to his field. “Its not about me but it’s all about we’’ when it comes to treating GI cancers.
Narayana Health in Guwahati has a Gastrointestinal Oncology division that focuses specifically on management of GI cancers. They have a dedicated tumor boardwhich consists of foremost experts in their respective fields. All major surgeries(esophagectomy, gastrectomy, colectomy, whipples procedure, liver resection, gall bladder cancer resections etc.) are routinely performed with excellent outcomes. Gastroenterology procedures like endoscopy, ERCP, PTBD are regularly performed.
A dedicated Medical Oncology and chemotherapy unit provides services like chemotherapy, targeted therapy and immunotherapy of the highest standards and in accordance with international guidelines and protocols. The unit has the expertise and experience to administer and manage complicated chemotherapy protocols keeping a very high benchmark for patient safety.
Narayana Healthcare provides high end and sophisticated treatments even to the most marginalized section of the population, free of cost through various government health schemes.
The department of Gastrointestinal Oncology at NH has a group of specialized doctors including Dr Digvijoy Sharma, MS, DNB (G.I surgery, NIMS, Hyderabad), FMAS, FIAGES and Dr Naresh Jadhav, MD, DM (Oncology, JIPMER).