Over the past couple of years, cancer has become a pretty common concern. Although the disease is no longer without a cure, yet timely detection is of utmost importance in this regard. In this article, we shall continue to shed some more light on stomach (gastric) and large intestine (colorectal) cancers.
Are You At Risk?
In addition, being older or male, having a family member who has had stomach cancer, eating foods that have not been prepared or stored properly, smoking cigarettes, excess alcohol consumption may all increase risk of stomach cancer. This also dispels the myth that smoking causes only lung cancer and alcohol causes only liver cancer. Some of the known risk factors for colorectal cancer include age, obesity, lack of exercise, smoking and excess consumption of alcohol.
Some interventions may serve as protective factors – hormone replacement therapy (women these days have this after menopause, but remember, this can increase risk of other cancers like breast, and heart problems), removal of polyps (benign growths in the intestine). Of interest, but still not proven, is the role of certain vitamins, statins (medicines normally used for decreasing cholesterol levels) and pain killing drugs called nonsteroidal anti-inflammatory drugs NSAIDs (drugs like Ibuprofen) in reducing the risk of colorectal cancer.
All the points mentioned, apply to the most common type of stomach and colorectal cancer that is called adenocarcinoma. There are rarer forms like lymphomas, sarcomas, etc. for which these facts do not necessarily apply. Although many risk factors can be avoided, it is important to keep in mind that avoiding risk factors does not guarantee that you will not get cancer. Also, most people with a particular risk factor for cancer do not actually get the disease. Some people are more sensitive than others to factors that can cause cancer.
Screening for Cancer
Screening is a process by which one looks for cancer before any of the symptoms appear. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread. It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms. They may be repeated on a regular basis. If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.
There is no one standard or routine screening test for stomach cancer. Upper gastrointestinal endoscopy (popularly called OGD, or oesophagogastroduodenoscopy if you really like complex spellings) has been studied as a screening test to find stomach cancer at an early stage. Upper endoscopy is a procedure to look inside the oesophagus, stomach, and duodenum (first part of the small intestine) to check for abnormal areas. An endoscope – a thin, tube-like instrument with a light and a lens for viewing – is passed through the mouth and down the throat into the oesophagus. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.
However, endoscopy may be considered as a screening tool in high-risk people like:
- Older people with gastritis or pernicious anaemia.
- Those who underwent previous surgery on stomach.
- Those with family history of conditions called Familial adenomatous polyposis (FAP) and Hereditary Nonpolyposis colon cancer (HNPCC).
- Immigrants from countries where stomach cancer is more common.
5 Screening Tests
- Colonoscopy looks inside the rectum and colon for polyps, abnormal areas, or cancer. A colonoscope – a thin, tube-like instrument with a light and a lens for viewing – is inserted through the rectum into the colon. The apparatus also has a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.
- Sigmoidoscopy – inserted through the rectum into the sigmoid colon – is used to look inside the rectum and sigmoid (lower) colon for polyps, abnormal areas, or cancer.
- In a Digital Rectal Exam, the doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual.
- Faecal Occult Blood Test checks stool (solid waste) for blood that can only be seen with a microscope. Small samples of stool are placed on special cards and returned to the doctor or laboratory for testing. Blood in the stool may be a sign of polyps or cancer.
- Barium Enema includes a series of X-rays of the lower gastrointestinal tract. A liquid that contains Barium (a silver-white metallic compound) is put into the rectum. It coats the lower gastrointestinal tract and X-rays are taken. This procedure is also called a lower GI series.
New Screening Tests
Virtual colonoscopy: This is a procedure that uses a series of X-rays called computed tomography to make a series of pictures of the colon. A computer puts the pictures together to create detailed images that may show polyps and anything else that seems unusual on the inner linings of the colon. This test is also called colonography or CT colonography. Clinical trials are comparing virtual colonoscopy with commonly used colorectal cancer screening tests. Other clinical trials are testing whether drinking a contrast material that coats the stool, instead of using laxatives to clear the colon, shows polyps clearly.
DNA Stool Test checks the DNA in stool cells for genetic changes that may be a sign of colorectal cancer.
Making the Choice
Treating stomach or colorectal cancer that is already diagnosed depends on several factors:
- Stage: This defines the extent of disease, small or big, whether it is still in the place of origin or has spread elsewhere.
- General condition of the patient, including age, physical status, other coexisting diseases, etc.
- Safety/ risks of different treatment options.
- Curability, and by corollary, incurability.
- The patient’s choices/priorities.
Broadly speaking, there are three ways of treating these cancers, and the patient may be offered the choice. These are: medical treatment (popularly called chemotherapy, though this is no longer strictly accurate because of newer medicines which work differently), surgery, and radiation therapy. The main fact to be emphasized is that today, with early stage disease, a complete cure is possible. Even if the disease is at an advanced stage, its control, relief of symptoms, improvement of quality of life, and prolongation of life are achievable.