Gastrointestinal (gastrointestinal) cancer: symptoms and signs, treatment, prognosis

Physicians involved in the field of oncology know how important it is when the relatives of a patient, even at a terminal stage, without losing hope, look for ways to help their loved one and make every effort to find the answer to the question: is it possible to defeat stomach cancer? In any case, it is possible to influence the tumor and the patient’s condition. If it is not always possible to destroy it, then you can win time from the disease and give your loved ones the opportunity to talk about the main thing.

Treatment of stomach cancer, depending on the stage, includes methods such as surgery, chemotherapy, targeted therapy and radiation therapy. Of course, the choice of the necessary treatment package depends on the stage at which the tumor was detected.

A distinctive feature of gastric cancer is its tendency to metastasize to the pancreas and other digestive organs. In total, four stages are distinguished, in addition to the so-called “zero” stage, when tumor cells just begin to multiply within a small area of the gastric mucosa.

Stage 1 - fungoid (polypoid) stomach cancer. It is clearly demarcated from healthy tissues, has exophytic growth, that is, it does not go into the tissue, but only connects to it with a “leg”.
Stage 2 - saucer-shaped and cup-shaped stomach cancer. At this stage, the tumor has clear contours and raised edges.
Stage 3 - ulcerative-infiltrative (ulcerating) stomach cancer. This is the stage when the tumor is not separated by clear boundaries from the wall of the organ.
Stage 4 - terminal - diffuse gastric cancer. Characterized by thickening of the entire wall of the organ. The entire stomach ultimately forms a single thick-walled tube.

Stage I gastric cancer is characterized by damage to the gastric mucosa and does not spread to the tissues. If such a tumor is diagnosed in time, endoscopic surgery is sufficient to cure it. This procedure is performed using a special endoscope, which is inserted into the stomach through the oral cavity. That is, the operation occurs without incisions. The more advanced the tumor, the more radical treatment may be required.

Gastrointestinal cancer: features of cancer

Detection and treatment of gastrointestinal cancer
The gastrointestinal tract (GIT) consists of the following parts:

esophagus (tube connecting the mouth to the stomach);
stomach. This is a bag-shaped organ. The stomach consists of several sections. Most often, neoplasms occur in the lower (pyloric) section, which has a transition to the small intestine. The stomach is the most common location of oncology among the gastrointestinal tract.
intestines. It consists of a small and large intestine, which ends in the anus.

Gastrointestinal cancer or carcinoma is a malignant tumor that develops in the mucous membrane of the digestive tract. The esophagus, stomach and intestines are connected into a single system, so a cancerous tumor in one of them can easily spread to another.

Such neoplasms are characterized by fairly rapid growth rates. They grow into the wall of the organ, leading to its deformation, and then can spread to surrounding structures. Cancer tumors are also capable of forming metastases, that is, secondary tumors in other organs.

A person with gastrointestinal carcinoma has problems digesting food, which negatively affects the entire body. It is possible to completely block the lumen of the organ (stenosis). This is a dangerous condition that requires emergency care.

Another danger of the disease is that the first symptoms of gastrointestinal cancer often appear late, and in the early stages it is difficult to suspect cancer. It is discovered either accidentally during examinations, or in an advanced state, when the tumor reaches a large size.

Diagnostics

A preliminary diagnosis is established based on the patient’s complaints and the results of palpation examination. In order to confirm it and identify the characteristics of the course of the disease, a number of instrumental and laboratory diagnostic methods are prescribed.

X-ray examination

X-rays are performed using a barium-based contrast agent. The technique is used to determine the presence of a neoplasm in the gastrointestinal tract, its size, and location.

The procedure also makes it possible to determine the extent of the pathological process and the presence of metastatic lesions.

Endoscopy

The method is aimed at conducting a visual examination of the gastrointestinal tract. Endoscopy is performed by inserting a special device called an endoscope into the esophagus. At one end there is a camera and lighting fixture.

The procedure does not require surgical intervention, since the endoscope is inserted through the anus or oral cavity, depending on the area where the tumor is located.

Biopsy

Performed during endoscopy. The specialist collects a section of tumor tissue. The obtained materials are sent for histological examination.

The method is aimed at determining the composition of the formation of cancer cells and determining the nature of the course of the disease. When metastatic lesions are detected, cells are collected from the lymph nodes.

Laboratory research

The patient will have to undergo blood, urine and stool tests. This allows you to get a more complete picture of the disease, establish hormone levels, the presence of tumor markers and other changes.

Magnetic resonance or computed tomography can be used as additional diagnostic methods.

Causes of gastrointestinal cancer

Studies have shown that gastrointestinal carcinoma is more often diagnosed in men over 55 years of age. The bacterium Helicobacter pylori plays a role in the development of many diseases, so its presence is a risk factor. Also, the gastrointestinal tract is significantly influenced by human nutrition and diet. Eating hot, spicy, too salty, poorly chewed food, as well as strong alcoholic drinks, negatively affects the digestive system and leads to the development of inflammatory diseases.

There are precancerous conditions against which malignant tumors develop:

ulcers;
gastritis;
metaplasia;
leukoplakia;
Barrett's esophagus
ulcerative colitis;
pernicious anemia;
duodenogastric reflux;
adenomatous polyps;
Ménétrier's disease;
sideropenia.

Malignant transformation occurs due to changes in the structure of the mucous membrane that occur under the influence of a long-term inflammatory process. It may not happen immediately, but after a long time.

Interesting fact! Chronic gastritis causes stomach cancer in 70-80% of cases!

Other risk factors for the disease are:

smoking;
obesity;
lack of vitamins and microelements in food, drinking water with nitrites and nitrates;
oncology in the family;
damage to the esophagus and stomach by chemicals;
gastric atrophy;
hereditary diseases (neurofibromatosis 1, multiple neoplasia type 1, Gordner syndrome, Lynch syndrome, etc.).

There are also cases of tumor development after operations on the gastrointestinal tract.

Causes of stomach cough, symptoms and treatment

What is stomach cough, symptoms, treatment needs to be considered in more detail. There are often situations where a cough occurs, seemingly for no particular reason. That is, a person does not have a cold or a sore throat, but an unpleasant cough, occurring systematically, interferes with a normal lifestyle. As a rule, it is not accompanied by sputum production and has a dry, debilitating character, worsening at night. If the cough is accompanied by symptoms that are not characteristic of a cold or allergic disease, such as belching, heartburn, nausea, a stomach cough can be assumed.

First of all, you need to pay attention that in any case, if such a cough occurs, you must consult a doctor to identify its real causes and prescribe appropriate treatment. Delays in examination, diagnosis and timely treatment can cause serious complications.

1Etiology of the disease
2Characteristic symptoms
3Diagnostic methods
4Therapeutic measures

1Etiology of the disease

Stomach cough can occur for many reasons. These can be pathologies and diseases of the gastrointestinal tract, as well as infections of various types. At the same time, cough is only one of the symptoms accompanying the disease against the background of other characteristic signs inherent in the following diseases:

gastroesophageal reflux;
enteroviral and adenoviral infections;
parasitic infections;
intestinal dysbiosis;
gastritis and peptic ulcer;
problems with the liver and rectum;
foreign body in the esophagus;
food poisoning.

Stomach cough most often appears after the age of 35-40 in people who are overweight, abuse alcohol and smoke. If such symptoms occur in children, it is necessary to immediately examine the child in order to identify the causes and prescribe timely treatment.

2Characteristic symptoms

Stomach cough manifests itself in different ways depending on its causes. But it is precisely these features of the manifestation that contribute to the fact that it cannot be confused with a cough that occurs with a cold, sore throat, ARVI or allergic reactions. Another characteristic sign of stomach cough is that it cannot be cured with conventional mucolytic agents. The following symptoms accompany stomach cough in various diseases:

Infectious diseases of the gastrointestinal tract affect the organs of the respiratory system, which causes a dry, prolonged, debilitating cough.
With enterovirus infection, cough is accompanied by symptoms characteristic of this disease - nausea, vomiting, abdominal cramps, diarrhea.
With gastroesophageal disease, when the motility of the digestive tract is impaired, gastric contents reflux into the esophagus, leading to damage to the lower esophagus by acid. With this disease, cough appears immediately after eating; it is accompanied by heartburn, sore throat, wheezing during sleep, even apnea.
The same symptoms accompany gastritis and peptic ulcers, the course of which is also associated with increased acidity, but cough and accompanying symptoms do not appear immediately, but 1.5-2 hours after eating.
With parasitic infection and dysbacteriosis, respiratory syndrome (breathing problems when coughing) is possible, which is associated with general allergization of the body as a result of disruption of the immune system;

Stomach cough often worsens at night or when the patient is in a horizontal position. Since it is long-term, painful in nature against the background of insomnia and the underlying disease, patients are characterized by increased fatigue, a constant feeling of malaise, and general weakness.

3Diagnostic methods

As a rule, when the first symptoms appear, the patient begins self-medication aimed at suppressing discomfort, thinning sputum, complaining of having caught an ARVI or a cold. If the cough does not go away within 3-5 days, you should not continue self-medication, which will not give a positive result, but you should consult a doctor. In addition, it must be borne in mind that self-medication for stomach cough can even be dangerous, since some antitussive drugs can worsen the underlying disease that caused the cough. For example, sugar contained in cough syrups will only contribute to the proliferation of infection, if any, in the gastrointestinal tract.

When visiting a doctor, the primary task is to identify the nature of the disease. For this, various diagnostic methods are prescribed:

fibrogastroscopy or fibrogastroduodenoscopy, which allows you to see a complete picture of the condition of the mucous membrane of the stomach and esophagus and make a diagnosis;
a general blood and urine test, which will give an idea of the general condition of the body, the presence of inflammatory processes and other indicators necessary for diagnosis;
x-ray of the lungs to exclude the possibility of pulmonary pathology, and x-ray of the mediastinal organs;
stool analysis for the presence of parasites and clarification of the composition of the intestinal bacterial flora;
Ultrasound of the abdominal organs.

Additionally, consultations with various doctors are prescribed: an infectious disease specialist if the body is suspected of being damaged by pathogenic microbes, or a gastroenterologist if a disorder of the gastrointestinal tract is detected. After undergoing the examination and receiving diagnostic results, a medical report is made, a final diagnosis is established, and appropriate treatment is prescribed.

4Therapeutic measures

Treatment of stomach cough is complex and is aimed primarily at treating the cause, that is, the underlying disease that causes it.

If the cough is associated with diseases of the gastrointestinal tract, the main purpose is to maintain a proper diet. It includes:

frequent meals in small portions;
using only fresh products for cooking;
the presence of vegetables and root vegetables in the diet in sufficient quantities;
lack of fast food in the diet;
maintaining an upright position and movement after eating for 20-30 minutes.

Antacids are also prescribed - medications that protect the gastric mucosa from the irritating effects of hydrochloric acid and bile produced.

If the cough is caused by an infection, then treatment is aimed at antimicrobial therapy. At the same time, regardless of the cause of stomach cough, but based on the patient’s condition, the doctor may prescribe drugs for the symptomatic treatment of the cough itself, but sometimes they can do without them. The cough usually disappears when the underlying disease is cured. Symptomatic therapy for cough includes drugs that dilute sputum and expand the lumen of the bronchi - mucolytics and bronchodilators.

Folk remedies are also used to treat stomach cough, but their use must be agreed upon with a doctor, and they must act as additional means to the main treatment and not interfere with it. For gastritis, you can use a product based on olive oil (250 ml) and honey (100 g) to suppress cough. You need to store the mixture in the refrigerator and take 1 tsp. before eating.

A remedy based on mumiyo helps with stomach coughs. Shilajit crumbs, approximately 0.5 g, should be diluted in warm milk and drunk before meals 2 times a day.

With increased stomach acidity, raw potato juice helps, which should be consumed fresh, 0.5 tbsp. on empty stomach.

Decoctions of medicinal herbs also help in the treatment of stomach cough: licorice, chamomile, plantain, sage. By enveloping the walls of the stomach, infusions of these herbs soothe coughs.

The main thing is to respond to this unpleasant symptom in a timely manner. It would seem that a harmless deviation from the norm can be a sign of long-term breathing disorder, which not only interferes with the usual way of life, worsening it, but also leads to serious complications. Therefore, timely contact with specialists with signs of stomach cough will help diagnose its causes and prescribe the correct treatment.

Classification of gastrointestinal cancer

Gastrointestinal tumors are classified depending on location.

There are the following types of esophageal cancer:

cancer of the cervical and upper thoracic esophagus;
cancer of the mesothorax;
lower thoracic;
abdominal.

Stomach cancer is divided into:

cancer of the pyloric (exit) section);
carcinoma of the body of the stomach;
carcinoma of the lesser curvature;
and cardiac department.

Bowel cancer is divided into:

colon cancer (colorectal);
small intestine cancer.

According to histological type, gastrointestinal cancer can be:

glandular or adenocarcinoma;
squamous;
glandular-squamous;
small cell;
undifferentiated;
signet ring cell.

Interesting fact! The most common type is adenocarcinoma. In second place is squamous cell carcinoma.

There are 3 forms of malignant tumors of the gastrointestinal tract:

ulcerative (grows exophytically into the lumen of the organ);
nodular or polypous (has the shape of a cauliflower, as it grows it blocks the lumen of organs);
infiltrative (diffuse).

It develops in the submucosal layer, often covering organs circularly, that is, in a circle. This tumor looks like a whitish, thickened mucous membrane, against which ulcerations may occur.

Classification of the disease

In oncology, several classifications of malignant lesions of the stomach are used; this is necessary to choose a more effective course of therapy for gastrointestinal cancer.

According to Bormann's classification, cancer tumors are divided into four types:

Polypous or fungiform tumor. This neoplasm grows from the mucous layer into the organ cavity, the boundaries of the tumor are clear, the base is wide or in the form of a thin stalk. Fungal cancer is characterized by slow growth and late appearance of metastases. Polyp cancer is mainly localized in the lower part of the stomach.
Pronounced tumor. It visually resembles a saucer with raised outer edges and a sunken middle. Such a tumor grows into the lumen of the stomach, metastases form late. The malignant formation deslates in the greater curvature of the stomach.
Ulcerative-infiltrative tumor of the stomach. The neoplasm does not have clear outlines; its growth is infiltrative.
Diffuse infiltrative carcinoma. This tumor has a mixed structure and originates in the mucous and submucosal layers. During examination, small ulcers may be detected. In later stages of the disease, the walls become thicker.

According to histology, stomach cancer is also divided into types:

Adenocarcinoma. This type of cancer affects almost 95% of cases. The tumor begins to develop in the secretory cells of the mucous layer.
Squamous cell carcinoma. A tumor of this type is formed from an atypical degeneration of epithelial cells.
Signet ring cell tumor. The formation begins from goblet cells, which are responsible for the production of mucus.
Glandular cancer. The cause of this type of cancer is the malignant degeneration of healthy glandular cells.

By the structure of the cells, you can find out how aggressive the growth of cancer is. The classification identifies the following forms:

Highly differentiated cancer - atypical cells differ little from normal ones. This form has a slow tumor growth rate, and metastasis occurs only at the last stage.
Moderately differentiated cancer occupies the middle level in terms of the degree of difference from healthy stomach cells.
A poorly differentiated form of cancer is defined when malignant cells are almost completely different from normal ones in their structure.
Undifferentiated. The tumor originates in immature cells of the gastric mucosa. It is characterized by rapid growth and aggressive course. Metastasis occurs in a short time.

Stomach cancer is divided into forms depending on the type of tumor growth.

Diffuse - the cells of a growing formation have no connection with each other. The tumor affects the entire thickness of the walls of the organ, but does not grow into the cavity. The diffuse type of malignancy occurs more often with undifferentiated cancer.
Intestinal type - with this pathology, degenerated cells are interconnected with each other. The tumor protrudes into the organ cavity. This type of cancer is characterized by slow growth and is less aggressive.

Symptoms and signs of gastrointestinal cancer

Symptoms of gastrointestinal cancer differ depending on the location of the tumor, but they have something in common. Patients often complain of weakness, fatigue, and weight loss. The reason for this condition is the restriction of food intake into the body, as well as cancer intoxication.

When the esophagus is damaged, when the tumor reaches a large size, difficulty swallowing (dysphagia) is observed, which is associated with blocking the lumen of the organ. Some people experience pain when swallowing. Other symptoms of carcinoma of this localization are aching pain in the chest and back, profuse salivation.

Late manifestations of the disease may include heartburn, regurgitation, nausea, bad taste in the mouth and bad breath. These phenomena appear due to metabolic disorders and a decrease in the quality of oxidative processes. Metastases may be indicated by coughing, hoarseness, and suffocation.

Signs of gastrointestinal cancer in the stomach are:

pain and discomfort in the abdomen;
a feeling of overcrowding and early satiety (in some cases, patients, on the contrary, constantly experience hunger and cannot get enough);
nausea and vomiting;
loss of appetite;
dyspeptic disorders.

Important! With gastrointestinal cancer, bleeding may occur. This is indicated by vomiting blood and blood in the stool.

Signs of bowel cancer:

constipation or diarrhea;
change in stool color;
jaundice;
nausea, vomiting;
pain and bloating.

Note! Symptoms of gastrointestinal cancer in the early stages are often subtle. When there are pronounced deviations, this indicates that the process is neglected.

Main manifestations of pancreatic cancer

Pancreatic cancer is one of the most difficult to diagnose oncological diseases and ranks sixth in prevalence among malignant lesions of other organs.

The pancreas, being one of the most important organs of the digestive and endocrine systems, can be susceptible to a number of diseases, including cancer. Diagnosis of cancer is also complicated by the fact that in modern countries millions of people suffer from diabetes mellitus and other disorders of the functioning of the pancreas, and therefore do not notice the first symptoms of the appearance of a tumor, considering them to be manifestations of the underlying disease. It is for this reason that every person, and especially those with metabolic disorders or any diseases of the gastrointestinal tract, should have an idea of the main symptoms indicating the possible development of an oncological process in the pancreas.

Symptoms

The appearance of a malignant tumor in the pancreas can go unnoticed for quite a long period of time, but over time the following symptoms appear.

The appearance of acute pain in the upper abdominal cavity, which decreases slightly if you pull your legs towards your stomach, but at the same time can intensify with a sharp tilt of the torso down.

A significant decrease in body weight caused by a decrease in the production of pancreatic juice by the pancreas due to tumor growth and, as a result, a deterioration in the absorption of nutrients from food.

Decreased appetite, and in some cases even anorexia - the appearance of a persistent aversion to any food or refusal to eat.

The emergence of aversion to certain types of food.

Jaundice is a change in the shade of the skin, eye sclera and mucous membranes; this symptom appears due to compression of the bile duct by an enlarging tumor.

Itchy skin - this symptom occurs due to the development of jaundice as a result of the deposition of bile crystals in the skin.

Vomiting - occurs due to compression of the growing tumor at the junction of the stomach and duodenum.

Diarrhea (loose stools) - occurs due to a decrease in the production of digestive juices by the pancreas and, as a result, disruption of the process of food digestion.

The presence of fat in the stool - this symptom appears due to the gradual loss of the pancreas’ ability to produce enzymes for breaking down fat.

Pale color of the stool - occurs due to compression of the bile duct by the tumor and disruption of the normal process of bile outflow.

Darkening of the color of urine.

Heaviness in the right hypochondrium - occurs if the tumor compresses the splenic vein, causing the spleen to increase in size.

Signs of impaired insulin production: severe weakness, trembling hands, feeling of hunger, rapid heartbeat, and in complicated cases, loss of consciousness or coma.

The appearance of heartburn due to increased acidity of gastric juice due to increased production of the hormone gastrin by the growing pancreatic tumor.

The appearance of signs of diabetes mellitus: frequent urination, weight loss, extreme thirst. These symptoms may appear when the tumor produces more glucagon. Since one of the important functions of the pancreas is the regulation of blood glucose levels, signs of diabetes mellitus in patients suffering from malignant diseases of this organ appear quite often (in approximately 35% of all cases). However, the overwhelming majority of people diagnosed with diabetes do not have malignant tumors in the pancreas, so the presence of these symptoms is an important reason to pay attention to your own health, and not to panic.

Since the above manifestations can be observed in a number of other diseases (diabetes mellitus, hepatitis, cholelithiasis, gastritis, etc.), if they are detected, you should undergo a high-quality examination to identify the true cause of the disorders. In the vast majority of cases, the doctor diagnoses some kind of acute or chronic disorder of the digestive system, but, hoping for the best, it is better to take the time to diagnose it in order to rule out a more serious illness.

First signs

The effectiveness of treatment for pancreatic cancer depends to the greatest extent on the timely detection of the disease. It is for this reason that it is advisable to pay attention to the very first signs and manifestations indicating the possible development of a tumor.

The initial signs of pancreatic cancer include:

the occurrence of mild pain in the epigastric region, not associated with food intake. The pain is often worse at night;
the appearance of pain in the right hypochondrium or in the navel area;
irradiation of pain to the lower back or interscapular region of the back;
the appearance of a jaundiced tint of the skin (with cancer of the head of the pancreas). The intensity of yellowing of the skin depends on the degree of compression of the bile ducts by the growing tumor and intensifies over time;
slight discomfort in the abdominal area;
loss of appetite, nausea, heartburn, aversion to certain types of food or smells;
increased fatigue, weakness, decreased performance.

Since at an early stage of development of the disease, the symptoms of pancreatic cancer are very similar to the signs of various diseases of the gastrointestinal tract, when they appear, it is necessary to undergo a comprehensive examination. Even if other diseases are detected (for example, gallstones), it is also necessary to examine the pancreas, because the tumor can develop in parallel with the intensification of the symptoms of another disease.

It should also be borne in mind that from the moment the malignant process begins until the first signs of the disease appear, at least six months pass, and in some cases much more, so it is necessary not only to pay attention to any suspicious symptoms, but also regularly (once or twice per year) perform diagnostic ultrasound for preventive purposes.

Symptoms depending on the stage and type of tumor

The manifestations of pancreatic cancer largely depend on the stage of the disease.

At the first stage, there are usually no symptoms, because the tumor is small in size and therefore does not compress nearby vessels or nerves. If the tumor produces any hormones, then, for example, initial signs of diabetes mellitus or other endocrine disorders may be observed.
At stage 2 A, the tumor may spread towards the bile duct or duodenum, but has not yet affected the lymph nodes. Consequently, the first signs of difficulty in the outflow of bile (jaundice) or digestive disorders (heartburn) may appear;
At stage 2 B, the tumor reaches the lymph nodes and increases in size. Depending on its size and location, symptoms from the endocrine or digestive systems may appear.
At the third stage, the tumor grows towards the spleen, stomach and colon, reaches large vessels and nerves, and grows into the nearest lymph nodes. All signs of the disease during this period are quite pronounced. In the presence of metastases, a person’s general well-being worsens.
At the fourth stage, metastases occur in other organs. Along with an increase in the main symptoms, the patient feels severe weakness, he experiences severe weight loss and lack of appetite. Metastases can occur in the lungs, abdominal cavity, stomach, liver, bones, intestines, distant lymph nodes and brain tissue. In these cases, symptoms characteristic of damage to these organs occur: bone pain, cough, shortness of breath, blood in the sputum, headaches, swelling of the legs. Pancreatic tumors are characterized by early metastasis, so timely detection of the disease is of great importance.

Symptoms of the disease also vary depending on the type of pancreatic tumor.

Adenocarcinoma of the pancreas (pancreatic adenocarcinoma) usually manifests itself with symptoms such as jaundiced skin, weight loss, fat in the stool, and abdominal pain. When the tumor is initially localized in the head of the pancreas, these symptoms appear earlier than with cancer of the body or tail of this organ.
Pancreatic islet cell tumors cause nausea, vomiting, weight loss, abdominal pain, and other symptoms. In addition, these types of tumors secrete excessive amounts of certain hormones.

Depending on the type of hormones produced by islet cell tumors, the following symptoms appear.

Insulinoma (a tumor in the presence of which increases the production of insulin in the body) is manifested by severe sweating, increased anxiety, frequent dizziness, and loss of consciousness due to low blood glucose levels, i.e., symptoms of hypoglycemia occur. Loss of consciousness with insulinoma or as a complication of diabetes mellitus can pose a serious danger to the patient’s life, which is why such a person should always have some sweets with him in order to increase blood sugar levels in time by having a light snack with carbohydrate foods.
Glucagonoma (a tumor that provokes the release of excess amounts of glucagon) is characterized by the appearance of diarrhea, increased thirst, frequent urination, loss of body weight, and the formation of a red-brown rash on the skin, i.e., signs of diabetes mellitus appear.
Gastrinoma (a tumor that produces secretions of excess gastrin) is manifested by pain in the abdomen, the appearance of non-healing stomach ulcers, increased acidity of gastric juice, weight loss of the patient and other symptoms characteristic of gastritis.
Somatostatinoma (a tumor that secretes excessive amounts of somatostatin) provokes abdominal pain, weight loss, and foul-smelling stool.
VIPoma (a tumor in which the patient's body produces an excessive amount of vasoactive intestinal peptide) is characterized by abdominal cramps, frequent watery diarrhea, and redness of the facial skin.

As the tumor further increases in size, it begins to put pressure on nearby organs, vessels and nerves, resulting in additional symptoms. Depending on the location of the tumor and the direction of its growth, the following groups of signs are distinguished.

With cancer of the tail of the pancreas, the main symptom is the appearance of significant pain in the abdomen, and the pain can also radiate to the back. Pain in such cases is usually not associated with food intake, i.e. it can appear both during the day and at night.
In the presence of a tumor of the head of the pancreas, skin itching, jaundice, lightening of the stool, and darkening of the urine are noted. These signs appear due to the fact that the growing tumor survives the bile duct, as a result of which the outflow of bile into the duodenum becomes difficult.
When the tumor compresses the stomach and duodenum, nausea and vomiting occur, and diarrhea is also often observed.
When the tumor is localized in the tail or body of the pancreas, a significant enlargement of the spleen very often occurs.
With head cancer, symptoms of acute cholecystitis or pancreatitis are often observed.
When a tumor grows into the wall of the stomach or duodenum, gastrointestinal bleeding may appear in the form of vomiting of black food or stool of the same shade.

If any of the above symptoms appear, you must urgently undergo examination and, if necessary, agree to surgery, because the earlier the tumor is removed, the higher the chances of recovery. It should also be borne in mind that these symptoms can be observed in a number of other diseases, for example, diseases of the stomach or gall bladder. The pancreas itself can also secrete an excess amount of hormones, not only when affected by a malignant tumor, but also when diabetes develops due to dietary errors or in the presence of a hereditary predisposition to the disease.

Source: bez-gastrita.ru

Diagnosis of the disease

Diagnosis of gastrointestinal cancer begins with a thorough history taking and external examination of the patient. The doctor palpates the abdomen for the presence of enlarged organs and lymph nodes, pays attention to the color of the person’s skin, general condition, and examines the oral cavity.

If colorectal cancer is suspected, it is necessary to conduct a palpation examination of the rectum.

To make a diagnosis use:

X-ray with barium contrast. This technique allows you to confirm the presence of a tumor in the stomach, esophagus or intestines, its location, size, extent and various complications.
Endoscopy. This is a more advanced way. With its help you can examine organs from the inside. In this case, no incisions are made. A flexible tube with a camera at the end is inserted through the mouth or into the anus (when examining the intestines).
Biopsy. During an endoscopic examination, a biopsy is often performed (a fragment of the tumor is taken for microscopic examination). This procedure is a mandatory step in the diagnosis of malignant tumors, since only a biopsy makes it possible to determine the type and form of oncology.
Laboratory tests, including a biochemical blood test and a 24-hour urine test. The fact is that tumors of the gastrointestinal tract are capable of producing various substances or hormones. During the analysis, it is determined whether there are deviations in the indicators of these substances, which are called tumor markers.

What tumor markers should be tested for possible gastrointestinal cancer? One of the tumor markers that indicates neuroendocrine tumors is chromogranin A. The level of serotonin in the urine often increases.

To detect metastases in surrounding organs and structures (lymph nodes, blood vessels, muscles, etc.), CT and ultrasound of the abdominal or thoracic cavity, as well as the retroperitoneal space, are performed. In addition, tracheobronchoscopy (to examine the bronchus) and laparoscopy (to examine the peritoneum) may be needed.

More advanced techniques for searching for metastases in any part of the body are MRI (using a magnet) and PET (done using a radionuclide substance that is injected into a vein).

If metastases are found, they also need to be taken for a biopsy. The material is taken from the lymph nodes using a special syringe; a surgical incision may be required to examine the internal organs.

Stages of stomach cancer

In gastric oncology, the following stages of the disease are distinguished:

Stage 0. Precancerous period, which is quite difficult to diagnose. It is characterized by the appearance of intraepithelial cancer, so malignant cells can only be found in the inner surface layer of the membrane.
Stage 1. Considered the earliest stage of development of a malignant tumor. A tumor has formed on the mucosa, which can damage the muscle layer and penetrate into single lymph nodes. Detection of oncology at this stage gives a great chance of completely eliminating the problem and, after qualified help, returning to normal life.
Stage 2. The neoplasm begins to grow into the outer layer, affecting a large number of lymph nodes. After a course of therapy at this stage, doctors give a 50% chance that the patient will be able to live more than 5 years.
Stage 3. Cancer at this stage significantly worsens the patient's condition. Cancer cells spread to the serous and muscular layers, damaging the liver, kidneys, spleen, small intestine, etc.
Stage 4. Damage to neighboring organs and distant tissues occurs. In most cases, stage 4 stomach cancer is fatal, but death can be delayed by at least a year. Practice shows that only 5% of all patients, after undergoing a course of therapy and fighting metastases, were able to live more than 5 years.

If you consult a doctor in a timely manner, who will tell you how to treat stomach cancer and prescribe effective therapy, there is a high probability of being completely cured of the disease. If you postpone this period and do not start treatment, the severity and specificity of the cancer will gradually increase. In later stages, cancer cells will metastasize to nearby organs and lymph nodes.

Treatment of gastrointestinal cancer

Treatment for gastrointestinal cancer consists of surgical removal of the tumor combined with chemotherapy and/or radiation. The most common and effective method is surgery. The rest are used as a supplement and do not significantly affect the life prognosis for the patient.

The choice of treatment for gastrointestinal cancer depends on the extent of the process:

In the earliest stages, when the tumor is only in the mucous membrane, endoscopic resection can be performed. A special tip for resection is installed at the end of the endoscope, the tube is inserted through the mouth into the esophagus, stomach or duodenum and the tumor is removed. The operation is controlled through a camera equipped with an endoscope.
For small tumors, wide excision is practiced: the tumor and several centimeters of surrounding tissue are cut out.
The best results in the treatment of common cancers are observed after resection. This is an operation during which part of an organ with a tumor or the entire organ is removed through an incision in the abdomen. Of course, it is not always possible to perform a total resection due to the spread of cancer cells over a long distance. In such cases, the doctor’s task is to remove as much of the tumor as possible (subtotal resection) and restore the functionality of the gastrointestinal tract so that the person can eat normally. In addition to part of the affected organ, if necessary, lymph nodes are removed, as well as other damaged organs (intestines, spleen, etc.). Such operations are quite difficult, so the mortality rate ranges from 5 to 10%. After the operation, the resulting material is sent to the laboratory and examined under a microscope to determine the result of treatment and the tactics of further therapy.

Interesting fact! A total resection is when no cancer cells are found at the edges of the removed tissue.

After the operation, it is necessary to perform plastic surgery of the removed fragments. The doctor must choose the most rational method of plastic surgery in order to restore the anastomosis as simply as possible. The best results were observed in single-stage operations.

It is worth noting that the majority of patients with gastrointestinal carcinoma are elderly people, and, as is known, they often have other concomitant pathologies (in particular, cardiovascular and respiratory systems). Because of this, surgical treatment options are significantly limited. To determine the indications for surgery, you need to undergo a series of tests, otherwise the treatment may be fatal.

Those patients for whom surgery is contraindicated are provided with palliative care. It may consist of chemotherapy, radiation, symptomatic therapy. If complications such as stenosis are present, bypass surgery is performed. They can also perform a gastrostomy (creating an artificial entrance to the stomach through the abdominal cavity) or colostomy (bringing a section of intestine into the abdominal wall, creating a colostomy for emptying).

Chemotherapy for gastrointestinal cancer is used before surgery to reduce the size of the tumor or after (to destroy its remains). Preoperative chemotherapy has a positive effect on further resection and reduces the likelihood of local relapses. Doctors prescribe several cytotoxic drugs according to a specific regimen.

Chemotherapy regimens for different types of gastrointestinal cancer are presented

Scheme of 1st line chemotherapy for esophageal cancer:

Platidiam 100 mg/m2 (on the 1st day of the course);
Etoposide 120 mg/m2 (on days 3, 4 and 5);
5-fluorouracil 500 mg/m2 (days 1 and 8).

Scheme of 2nd line chemotherapy for esophageal cancer:

Platidiam 100 mg/m2 (on the 1st day);
Etoposide 120 mg/m2 (on days 3, 4 and 5);
Farmarubicin 30 mg/m2 (3 and 10 days).

Chemotherapy regimen for stomach cancer:

Doxorubicin 20-30 mg/m2 (days 1 and 8);
Vepesid 120 mg/m2 (5, 6, 7 days);
Platidiam 70-80 mg/m2 (on day 3 of the course).

Chemotherapy regimen for stomach cancer:

Alternative methods for treating gastrointestinal cancer

Some patients may be offered alternative methods to surgery. For example, there is cryosurgery, which uses liquid nitrogen to freeze cancerous tissue. The tumor can also be destroyed using ultrasound, laser, and radiotherapy.

Radiotherapy is a type of radiation therapy that uses high doses of radiation. The beam is directed precisely at the tumor, as a result of which its cells die. There is also the option of radiation therapy, in which a radioactive substance is placed inside the tumor. This method is called brachytherapy.

Currently, a method of hormone therapy is being developed: the patient is administered drugs that are analogues of somatostatin. This prevents the tumor from producing hormones and slows its growth.

Additionally, interferon immunotherapy may be performed during treatment of gastrointestinal cancer. It stimulates the human immune system, helping the body work better and fight tumor intoxication.

Targeted therapy

One of the most progressive treatment methods. In targeted therapy with drugs, active substances are introduced that are created specifically to fight a certain type of cancer cells. This method works precisely, with virtually no effect on healthy tissues, however, doctors around the world are still working to improve its effectiveness. Targeted therapy for stomach cancer can work alone or in combination with other treatments, and can be used for any stage of cancer.

Radiation therapy (radiotherapy) for stomach cancer is a method used in combination with chemotherapy and surgical treatment. With its help, damage to healthy tissue is minimal, since tumor cells are targeted. Its main function is to reduce pain, even in the presence of metastases. This method is not therapeutic in itself, but it greatly alleviates the patient’s condition, helps reduce suffering, prolong life, and can be used up to stage 4 of stomach cancer inclusive.

Metastases and relapse in gastrointestinal cancer

Metastases from cancer of the stomach, intestines or esophagus spread in several ways:

Implantation (the tumor volume increases and grows into neighboring structures);
Hematogenously (cancer cells break off from the primary tumor, enter the bloodstream and spread with the bloodstream to any part of the body);
Lymphogenous (through the lymphatic system).

Metastatic tumors have the same shape as the primary tumor. The path of their dissemination depends on the localization of the oncological process. Thus, neoplasms of the esophagus first spread through the lymphatic vessels, which are located in the submucosal layer. They can be found 5 and even 10 cm from the visible edge of the tumor. Next, metastasis occurs to the lymph nodes (cervical, paraesophageal, tracheobronchial, paracardial). Distant metastases are most often found in the liver, lungs and skeletal system.

Metastases from stomach cancer usually spread through the lymphogenous route. First, the lymph nodes located in the ligaments of the stomach are affected, then the retroperitoneal ones, and finally metastasis occurs to distant organs (small intestine, pancreas, liver, colon).

Metastases are treated surgically. In this case, the affected organ may be removed. In case of liver metastases, liver transplantation or hepatic artery embolization is performed. Treatment also includes powerful chemotherapy drugs.

In what organs do they occur?

All formations of the gastrointestinal tract of a malignant type include a group of various diseases depending on the location of the focus of the pathological process.

On this topic

Oncogastroenterology

Feces for stomach cancer

Natalya Gennadievna Butsyk
December 6, 2020

Gastrointestinal cancer includes cancerous tumors that form in the esophagus and pancreas. These also include formations that occur in the stomach, gall bladder, liver, rectum and colon, and in the anus.

Similar neoplasms also include stromal tumors of organs and tissues of the digestive system.

Prognosis for gastrointestinal cancer

The prognosis for life with gastrointestinal cancer depends on the following factors:

tumor location and size;
the presence of metastases in the lymph nodes, liver and other organs;
Is it possible to surgically remove the tumor?

For esophageal carcinoma, the average 5-year survival rate after complex radical treatment is 56%, for stomach tumors - 25%, for intestinal carcinoma - 40-50%.

These indicators are explained by the fact that most patients are admitted with stage 3-4. Stages 1 and 2 are rarely observed, but if you perform high-quality surgery during this period, you can achieve 80-90% 5-year survival and about 70% 10-year survival.

Untreated cancer has a poor prognosis. Such people live a maximum of 5-8 months. Palliative care helps people live for several years, and for some even more than 5 years.

Causes

The main causes of esophageal cancer can be considered poor diet, especially very frequent consumption of hot foods and alcohol.

The human environment plays a certain role, for example, in large industrial cities, the incidence of cancer, in particular of the esophagus and stomach, is very high.

Increases the chances of developing a tumor and hypovitaminosis - A and C.

Smoking has a very detrimental effect on the digestive tract; experts have found that smokers are 2-4 times more likely to suffer from esophageal cancer, unlike non-smokers.

Precancerous pathologies of the esophagus include: achalasia and Barrett's esophagus (people with these pathologies are predicted to develop carcinoma in 10-15% of cases).

Disease prevention

Prevention of gastrointestinal cancer includes a balanced diet. It is necessary to eat vegetables and fruits, drink more green tea. If you don’t want to get sick, then you should give up alcohol and cigarettes altogether.

Since the symptoms of the disease in the early stages are subtle, doctors need to be more alert about oncology and, in case of the slightest suspicion, refer the person for an extensive examination.

If there are precancerous diseases, it is necessary to treat them promptly and then undergo regular examinations.