Fighting GI cancer with awareness

World Digestive Health Day

Medical technology has given us endless possibilities. Newer treatments, smarter therapies and breakthroughs in healthcare have put us steps ahead of some of the most life threatening diseases. That said, in the absence of awareness, these advancements fail to serve their purpose. In the case of gastrointestinal (GI) cancer, early diagnosis still remains a challenge.

As India lacks a screening programme, there is no comprehensive data on the burden of GI cancer in the country. But that does not mean it does not exist. As per statistics, stomach cancer is the fourth most common cancer in India and third most common cancer in men.

In 2018, out of the 57,394 new cases, 38,818 were men. Lack of awareness about the disease leads people to discard the symptoms until they reach an advanced stage. In fact, approximately 90% of the patients are detected with GI cancer only at an advanced stage.

Stomach, colon and oesophageal cancer are the common gastrointestinal cancers prevalent in Karnataka. Approximately, out of every 100 GI cancer cases, Stomach constitutes 40 to 50% followed by colorectal and esophageal which are 20% each, Liver and pancreas cancers 10% each.

On the one hand, south Karnataka has more detection of stomach and colon cancer cases, on the other hand, in the northern part of the state, colon and oesophagus cancer tops the list.

The term ‘GI Cancer’ represents a group of cancers that affect the digestive system. Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumour. Also called gastric cancer, the disease usually grows slowly over many years. Oesophagus food pipe cancer, stomach cancer, colon cancer, liver cancer, pancreatic cancer and gallbladder cancer are all forms of GI cancer.

Lack of knowledge among patients, delays the treatment process, for instance, if one has trouble swallowing food, or appetite loss then most often, he/she consider it as gastric and take over the counter medicines. This is where we are making the first mistake.

There are few basic symptoms which must not be ignored. Patients and doctors should look out for some common symptoms of gastrointestinal cancers like loss of appetite, weight loss, low haemoglobin, difficulty in swallowing, intractable abdominal and back pain, blood in stools with altered bowel — alternating constipation and diarrhoea.

Screening tests

Of course there are not as many diagnosis centres, for a population of 130 crore people, however awareness still plays a critical role in addressing GI cancer so that necessary actions are taken on time. There is a lot of hope for patients if the cancer is found early.

The most common screening tests available in India to detect GI cancer is haemoglobin stool occult, which is a basic screening test. The test one chooses also depends on the condition of the patient.

For instance, while cholangioscopy is done for bile duct, cholonoscopy for colon cancer, endoscopy is performed for upper GI cancer (oesophagus and stomach) and ultrasound or CT Scan is done for liver, pancreatic and gallbladder cancer.

It must be made mandatory for all citizens to undergo basic tests like haemoglobin stool occult, sugars and blood pressure evaluation when he or she applies for Aadhaar or driving licence so that we make people aware about healthy life style rather than we treat them.

Smokers, alcoholics and patients with family history of GI cancer should go for screening every 10 years. Rather than focusing on investing in treating the disease, the need of the hour is to invest in selective screening of the disease and generate awareness about GI cancer.

Interestingly, innovations in many of these tests are making early detection even simpler. Technologies like spy glass cholangioscopy allow the Gastroenterologist to insert a smallest endoscope with tiniest camera in to bile duct to take a clear look at your bile duct, liver. This is not only useful in collecting biopsy samples, but also to understand how far the cancer has spread.

As technologies pave the way for better treatments, it is time for Indian healthcare system to bring them to its people. After all, awareness is the stepping stone towards fighting the most critical disease battles.

(The writer is Head of Gastroenterology BGS Glenegales Global Hospital and Meenakshi Institute of Gastroenterology)