World Cancer Day 2021: All You Need To Know About Gastroesophageal Cancer

World Cancer Day 2021: Esophageal cancer is the 8th most common cancer worldwide. Its incidence is around 5 per 1,00,000 population. In India it occurs in 6 per 1,00,000 population. It is more common amongst men than women. Esophageal cancer has a high incidence in the Northeastern region of India. One million cases of stomach cancer are diagnosed annually in the world. India has a lower incidence as compared to specific areas like Southeast Asia. Certain areas like the Northeastern states and Kashmir have a higher incidence than the rest of India. On World Cancer Day 2021, here's everything you need to know about gastroesophageal cancer.

World Cancer Day: Gastroesophageal cancer symptoms, causes, treatment and more

Gastroesophageal cancer can occur at the following sites:

1. Esophagus - Upper, mid, or lower third part

2. Gastroesophageal junction

3. Stomach - proximal or distal

How common is Gastroesophageal cancer?

• Esophageal cancer is of two types:
• Adenocarcinoma, which is more common in the lower part
• Squamous cell carcinoma, which is more common in the upper esophagus

Proximal Stomach cancer is more common in the higher socioeconomic class due to lifestyle and food-related habits. Distal stomach cancers are commoner in the lower socioeconomic level due to gastritis due to Helicobacter pylori (H. pylori) infection.

How gastroesophageal cancer manifests?

Esophageal cancers commonly present with dysphagia (i.e. difficulty in swallowing), which occurs initially with solid foods and then progress to liquids. Any dysphagia cannot be ignored. The patient needs to consult a doctor to further investigate it. The other symptoms are weight loss, and anorexia. Stomach cancers usually present with vague symptoms of weight loss, loss of appetite, anemia. It tends to present late due to vague symptoms. So, a significant drop in hemoglobin levels will need medical intervention.

Gastroesophageal cancer can lead to unintentional weight loss
Photo Credit: iStock

What are the modalities for diagnosis for Gastroesophageal cancer?

Upper GI endoscopy is done to see the tumor's extent and location, and a biopsy is taken. Imaging modalities like CT scan and the PET scan are done to stage and see the extent of the progression of the disease, which helps in deciding the treatment.

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How is gastroesophageal cancer treated?

The treatment of this cancer is multi-modality therapy, where surgical, chemotherapy, and radiotherapy are the different modalities used in combination according to the disease stage. Esophageal cancers often require chemotherapy or radiation therapy first and then followed by surgery. Minimal invasive surgery like Robotic Esophagostomy is very commonly adapted by experts, as the patient recovery is early and reduces the duration of hospitalisation. Stomach cancer requires surgery where a partial or total gastrectomy is done to remove lymph nodes surrounding the stomach. In some patients, chemotherapy is given after surgery depending upon the extent and stage of cancer.

How can gastroesophageal cancer be prevented?

• An active and healthy lifestyle with adequate amount of rest and physical activities
• Avoiding smoking and alcohol decreases the risk
• Difficulty in swallowing and significant weight loss must be investigated

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However with early detection of cancer and appropriate treatment, patients live a longer life, and outcomes improve. Patients treated for cancer in the past will need to follow-up with experts regularly for detection of recurrence of the disease and seek medical care at the earliest.

(Dr. Ganesh Nagarajan is a Consultant Gastroenterology Surgery at P. D. Hinduja Hospital & MRC)

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