What is GI Cancer?
Gastrointestinal (GI) cancers include all cancers in the digestive tract organs such as the esophagus, stomach, small intestine, colon/rectum, pancreas, liver, and biliary system. These organs are responsible for breaking down food, absorbing nutrients, and removing waste from the body. When mutations occur in the cells of digestive organs, cancerous tumors can form over time.
The risk of developing GI cancer increases with age, and men tend to be diagnosed more often than women. Some GI cancers (e.g., pancreas and colon, and to a lesser extent, stomach) are linked to specific inherited genetic conditions. Certain lifestyle choices can increase the risk of GI cancers. As with any cancer, treatment is most effective (and can even cure) when diagnosed early.
Digestive cancer specialists at NewYork-Presbyterian/Columbia University Irving Medical Center are experts in treating patients with GI cancers. Screening, surveillance, diagnosis, and treatment of these cancers vary depending on the type and stage. Our team will assess your cancer, customize a care plan tailored to your individual needs, and support your family.
Types of Gastrointestinal Cancers
- Esophageal cancer affects the esophagus, the muscular tube that brings food from the throat to the stomach. Mutations can cause cancerous cells to grow in the esophagus lining or in the gland cells that secrete mucus. About 1 percent of new cancer diagnoses in the United States are due to esophageal cancer.
- Stomach cancer is also known as gastric cancer. It can form anywhere in the stomach but most commonly affects the part that attaches to the esophagus, the gastroesophageal junction. Stomach cancer affects about 28,000 people in the United States each year.
- Liver cancer affects the liver, which is responsible for breaking down toxins in the body, like drugs and alcohol. It also creates bile which helps digest fats while food passes through the GI tract.
- Bile Duct Cancer is rare and can affect bile ducts inside or outside of the liver. Bile ducts are the small tubes that move bile along the GI tract to help your body digest food.
- Gallbladder cancer affects the gallbladder, a small organ that stores the bile produced by the liver. Gallbladder cancer is rare and difficult to detect, as there are rarely symptoms in the early stages.
- Pancreatic cancer affects the pancreas, creating chemical juices that aid digestion. The pancreas also produces hormones like insulin and glucagon, which regulate sugar levels in our blood. Cancer that develops in the pancreas does not typically show symptoms immediately, so it is often diagnosed at a later stage, possibly after spreading to other organs. There are over 50,000 cases per year in the United States.
- Ampullary cancer affects the ampulla of Vater, a part of the GI tract in which the pancreatic and bile duct secretes digestive juices into the small intestine. In rare cases, this type of cancer is linked to inherited genetic disorders such as Lynch syndrome and polyposis.
- Colorectal cancer affects the colon (also called the large intestine) and rectum. There are more than 150,000 new diagnoses each year, making it the third most common type of cancer in the United States. Discover the misconceptions associated with colorectal cancer.
- Anal cancer is uncommon and affects the anal canal, the tube at the end of the large intestine through which food waste leaves the body.
- Small intestine cancer is a rare type of cancer that affects the small intestine. The small intestine contributes to the breakdown of food and the absorption of nutrients into the bloodstream. Digestive diseases like Crohn’s disease and celiac disease are linked to small intestine cancer.
- Gastrointestinal stromal tumors (GIST) are a type of sarcoma, a cancer that affects bones and soft tissue. Though GISTs are rare, they can develop in any organ along the GI tract. They are most commonly found in the stomach and small intestine.
- Neuroendocrine tumors can develop anywhere in the body, disrupting the normal production of hormones. They commonly affect the small intestine, rectum, appendix, pancreas, and lungs.
Signs & Symptoms of Gastrointestinal Cancer
In its early stages, GI cancers may be challenging to detect, as gastrointestinal cancer symptoms may not be present when the tumors are first developing. GI cancers are typically identified in screenings before symptoms are experienced, or when the cancer has advanced to the point that serious complications arise.
Once the cancer has advanced to a certain stage, possible symptoms of gastrointestinal cancer include:
- Abdominal pain
- Difficulty swallowing
- Loss of appetite
- Weight loss
- Bloody or unusually dark stool
- Gastrointestinal obstruction
- Changes in stool consistency (diarrhea, constipation, narrowing of stool)
- Abdominal bloating or swelling
Causes of Gastrointestinal Cancer
GI cancers occur when the cells that line the organs of the digestive tract mutate and replicate, eventually forming tumors that can then spread to lymph nodes and other organs (e.g. liver, lung, peritoneal cavity).
Experts agree that tumors are more likely to form when the cells in the digestive tract are damaged. Infections, obesity, smoking, excessive drinking, and other behavioral and environmental risks can damage cells in the digestive tract, increasing the likelihood that cancer-causing mutations will occur and endure.
Certain factors can increase a person’s risk of developing GI cancer. Some of these factors involve inherited genetic conditions (about 5–10% of pancreatic cancers; about 10–20% of colorectal cancers), while others involve lifestyle choices and can therefore be changed to reduce the risk of GI cancer.
Risk factors include:
- Sex. Most types of GI cancers are more likely to develop in men.
- Age. The risk of GI cancer increases with age.
- Inherited genetic mutations. GI cancer can be caused by a mutation that is inherited from a parent. These mutations cause hereditary cancer syndromes that can lead to early-onset GI cancers and also some non-GI cancers. For colorectal cancer, such syndromes include Lynch syndrome, Familial Adenomatous Polyposis, MUTYH-associated polyposis, Juvenile Polyposis, Peutz-Jeghers, and others. For pancreatic cancer, syndromes include those related to mutations in BRCA1/2 (may be related to hereditary breast-ovarian cancer syndrome), ATM, PALB2, CDKN2A (familial atypical mole and multiple melanoma), and PRSS1 (hereditary pancreatitis).
- Existing medical conditions. Examples include gastroesophageal reflux, Barrett’s esophagus, gastric intestinal metaplasia, gastric adenomatous polyp, chronic pancreatitis, liver cirrhosis, and inflammatory bowel disease.
- Smoking. Smoking can increase the risk of gastrointestinal cancer, especially cancers of the upper stomach.
- Heavy alcohol consumption. Links have been shown between heavy drinking and the risk of GI cancer.
- Poor diet. Foods that are high in fat increase the risk of GI cancer. Learn more about the relationship between diet and colorectal cancer.
- Obesity. A strong link has been shown between obesity and gastrointestinal cancer development, especially in the esophagus.
Early detection remains the most effective way to prevent the emergence of GI precancerous and cancerous conditions. When identified in its precancerous stages, GI cancer is highly treatable, and tests performed by a doctor can often detect gastrointestinal cancer symptoms before they develop.
Common screening tools for GI cancer include:
- Colonoscopy (for colorectal cancer)
- Upper endoscopy (for esophageal and gastric cancers)
- Endoscopic ultrasound (for pancreatic cancer)
- Forms of stool testing such as fecal occult blood testing (FOBT) and fecal immunochemical testing (FIT) for screening and detection of colorectal cancer
Limiting alcohol consumption, maintaining a balanced diet, engaging in regular physical activity, and avoiding tobacco products can also help reduce the risk of developing GI cancers.
Trust NewYork-Presbyterian for Gastrointestinal Cancer Care
Our team of health care experts at NewYork-Presbyterian is experienced in diagnosing and treating various forms of gastrointestinal cancer. Contact us to make an appointment today.