CONDITIONS
Cancers of the stomach, pancreas, colon and liver have different causes and courses, but one common denominator. Early diagnosis and specialised, multimodal treatment determine survival time and quality of life.
Common principles of treatment
In all cancers of the digestive system surgical removal is the main treatment when the disease is localised. Chemotherapy and radiotherapy are used before surgery to shrink the tumour or afterwards to eliminate residual cells and reduce the likelihood of recurrence. Targeted therapies and immunotherapy add options at the advanced stages.
- Endoscopy and biopsy
Gastroscopy or colonoscopy with tissue sampling. Endoscopic ultrasound for the pancreas.
- Imaging
CT or MRI and ultrasound for the extent of the disease.
- Markers
Blood tests and tumour markers, such as CEA for the bowel and AFP for the liver.
- Treatment plan
The tumour board combines surgery, drugs and radiotherapy according to the stage.
Stomach cancer
Cancer cells grow uncontrollably in the wall of the stomach. Because early symptoms are absent or resemble common indigestion, the disease is often found at an advanced stage.
Symptoms
- Indigestion and heartburn
- Loss of appetite
- Unexplained weight loss
- Nausea and vomiting, often with blood
- Feeling full after little food
Diagnosis
- Endoscopy with biopsy
- CT scan and other imaging tests
- Biomarkers and blood tests
Treatment
Surgical removal of the cancerous tissue, often together with neighbouring lymph nodes, is the main option. The operation is performed under general anaesthesia and lasts several hours. Physiotherapy and nutritional support may be needed afterwards. Possible side effects are pain, infection and difficulties with eating.
Chemotherapy and radiotherapy shrink the tumour before surgery or eliminate residual cells afterwards. They cause fatigue, nausea and hair loss, but significantly increase the overall effectiveness of treatment.
Pancreatic cancer
One of the most aggressive forms of cancer, often diagnosed at an advanced stage, because symptoms appear after the disease has progressed.
Symptoms
- Abdominal and lower back pain
- Jaundice, yellowing of the skin and eyes
- Dark urine and pale stools
- Loss of appetite and weight
Diagnosis
- Ultrasound, CT and MRI
- Endoscopic ultrasound
- Biopsy
Treatment
The Whipple procedure is the most common surgical treatment and involves removing the head of the pancreas, the duodenum, the gallbladder and part of the stomach. It is complex, requires a hospital stay of several weeks and may be followed by digestive disturbances and the need for enzyme replacement.
In parallel the patient receives chemotherapy, and in selected cases radiotherapy, to reduce the likelihood of recurrence. Common side effects are fatigue, nausea and a fall in immune function.
Colorectal cancer
It starts from polyps in the wall of the bowel and usually affects people over 50. Hyperplastic polyps do not turn into cancer. Adenomas can become malignant over time, and some polyps already contain cancer cells. This is why screening colonoscopy saves lives.
Symptoms
- Changes in bowel habits, diarrhoea or constipation
- Blood in the stools
- Abdominal pain and bloating
- A feeling of incomplete emptying
Diagnosis
- Colonoscopy with biopsy, the basic tool
- CT scan
- Tumour markers in the blood, such as CEA
Treatment
Surgical removal involves resecting the cancerous segment of the bowel and joining the healthy segments. A temporary or permanent colostomy may be needed. The digestive system needs time to recover and often nutritional support. Possible side effects are pain, infection and adhesions.
Chemotherapy reduces the likelihood of recurrence and, in metastatic disease, is combined with targeted therapies. Side effects are hair loss, nausea and loss of strength.
Liver cancer
It may be primary, arising from the liver cells themselves, or secondary, from metastases of other cancers. It mainly affects people over 60, but appears earlier in those with a hereditary predisposition, excessive alcohol consumption or hepatitis.
Symptoms
- Jaundice
- Abdominal swelling
- Weight loss and fatigue
- Nausea and vomiting
- High fever
- Lack of appetite
Diagnosis
- Ultrasound, CT or MRI
- Biopsy
- AFP (alpha-fetoprotein) marker in the blood
Treatment
Hepatectomy, the removal of the tumour together with part of the healthy liver, is feasible at the early stages, requires high specialisation and weeks of recovery.
When surgery is not possible, local treatments are used, such as radiofrequency ablation and percutaneous drug injection. At the advanced stages targeted therapies, such as sorafenib, and immunotherapy help control the disease, with side effects such as diarrhoea, fatigue and skin rashes.
Prevention and early diagnosis
Cancers of the digestive system require a multimodal approach by specialised physicians. Prevention, early diagnosis and personalised treatment improve the prognosis and the quality of life.
- Screening colonoscopy from the age of 50, or earlier with a family history
- Testing and treatment for Helicobacter pylori infection
- Vaccination and testing for hepatitis B and C
- Limiting alcohol, stopping smoking, maintaining a normal weight
- Genetic counselling when many relatives have bowel cancer or Lynch syndrome
Your care at the 4th Oncology Clinic
Every case is discussed at the Clinic’s tumour board, where medical oncologists, surgeons, radiation oncologists, radiologists and pathologists jointly design the personalised treatment plan. Our patients have access to new treatments through the Clinical Trials Centre and, where there is a family history, to genetic counselling. Meet our team or contact us for an appointment.
Stomach, Pancreatic, Colorectal and Liver Cancer
Book an appointment
Appointments: 210 48 09 150, 210 48 09 160
Daily 08:00 to 16:00
oncology.clinic4@gmail.com