1.OVERVIEW
The gastrointestinal (GI) tract is 25-foot-long pathway that extends from the mouth to the anus. Everything you eat passes through the esophagus and gets processed in the stomach and small intestines to extract nutrients. Ultimately, the waste is removed from your body through the colon and rectum. Sometimes, a tumor can form in one of these organs, after a change in the DNA causes abnormal cells to grow. What’s behind this kind of change (known as a mutation)? It could be anything from underlying conditions to lifestyle choices to genetics.Treatments are more effective when the cancer is detected at an early stage—which, unfortunately, can be a challenge.

2.TYPES AND RISK
The most common types of gastrointestinal cancers are as follows:

• Esophageal cancer
• Gastric (stomach) cancer
• Colorectal cancer
• Pancreatic cancer
• Liver cancer

Other types are much less common, including neuroendocrine tumors, gastrointestinal stromal tumors and anal cancer.Generally speaking, gastrointestinal cancers are more likely to develop in men, and the risk increases with age. Studies have linked these cancers to cigarette smoking, alcohol consumption and unhealthy diets.Tumors may also result from specific underlying conditions—like gastroesophageal reflux disease in the esophagus, Helicobacter pylori infection in the stomach, diabetes in the pancreas, inflammatory bowel disease in the large intestine (colon and rectum), hepatitis B or C virus infection or cirrhosis in the liver.A small percentage of gastrointestinal cancers are inherited.

3.SYMPTOMS
Most of the time, symptoms of gastrointestinal cancers don’t occur until the tumor has become more advanced. Then, they depend on the type of cancer. Patients with esophageal cancer may have difficulty swallowing, whereas those with gastric cancer will notice ulcer-like symptoms (e.g., indigestion, loss of appetite, bloating and pain). Liver cancer and pancreatic cancer can also lead to abdominal pain, and colorectal cancer—as you might expect—causes changes in bowel function or bleeding.

4.TREATMENT
When the tumor is easy to reach, surgery might be all that’s necessary. When it’s harder to reach or its removal would significantly affect gastrointestinal function, then chemotherapy, radiation therapy or targeted therapy may be tried first.Surgery involves complete removal of the tumor, along with surrounding tissue. To restore function of the esophagus or stomach, a procedure called anastomosis may be performed to connect the remaining healthy portions of the organ. Some liver cancer patients could be eligible for transplantation.

5.DIAGNOSIS
If patients have symptoms and the doctor has reason to suspect a diagnosis of gastrointestinal cancer, they may perform some of the following tests:

• Endoscopy or esophagogastroduodenoscopy (EGD) to check the lining of the esophagus, stomach and small intestine for tumors
• Colonoscopy to check the colon and rectum for polyps, which can become cancerous
• Lab tests to look for changes in the blood that could be signs of cancer
• Imaging studies (MRI, X-ray, ultrasound, CT scan or PET scan) to check for abnormal tissue anywhere in the digestive system
• Biopsy to obtain a sample of abnormal tissue and analyze it for the presence of cancer cells
  
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  With Regards
  Jessica Watson
  Associate Managing Editor
  Clinical Gastroenterology Journal