Malignant Surgery

Defining Cancer

Gastrointestinal cancer (cancer of the digestive system) includes cancers of the esophagus, gallbladder, liver, pancreas, stomach, small intestine, large intestine (colon) and rectum.

At its heart, cancer is the result of uncontrolled cell growth. Our bodies are composed of trillions of cells, all working together. In cancer, one of those cells stops paying attention to the normal signals that tell cells to grow, stop growing or even to die. Cancer cells still share many of the same needs and properties of normal cells but they become independent of the controls that make our body function smoothly. Adenocarcinoma normally begins in the mucus-producing glands in our body. The process by which normal cell changes into one that behaves so abnormally can take a long time and is often triggered by outside influences. The next few sections describe the differences between normal and cancer cells and outline the steps leading to the creation of a cancer cell from a normal cell.

Cancer is a general term that describes a large group of related diseases. Every case of cancer is unique, be it liver, stomach or gallbladder cancer, with its own set of genetic changes and growth properties. Some cancers grow quickly while others can take years to become dangerous to the patient. The many differences between cases of cancer, even of the same organ is one of the main reasons that treatment is so difficult.

Despite the differences between different types of cancer, all cancers including esophagus and pancreas cancer DO share some common features and these shared properties are the basis for many cancer treatments and research efforts. It is important to understand the basic and shared features of cancer. This will allow for an understanding of detection, diagnosis and treatment options.

Numerous changes must occur for a normal cell to become a cancer cell. Additional changes are needed for that single cell to form a tumor and then for that tumor to grow and spread. The presence of a carcinoid tumour in the body may also be possible.

Malignant Surgery Practice Provides Comprehensive, Expert Cancer Care in Kolkata for Patients with these Cancers:

  • Esophageal Cancer: Radical Esophagectomy with gastric or colon pull up. In this surgery, the esophagus along with its adjacent lymph nodes are removed and replaced with a stomach tube or the colon.
  • Stomach Cancer: Whole or part of the stomach along with lymph nodes is removed and continuity is restored by joining the stomach with the small intestine.
  • Pancreas Cancer: Cancer of the pancreas essentially involves the head of the pancreas and the treatment for this is a Whipple's surgery. This is a complicated operation which involves removal of the head of the pancreas with the whole of the duodenum, part of the stomach, gallbladder, bile duct and initial part of the small intestine. Following this, the remnant pancreas, bile duct and stomach is joined up. A feeding tube may also be inserted for postoperative nutritional support. Pancreatectomy is another surgical procedure for removing the pancreas.
  • Gallbladder Cancer: Surgery involves removal of the gallbladder with part of the adjacent liver and the draining lymph nodes. Radical cholecystectomy proves to be effective for treating the patients.
  • Cancers of the Bile duct: Removal of the bile duct with a portion of the liver.
  • Liver Cancer: There are many types of liver cancer including cholangiocarcinoma. Liver resection is an effective treatment option. Resection of the left or right side of the liver may help in providing relief.
  • Colon & Rectal Cancer: A treatment option is a colectomy, which is the removal of part or whole of the colon. If a part of the colon is removed, the remaining colon is again joined up. Some patients may require a diverting stoma (an opening on the abdominal wall where stool comes out and is collected in a bag). This stoma and bag system is a sealed system with no odor and soiling. This stoma in most cases is temporary and is closed after 3 to 6 months. Only in a very few selected cases, the stoma is made permanent. Some cases of rectal cancer may require radiotherapy and/or chemotherapy before or after an operation. The surgeon who deals with colon and rectal cancer is a colorectal surgeon.

Frequently Asked Questions (FAQs):

  • Q. What are the risks of cancer surgery?
    A: It is an effective option for cancer treatment in Kolkata. However, like any other surgery, cancer surgery also has risks. The side effects which you might experience after cancer surgery will depend on your specific surgery. In general, most cancer operations carry a risk of:
    Pain. Pain is a common side effect of most operations. Some cause more pain than others do. Your health care team will tell you how to manage your pain and will provide medications to reduce or eliminate the pain.
    Infection. The site of your surgery can become infected. Your health care team will show you how to care for your wound after surgery. Follow this routine closely to avoid infection, which can lengthen your recovery time after surgery. Doctors treat infections most often with antibiotics.
    Loss of organ function. To remove your cancer, the surgeon may need to remove an entire organ. For example, a kidney may need to be removed (nephrectomy) if you have kidney cancer.
    For some such operations, the remaining organ can function sufficiently to compensate for the loss, but in other situations, you may be left with impairments. For instance, the removal of a lung (pneumonectomy) may cause difficulty in breathing.
    Bleeding. All operations including hemicolectomy carry a risk of bleeding. Your surgeon will try to minimize this risk.
    Blood clots. While you're recovering from surgery, you're at an increased risk of developing a blood clot. Though the risk is small, this complication can be serious.
    A blood clot that breaks off and travels to a lung is called a pulmonary embolism, a dangerous and sometimes deadly condition.
    A hepatobiliary surgeon will take precautions to prevent blood clots from developing, such as getting you up and out of bed as soon as possible after your operation or prescribing a blood-thinning medication to reduce the risk of a clot.
    Altered bowel and bladder function. Immediately after your surgery, you may experience difficulty having a bowel movement or emptying your bladder. This typically resolves in a few days, depending on your specific operation. Whatever cancer treatment your doctor recommends, you're likely to feel some anxiety about your condition and the treatment process. Knowing what to expect can help. This information will help you ask important questions when you meet with your doctor.
  • Q. What is stomach cancer? A: The stomach is a sack-like organ located just under the diaphragm (the muscle under the lungs). Stomach cancer, also called gastric cancer, is the name for cancer that begins in the stomach, generally in the stomach lining. This type of cancer can eventually spread to lymph nodes and organs such as the liver, pancreas, colon, lungs and ovaries. People occasionally confuse the stomach organ with the abdominal area, saying they have a "stomach ache" when the pain actually could be occurring in the appendix, small intestine, colon (large intestine) or gall bladder, along with the actual stomach. The stomach can be divided into five sections, and the location of cancer in the stomach can affect things like symptoms, prognosis and treatment options. D2 total gastrectomy and D2 subtotal gastrectomy are two treatment options.
  • Q: What are the causes and risk factors for stomach cancer? A: Risk factors are conditions that increase a person's chance of getting a type of cancer. Risk factors are different for various types of cancer. Doctors have determined a number of risk factors for stomach cancer:
    A: Risk factors are conditions that increase a person's chance of getting a type of cancer. Risk factors are different for various types of cancer. Doctors have determined the number of risk factors for stomach cancer:
    Aging. There is a sharp increase in stomach cancer after 50. Most people diagnosed with stomach cancer are in the 60-70 age range.
    Being male. Stomach cancer is about two times more common in men than in women.
    Diet. Foods that are smoked, salted fish and meat, pickled vegetables, and foods that are at the same time high in starch and low in fiber have been identified as possible risk factors. Scientists believe that the dramatic decline in stomach cancer incidence in the United States from the 1930s may be due to the increased use of refrigeration for food storage, which replaced salting or smoking food for storage.
    Tobacco and alcohol abuse. Increases the risk of cancers in the upper portion of the stomach, which can be difficult to treat successfully.
    Previous stomach surgery. After surgery, more nitrite-producing bacteria are present in the stomach. Nitrites can be converted by other bacteria into compounds that have been found to cause stomach cancer in animals.
    Family history of stomach cancer. Several close blood relatives who have or had stomach cancer increases a person's risk. Helicobacter pylori infection. An infection that, if long-term, can lead to chronic atrophic gastritis, which is inflammation of the stomach's inner layer. Chronic atrophic gastritis is a possible precancerous change to the lining of the stomach. Also, the risk may be increased to varying degrees for people with pernicious anemia, achlorhydria, Menetrier's disease, familial cancer syndromes, stomach polyps and blood group A.
  • Q: What are the symptoms of stomach cancer? A: These symptoms might be caused by stomach cancer:
    • o Indigestion or a burning sensation (heartburn)
    • o Discomfort or pain in the abdomen
    • o Nausea and vomiting
    • o Diarrhea or constipation
    • o Bloating of the stomach after meals
    • o Loss of appetite
    • o Weakness and fatigue
    • o Bleeding (vomiting blood or having blood in the stool)
  • However, many of these symptoms are more often caused by other medical conditions. It is important to consult a physician to find out what is causing the symptoms.
  • Q: How will my doctor know if I have stomach cancer? A: There are some commonly used procedures to detect stomach cancer, once it has been determined that risk factors or symptoms are present. To diagnose stomach cancer, a physician will check your complete medical history, conduct a physical examination and laboratory studies that may include a fecal occult blood test or a complete blood count (CBC). For a fecal occult blood test, a stool sample is examined for hidden (occult) blood, since stomach cancer can sometimes cause bleeding that cannot be seen. However, other conditions can cause bleeding, so having blood in the stool does not necessarily mean a person has stomach cancer. A doctor may perform a CBC to determine if a patient has anemia, which is a risk factor for stomach cancer. A physician may also use the following procedures to detect stomach cancer: Proper diagnosis is an important part of the best cancer care in Kolkata.
    Upper endoscopy. After sedating the patient, the doctor puts a lighted tube (endoscope) down the patient's throat to view the lining of the esophagus, stomach and first part of the small intestine. The doctor can also use this instrument to take a biopsy or tissue sample. A biopsy is the only sure way to determine if tissue is cancerous.
    Barium upper GI radiographs. With this test, patients drink a barium-containing solution that coats the esophagus, stomach, and part of the small intestine. The barium helps doctors spot abnormalities in the x-rays they take of the area. After the barium solution is taken, the air is pumped into the stomach to make small tumors easier to see.
  • Q: What about treatment? What should I ask? A: Three kinds of treatment are used to treat stomach cancer:
    Surgery. taking out the cancerous part in an operation. Surgery is the primary treatment for gastrointestinal cancer. Total gastrectomy or removal of the entire stomach is the most common treatment. However, sub-total, or removal of most, but not all, of the stomach, is also performed, depending on the location of the tumor. Surrounding lymph nodes are also removed during surgery. The gastrointestinal tract is then reconstructed to restore continuity.
    Radiation therapy. using high-dose x-rays or other high-energy rays to kill cancer cells
    Chemotherapy: using drugs to kill cancer cells. Chemotherapy and radiation therapy are used after surgery to minimize the risk of recurrence. Radiotherapy ablation helps to manage the pain.
  • Q: What are the side effects of treatment? A: The side effects of cancer treatment vary, depending on the type of treatment. Also, each patient reacts differently. Because treatment often damages healthy cells and tissues, it can cause unpleasant side effects.
    Gastrectomy (the removal of part or all of the stomach; the most effective treatment for stomach cancer) is major surgery, and patients will probably have to make temporary or permanent dietary changes. Those who have total gastrectomies can no longer absorb vitamin B12, which is necessary for healthy blood and nerves. These patients receive regular injections of B12. Some patients experience the dumping syndrome, when food and liquid enter the small intestine too quickly, causing cramps, nausea, diarrhea and dizziness shortly after eating. Foods containing high amounts of sugar often make this symptom worse. The symptoms usually disappear in 3 to 12 months, but they may be permanent.
    Because chemotherapy drugs enter the bloodstream, they can reach all parts of the body, making this treatment useful for cancer that has metastasized or spread, to organs beyond the stomach. Unfortunately, along with killing cancer cells, chemotherapy drugs also damage normal cells. This can lead to temporary side effects such as nausea and vomiting, loss of appetite, loss of hair, diarrhea, mouth sores, low blood count, increased chance of infection, bleeding or bruising after minor cuts/injuries, fatigue and shortness of breath.
    Side effects of radiation therapy can include nausea, vomiting and diarrhea. The skin in the treated area may become red, dry, tender and itchy. Patients should not use lotions or creams to relieve symptoms without a doctor's advice.
    Side effects of biological therapy vary depending on treatment but can include flu-like symptoms (chills, fever, weakness, nausea, vomiting, diarrhea), rash, bruising or bleeding. Patients may need to stay in the hospital while receiving some kind of biological therapy. There are remedies for many of the side effects treatment and therapy can cause, and patients need to communicate about their side effects with their doctor and/or nurse.
  • Q: Will I be able to adjust to this disease well? A: Each cancer survivor's recovery is different, and a person's adjustment after cancer treatment depends on several factors.
    Since the stomach is an important organ for helping the body absorb vitamins, if a person undergoes gastrectomy, doctors routinely prescribe vitamin supplements, some of which must be taken by injection. Patients often have to change their diet after partial or total gastrectomy. Doctors usually recommend smaller, more frequent meals. People need to seek support during and after cancer treatment. Taking advantage of a social support system, such as a cancer support group, helps patients by providing a forum of information and experiences. Maintain an open dialogue with your cancer care team to address any concerns you have.
  • Q: Are there clinical trials available for stomach cancer? A: Yes, clinical trials are available for stomach cancer. Patients may consider clinical trials as a means of treatment. Clinical trials are studies of promising new or experimental treatments and are performed on patients. Clinical trials are performed only when the treatment being studied is likely to be of value to the patient. Participating in a clinical trial is up to the patient. Doctors and nurses will explain the study and its risks in detail and give the patient a form to read and sign, which is known as informed consent. Even after giving informed consent and beginning a clinical trial, a patient may leave the study at any time. Click here for more information on clinical trials.