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Digestive Disease Center

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Gastrointestinal Cancer

The incidence of colorectal, esophageal and pancreatic-biliary cancers continues to increase in the United States, for unknown reasons. Fortunately, the incidence of gastric cancer has decreased.

Gastrointestinal cancer refers to malignant conditions of the gastrointestinal tract, including the esophagus, stomach, biliary system, pancreas, bowels, and anus. The symptoms relate to the organ affected, and can include obstruction (leading to difficulty swallowing or defecating), abnormal bleeding, or other associated problems. The diagnosis often requires endoscopy, followed by biopsy of suspicious tissue. The treatment depends on the location of the tumor, as well as the type of cancer cell and whether it has invaded other tissues or spread elsewhere in the body. This also determines the prognosis. — Wikipedia

There are many similarities between esophageal and colorectal cancer. We recognize increasingly the importance of early detection of these lesions, and their precursors. There is much debate about the best methods, and the effectiveness and costs of screening programs.

Early malignant and premalignant lesions of the rectum, esophagus and stomach can be removed by endoscopic techniques such as polypectomy and endoscopic mucosal resection. The validity of these "non-surgical" methods is enhanced by intraluminal staging through endoscopic ultrasound. Most invasive disease requires surgical resection (where possible) and a team approach involving the optimal application of all techniques including chemotherapy and radiation. Helping anxious patients through this minefield of tests and treatments is an important role for the section coordinators.

Gastrointestinal stromal tumors (GISTs) are uncommon tumors that form in the wall of the gastrointestinal tract from cells known as ICCs, or interstitial cells of Cajal. ICCs are sometimes called gastrointestinal pacemaker cells because they help transmit signals from the autonomic nervous system to the smooth muscles of the gastrointestinal wall, stimulating waves of contraction (peristalsis) that help propel food and waste products through the digestive system. GIST can begin anywhere in the gastrointestinal tract; 60 percent of tumors originate in the stomach, and another 30 percent in the small intestine. Other sites of origin include the esophagus, colon, rectum, and anus. GIST affects about 4,000 to 5,000 people in the United States each year. GIST treatment in adults has been greatly improved by the development of several highly effective targeted therapies. In children, however, the story is very different. — National Cancer Institute

Patients with gastrointestinal cancers are managed in close collaboration with faculty and staff of the MUSC Hollings Cancer Center.