Gastrointestinal Cancers: Risk Factors, Symptoms, and Screening
Gastrointestinal cancers (GI) may severely affect your digestive tract. Experts haven’t found exact causes, but gastrointestinal cancers can be linked to lifestyle habits and genetic conditions.
“Gastrointestinal cancers are complex, but that doesn’t mean they’re untreatable,” says Jennifer Wo, MD, a Mass General Brigham Cancer Institute radiation oncologist. “We’re often able to treat them when found early, so it’s important to know your risk factors and what symptoms to watch out for.”
Dr. Wo is the program director for the Gastrointestinal Radiation Oncology Program. Here, she explains risk factors, symptoms, screening, and steps you can take to help reduce your risk.
What are gastrointestinal cancers?
Gastrointestinal (GI) cancers affect the GI tract, also called the digestive tract. The digestive tract is a tube that goes from the mouth to the rectum. It carries food and liquids and turns them into energy in the process.
GI cancers include cancers of the:
GI cancer affects these areas when uncontrolled cell growth occurs in the digestive tract or doctors can’t remove malignant cells on time. Cancer cells may spread to other parts of the body through the lymph nodes — a system of vessels that carry white blood cells that help to fight infections in your body.
What are gastrointestinal cancer risk factors?
Gastrointestinal cancer tends to develop in men more than in women. According to the National Library of Medicine (NLM), 8 in 100 men develop GI cancer before age 75, compared to 4 in 100 women.
There are several factors that can increase your risk of developing gastrointestinal cancer. Gastrointestinal cancer risk factors include:
- Drinking alcohol
- Smoking
- Obesity
- Eating a diet high in red and processed meats
- Have human papillomavirus (HPV) infection or a history of it
- Type 2 diabetes
- Family history of GI cancer
- History of GI cancer or inflammatory bowel disease
If you have inflammatory bowel disease, or a family history of GI cancer, you may need screening even earlier, before you turn 45.
What are the symptoms of gastrointestinal cancer?
Early symptoms of gastrointestinal cancer can be vague and depend on the specific type of cancer.
Those symptoms may include:
- Unintentional weight loss
- Pain, swelling, or a lump in the abdomen
- Blood in the stool
- Nausea
- Diarrhea or constipation
“Make an appointment with your primary care provider if you’re experiencing any of these symptoms,” says Dr. Wo. “It’s best to get checked out to be safe.”
What is gastrointestinal cancer screening?
Gastrointestinal cancer screening includes:
- Colonoscopy, to look for and remove cancer in the colon and rectum. In this procedure, your doctor uses a thin tube with a small camera at the end to look inside the rectum and colon.
- Blood tests to look for markers or signs of cancer in the blood.
- Imaging, such as CT, PET, or MRI scans to rule out cancer or show tumors.
- Endoscopy, which uses a thin, flexible tube with a camera that goes down the throat to search for cancer in the upper digestive tract. They may also use an ultrasound attached to the tube to get images.
- Barium swallow, which is a special liquid drink that helps see the digestive tract clearly on x-rays.
Regular colonoscopies can detect colorectal cancers at an early stage, when treatment is easiest and most effective.
Doctors can also remove precancerous polyps during a colonoscopy. These are growths that may eventually turn into cancer. Removing the polyps means stopping cancer before it has a chance to take hold.
Your doctor may perform a biopsy as part of a cancer screening procedure, like colonoscopy or endoscopy. In other cases, doctors may obtain a biopsy following a suspicious test finding.
If you have a family history of colon or other GI cancers, genetic testing can help providers assess your cancer risk. Knowing your risk may lead us to recommend additional testing and screenings, and more frequent colon cancer screenings.
How can you prevent gastrointestinal cancer?
Your lifestyle choices can influence your risk of gastrointestinal cancers.
“While multiple risk factors may influence a person having gastrointestinal cancer, there are steps you can take in your daily life to reduce your risk of getting it,” Dr. Wo says.
Here’s how:
- Improve your diet with healthy food substitutions. Include a diet rich in wholegrains, dairy products, and foods with fiber.
- Stop smoking. Your primary care provider can help you quit.
- Limit alcohol. Your primary care provider can connect you with resources if you need help cutting back.
- Exercise on a regular basis.
- Maintain a healthy body weight.
How are gastrointestinal cancers treated?
Gastrointestinal cancers may require several different types of treatments, such as:
- Surgery to remove tumors
- Radiation therapy to destroy cancer cells
- Chemotherapy to kill cancer cells or slow tumor growth
- Targeted therapy drugs to block the growth and spread of cancer
- Immunotherapy drugs to activate your body’s own immune system to fight cancer cells
- Clinical trials that give you access to new treatments not yet widely available
Dr. Wo notes that treatment for GI cancer can be complicated, but choosing the right care team can make a difference. “Having a supportive team that’s experienced in treating gastrointestinal cancers and managing side effects is so important.”
Your care team may include GI cancer specialists, GI surgeons, interventional endoscopists who perform diagnostic endoscopies, and many others.
