Gastrointestinal cancer, or GI cancer, refers to the group of cancers affecting the digestive system. St. Luke’s GI Cancer Program treats the entire family of digestive cancers, from colon and rectal cancers to cancers of the appendix, pancreas, colon, stomach, liver, esophagus, bile duct and other digestive cancers.
At St. Luke’s, a core group of GI cancer experts work together, on a case-by-case basis, to develop the most effective and appropriate treatment plan. Patients receive care from fellowship-trained surgical oncologists, medical oncologists, radiation oncologists, and other specialists who identify the optimal treatment strategy.
St. Luke’s uses a combination of proven approaches, including minimally invasive laparoscopic procedures and innovative surgical techniques, progressive therapies that target specific genes in GI cancers, powerful and safe radiation therapy options, and access to the leading clinical trials and promising investigational therapies.
Dedicated nurse navigators and advanced practice nurses coordinate each aspect of your patient’s care, scheduling appointments and other cancer support services, including oncology dietitians, a cancer research nurse and palliative care nurse specialists.
The appendix is a small pouch-like tube at the start of the large intestine. Appendix cancer is relatively rare. Typically, the growths that affect the appendix are known as carcinoid tumors, which are mostly small and typically are benign. If they do spread, they can move to surrounding lymph nodes or into the liver causing complications. Non-carcinoid tumors can develop in the lining of the appendix and are a greater risk to spread in the abdominal cavity.
Symptoms
Most patients have no symptoms in the early stages. In patients who do experience symptoms, abdominal pain and bloating are most common. In fact, most cases of appendix cancer are discovered during appendicitis surgery.
Treatments
Appendix cancer can remain undiagnosed early on unless discovered during abdominal surgery or an imaging test for another condition. If appendix cancer is suspected, the surgeon would perform a biopsy. Treatments for appendix cancer include:
- Surgery
- Chemotherapy
- Radiation therapy
- Hyperthermic Intraperitoneal Chemoperfusion (HIPEC)
HIPEC may be recommended if appendix cancer spreads to the lining of the abdominal cavity. HIPEC is typically started immediately following the surgery to remove any visible tumors. In this process, a chemotherapy solution is heated to 108 degrees Fahrenheit and poured into the abdominal cavity, where it is circulated for 90 minutes to reach cancerous cells that may not be visible to the naked eye. This direct application allows for a heavier dose of medication directly to the cancer cells; the heat causes the cancerous tissue to be even more sensitive to the treatment.
For additional information on programs, services and locations, download and print the following PDFs:
St. Luke’s Radiation Oncology Program Guide
St. Luke’s Infusion Centers Guide
Colorectal cancer is referred to any cancer of the colon (the large intestine) or rectum. Most colorectal cancers start as a polyp, or growth. When discovered early, most are not cancerous. Removing the polyp early can prevent it from turning into a cancerous growth.
Symptoms
The causes of colorectal cancer remain unknown, although it seems rooted in genetic an environmental factors. Diet—particularly one that is high in fat and low in fiber—may contribute to this type of cancer. People who are frequently constipated are also at risk. There also is a strong link between family history and colorectal cancer, as those from families with history of colorectal cancer of colon polyps are at particular risk. Other risk factors for colorectal cancer include:
- Age (older than 50)
- Genetic abnormalities
- Ulcerative colitis
- Intestinal polyps
- Obesity
- Inactive lifestyle
- Smoking
- Excessive use of alcohol
Often, patients suffering from colorectal cancer experience no symptoms in the disease's early stages. As it progresses, patients may experience:
- Stomach pain
- Changes to bowel habits, such as constipation or diarrhea
- Rectal bleeding
- Bloody or tar-like stools
- Unexplained weight loss
Treatments
A doctor will perform a physical examination, review symptoms with the patient and perform testing for colorectal cancer that can include:
If initial testing indicates the presence of colon-rectal cancer, treatment may include:
- Sentinel Lymph Node Biopsy (SLNB) to determine if cancer has spread
- Surgery to remove the cancerous growth
- Laparoscopic surgery when appropriate for select colon cancer patients
- SIR-Spheres (Selected internal radiation therapy) for patients with primary colorectal cancer that has spread to the liver and failed to respond to chemotherapy.
- Colonic stenting to open obstructions in the colon from the tumor; may prevent the need for colostomies in certain situations
- Total Mestenteric Excisional Surgery – state-of-the-art treatment for rectal cancer
- Colostomy, surgery to divert a piece of the colon to an artificial opening in the abdominal wall to bypass the damaged part of the colon. Colostomies can be either temporary or permanent.
- Chemotherapy
- Radiation therapy
- External Beam Radiation Therapy (EBRT)
- Intensity Modulated Radiation Therapy (IMRT)
For additional information on programs, services and locations, download and print the following PDFs:
St. Luke’s Radiation Oncology Program Guide
St. Luke’s Infusion Centers Guide
The esophagus is the tube that connects the neck and chest to the stomach. Esophageal cancer occurs when cancerous cells develop in the esophagus.
Symptoms
More common in men than women, esophageal cancer tends to affect people older than 60. It may not yield any symptoms in its early stages. As the cancer develops, symptoms may include:
- A persistent cough that may include blood being coughed up
- Difficulty swallowing
- Painful swallowing
- Unexplained weight loss
- Vomiting
- Exhaustion
In addition to age and gender, other risk factors of esophageal cancer include:
- Smoking or use of smokeless tobacco
- Excessive use of alcohol
- Gastric reflux disease
Treatments
A doctor will perform a physical examination, review symptoms with the patient and perform testing for esophageal cancer that can include:
If testing indicates the presence of esophageal cancer, treatment may include:
- Chemotherapy
- Radiation therapy
- Surgery to remove the cancerous growth
For additional information on programs, services and locations, download and print the following PDFs:
St. Luke’s Radiation Oncology Program Guide
St. Luke’s Infusion Centers Guide
Gastrointestinal stromal tumors (GISTs) usually begin in cells that are found in the walls along the gastrointestinal tract. These tumors can be malignant or benign.
Symptoms
GISTs usually affect adults. The causes of GISTs are not known. Symptoms may not appear in the early stages, but may appear as the tumor grows. Common symptoms of GISTs are:
- Abdominal pain
- Bleeding into the intestinal tract that may cause dark stools
- Bleeding into the stomach that may cause the patient to vomit blood
- Loss of appetite
- Feelings of nausea
- Exhaustion
Currently, there are very few known risk factors for GISTs. In some instances, they have occurred in members of the same family, although most GIST cases are not inherited.
Treatments
A doctor will perform a physical examination, review symptoms with the patient and perform testing to determine the presence of GISTs. A valuable test for identifying tumors is P.E.T./CT, which produces images of the anatomy while looking at chemical and physiological changes in the body. Other tests used to identify GISTs are:
- Blood Tests
- Biopsy
- X-rays
- CT scans
- MRI
- Endoscopy
If initial testing indicated the presence of GISTS, treatment may include:
- Chemotherapy
- Radiation therapy
- Surgery
For additional information on programs, services and locations, download and print the following PDFs:
St. Luke’s Radiation Oncology Program Guide
St. Luke’s Infusion Centers Guide
The largest internal organ of the body, the liver is responsible for filtering harmful substances from the body so they may be eliminated through urine or stool. The liver produces bile, a digestive juice that helps the body digest fats. Liver cancer occurs when cancerous cells grow in this organ.
Symptoms
The causes of liver cancer are unknown. It usually affects people over the age of 60. Risk factors may include:
- Chronic hepatitis B and/or hepatitis C
- Family history of hepatitis and liver cancer
- Liver disease, such as cirrhosis
- Eating foods that have aflatoxin, a fungal substance that grows on nuts and grains
- Tobacco use
- Use of anabolic steroids
The early stages of liver cancer may produce no symptoms. As the cancer develops, symptoms may be caused by a swelling of or a growth in the liver. Common symptoms of liver cancer include:
- Development of a lump on the right of the body
- Abdominal discomfort
- Pain near the right shoulder blade
- Appetite loss
- Nausea
- Unexplained weight loss
- Jaundice
- Exhaustion
Treatments
Tests that examine the liver and the blood are used to detect and diagnose adult primary liver cancer. The following tests and procedures may be used:
- Blood Tests
- Laparoscopy - a surgeon makes small incisions in the wall of the abdomen and inserts a thin, lighted tube with a camera to look for signs of liver cancer and, if needed, take samples of tissue for biopsy.
- Biopsy
- CT scans
- MRI
If initial testing indicates the presence of liver cancer, treatment will depend on the stage of the cancer and may include:
- Targeted drug therapy
- Radiation therapy
- Surgery (Partial Hepatectomy)
- Laparoscopic liver resections
- Hepatic pumps – delivery of chemotherapy directly to the liver through the hepatic artery
- Chemoembolization – chemotherapy injected directly into the liver and blood supply of the tumor.
- TheraSphere, an FDA-approved outpatient treatment for inoperable liver cancer.
- Microwave ablation
For additional information on programs, services and locations, download and print the following PDFs:
St. Luke’s Radiation Oncology Program Guide
St. Luke’s Infusion Centers Guide
The pancreas is an organ in the upper abdomen that produces both insulin to help the body maintain blood sugar and enzymes in the intestines to help the body digest food. Pancreatic cancer is a severe condition that occurs when cancerous cells grow in this organ. Because it usually causes no symptoms in its early development, diagnosis of pancreatic cancer usually does not occur until the disease has reached an advanced stage.
Symptoms
Pancreatic cancer typically affects people between the ages of 35 and 70, and occurs more commonly in men. It is rare in rarely affects children or adolescents. The symptoms of pancreatic cancer usually don’t appear in the early stages of the disease. Gradually, the patient may experience pain in the upper abdomen or back, and a loss of appetite will be accompanied by weight loss. Other symptoms of pancreatic cancer include:
- A feeling of nausea or vomiting
- A tired, achy feeling
- Jaundice
While the cause of pancreatic cancer is unknown, the disease is commonly linked to smoking cigarettes even though it can strike non-smokers. Other risk factors of pancreatic cancer include:
- Pancreatitis
- Diabetes
- Excessive use of alcohol
- Poor diet that is high in fatty foods
- Obesity
- Exposure to industrial chemicals
- Family history
Treatments
A doctor will perform a physical examination, review symptoms with the patient and perform testing that may include:
If initial testing indicates the presence of pancreatic cancer, treatment may include:
- Chemotherapy
- Radiation therapy
- Laparoscopic pancreas resections
- The Whipple procedure and other surgeries for patients with tumors confined to the head of the pancreas that have not spread to any nearby blood vessels, organs or the abdominal cavity. The Whipple procedure is a complex surgery in which the head of the pancreas is removed, along with the duodenum (a part of the small intestine), a portion of the bile duct and sometimes a portion of the stomach. After the procedure, the surgeon reconstructs the digestive tract.
For additional information on programs, services and locations, download and print the following PDFs:
St. Luke’s Radiation Oncology Program Guide
St. Luke’s Infusion Centers Guide
Stomach cancer is relatively rare and, in recent years, has become less common. This type of cancer starts in the stomach lining. As the cancerous mass grows, it can break into and/or through the stomach wall and spread to other areas and organs of the body. Because stomach cancer tends to cause no symptoms in its early stages, it usually is not detected until the cancer is in an advanced stage.
Symptoms
While the causes of stomach cancer are unknown, doctors and scientists believe the decline in incidence might be attributed to improved diets and advances in safe food preservation. It’s important to note that normal stomach ulcers do not lead to stomach cancer.
Symptoms of stomach cancer include:
- An aching pain in the stomach
- Unexplained weight loss
- Loss of appetite
- Lack of energy
- Bleeding or vomiting blood in advanced cases
The risks of stomach cancer increase with:
- Age (it tends to develop in middle age)
- Excessive use of tobacco or alcohol
- Poor diet that is heavy on smoked or pickled foods or that is lacking fresh fruits and vegetables
- Family history of stomach cancer
Treatments
A doctor will perform a physical examination, review symptoms with the patient and perform testing that may include:
- X-rays of the esophagus, stomach and small intestines
- Endoscopy
- Blood Tests
- Tissue biopsy
If initial testing indicates the presence of stomach cancer, treatment may include:
- Chemotherapy
- Radiation therapy
- Surgery
For additional information on programs, services and locations, download and print the following PDFs:
St. Luke’s Radiation Oncology Program Guide
St. Luke’s Infusion Centers Guide
Beat Cancer With Us…
At St. Luke’s, our cancer patients benefit from all of that, plus an unparalleled level of support and compassion. You are not alone – we are with you every step of the way. Whether you are newly diagnosed or looking for a second opinion, we are here to help. Call St. Luke’s HopeLine – one number for all your needs: 484-503-HOPE.