tracking your health
Dr Handilu Kath Rengma
CIHSR
An Introduction to Diversity
Fight against cancer starts with understanding that knowledge is not just empowering but a survival tool.
This holds for gastrointestinal (GI) cancers which include malignancies of the esophagus, stomach, liver, gallbladder, pancreas, bowel (small intestine, colon and rectum), and anus.
They form a complex spectrum of diseases, each originating in different parts of the digestive system but sharing the common trait of uncontrolled cell growth.
The impact of these cancers is enormous, affecting millions worldwide. Significant financial, emotional, and economic burden is added to the physical affliction. We are reminded of our vulnerabilities and the paramount importance of early detection, informed prevention, and the dedicated pursuit of advances in treatment. This article endeavours to highlight these diverse yet interconnected cancers, aiming to uplift public awareness, foster early diagnosis, and highlight the strides being made toward more effective treatments.
Role of Risk Factors and Championing Prevention
The causes of GI cancers are multifaceted, with risk factors ranging from genetic predispositions and lifestyle choices to infections and chronic inflammatory conditions of the digestive tract. Some risk factors, such as diet, obesity, smoking, and alcohol consumption, sedentary lifestyle are modifiable and thus present opportunities for prevention. For instance, a diet high in processed and smoked meat, red meat, increased salt intake, low in fruits and vegetables, combined with obesity, smoking, and excessive alcohol consumption, significantly increases the risk. On the contrary, preventive strategies include adopting a healthy lifestyle, characterized by a balanced diet rich in fruits and vegetables, regular physical activity, abstaining from alcohol consumption, and tobacco use.
Vaccinations against infections like Hepatitis B, regular screenings, and awareness of family history can further enhance efforts to prevent liver cancer and other digestive tract cancers.
Recognizing symptoms and early detection
The silent progression of cancers underscores the importance of vigilance regarding symptoms.
While screening colonoscopy is recommended for age 50 and above Unexplained weight loss, loss of appetite, persistent abdominal pain, changes in bowel habits, blood in the stool, jaundice, and difficulty swallowing are among the red flags. Although these symptoms can indicate benign conditions other than cancer, immediate medical consultation is needed. Early detection through awareness of symptoms and adherence to screening recommendations can significantly improve outcomes, making the difference between life and death.
Navigating the treatment landscape
The treatment of cancers has undergone revolutionary changes, transitioning toward more personalized and effective strategies. Arrays of approaches are available which includes surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy. The choice of treatment is tailored to the individual, taking into account the type and stage of cancer, as well as the patient’s overall health. Ongoing research and technological advancements continue to refine these approaches, offering hope and improved quality of life to those facing a GI cancer diagnosis.
Urgent Need for Cancer Care Improvements in Nagaland
GI tract cancers share a significant burden and are among the commonest causes in Nagaland. In terms of proportion gastric cancer takes the lead followed by esophageal cancer. A significant number of which is preventable by means as previously mentioned. Nagaland faces urgent challenges in its cancer care facilities, characterized by an absence of specialized treatment centers and an overall inadequacy in healthcare infrastructure for cancer treatment.
Although cancer cases are only growing in number with each passing year and a significant number requiring radiation, including those affecting the digestive tract, currently, only two centers in Dimapur, CIHSR and Eden Hospital, offer such radiation facilities.
There must be urgency in the government to intensify its efforts in establishing dedicated cancer care facilities and to regularly increase public awareness. The situation is further complicated by financial constraints faced by patients and their families, many of whom belong to low-income backgrounds and also come from remote areas. Acknowledging the financial hurdles, the government’s initiatives such as the Chief Minister’s Fund and Ayushman Bharat scheme have been commendable. These policies aim to provide financial support to the needy, making it affordable for all segments of Nagaland's population. Despite these efforts, the pressing need for a concerted and comprehensive approach to enhance cancer care infrastructure remains.
Regarding the role of the multidisciplinary team and regular follow-up
The role of the multidisciplinary team in the pursuit of cancer treatment leads to better treatment plans, closer following of evidence-based guidelines, and improved patient health outcomes.
At CIHSR the team consists of radiation oncologists, oncosurgeon, and pathologists. This team approach provides personalized care tailored to the specific patient, making the treatment process more efficient and supportive. Essentially, it brings together the best expertise and resources to ensure the best possible care for cancer patients.
Following up with patients after their initial cancer treatment is crucial because cancer can recur. Regular check-ups allow us to monitor for signs of recurrence, manage any long-term side effects of treatment, and provide ongoing support and care. This continuous monitoring ensures any signs of cancer returning are caught early, when they are most treatable.
A Call to Action: Awareness, Advocacy and Support
As we navigate the complexities of gastrointestinal cancers, the collective efforts of individuals, healthcare professionals, and the wider community in raising awareness, advocating for early detection, and supporting affected individuals are crucial. It is through informed choices, recognition of symptoms, and adherence to screening that we can diminish the impact of these formidable diseases. Let this knowledge empower us to act decisively in our lives and communities, championing the cause of prevention, early detection, and support for those on the journey of treatment and recovery.
Dr Handilu Kath Rengma is Consultant, Gastrointestinal Oncosurgeon, Department of Surgery, CIHSR.
