Overview

A diagnosis of GI cancer can raise many questions about the available treatment options. Surgery is mostly recommended when it can safely remove the cancer or when it helps reduce symptoms effectively. In this article, you will understand the role of GI cancer surgery, various types of open and invasive surgical procedures, recovery expectations, and the potential risks associated with the treatment process.

Table Of Contents

• Understanding GI Cancer
• What Is GI Cancer Surgery? When is it Recommended?
• Types of GI Cancer Surgeries
• Open Surgery vs Minimally Invasive GI Cancer Surgery
• Recovery After GI Cancer Surgery
• Risks and Possible Complications of GI Cancer Surgery
• Conclusion
• Frequently Asked Questions

Understanding GI Cancer

GI cancer (Gastrointestinal cancer) is an abnormal or out-of-control growth of cells in the biliary system, stomach, and other organs of the digestive region. These cancers can affect organs such as the oesophagus, stomach, liver, gallbladder, bile ducts, pancreas, anus, rectum, large intestine, and small intestine.

People suffering from GI cancer can experience several symptoms based on the affected organ. These symptoms could be:

• Continuous pain in the abdomen
• Sudden weight loss
• Vomiting
• Nausea
• Difficulty in swallowing
• Changes in bowel habits
• Blood in the stool
• Jaundice

These symptoms might not be visible during the initial stage; they become more noticeable over time as complications develop.

The exact reason for GI cancer is not clear, but research shows it can happen due to mutations in the DNA of cells within the gastrointestinal tract. This rapid cell growth can lead to a tumour, which can affect nearby tissues and spread to other organs.

Some widely known GI cancers are colorectal cancer, stomach cancer, pancreatic cancer, liver cancer, and oesophageal cancer. Mutations or abnormal cell growth can happen for many reasons, such as environmental risk factors, smoking, obesity, and infections.

What Is GI Cancer Surgery? When is it Recommended?

GI cancer surgery is a process of removing cancerous tumours from the digestive system through a special surgery. Depending on factors like type, size, and location of the tumour, doctors decide whether to remove just a small portion of the infected organ, or to remove the entire organ including nearby tissues.

For patients with localised GI cancer, surgical resection is considered the most effective treatment option. The main objective is to remove the entire cancerous tumour along with some surrounding healthy tissue. This helps ensure the cancer won’t return in the near future.

But GI cancer surgeries are not always performed for complete removal; in advanced cases, palliative surgery can be recommended. This is to manage complications like intestinal blockage, bleeding, pain, or difficulty in swallowing. To improve treatment effectiveness, chemotherapy, radiation therapy, or immunotherapy are often provided after surgery.

Technological advancements in medical science have made the surgical process less invasive. Laparoscopic and robotic-assisted techniques help perform complex surgeries through smaller incisions. This results in reduced discomfort and faster recovery in patients.

Types of GI Cancer Surgeries

The types of gastrointestinal cancer surgery depend on factors like the organ affected, aiming to remove tumours, prevent any further spread, and restore digestive functions.

Open Oesophageal Surgery (Esophagectomy)

Open oesophageal surgery is performed for the treatment of cancer of the oesophagus. In this process, the affected portion of the oesophagus is removed surgically, and the remaining healthy portion is then reattached to the stomach. This process is usually recommended for localised oesophageal cancer, which is mostly followed by chemotherapy or radiation therapy.

Total Gastrectomy

Total gastrectomy is a process where the stomach is completely removed through surgery. This procedure is recommended when the cancer spreads to a large section of the stomach. The oesophagus is connected directly to the small intestine to restore the digestive system.

Partial Colectomy

Partial colectomy, also known as a colon resection, is a process in which cancerous sections of the colon along with nearby lymph nodes are removed. The remaining healthy ends of the colon are reconnected to restore normal bowel function.

Rectal Cancer Resection

In rectal cancer surgery, the tumour along with surrounding tissue and nearby lymph nodes are removed. This involves procedures like low anterior resection (LAR) or abdominoperineal resection (APR). In some rare cases, a temporary or permanent stoma might be required.

Distal Pancreatectomy

Distal Pancreatectomy is done for cancerous tumours present in the body or tail of the pancreas. In this process, the affected portion of the pancreas is removed. This can also include removal of the spleen if required.

Liver Tumour Resection (Hepatectomy)

Liver tumour resection or hepatectomy is performed for patients suffering from liver cancer or isolated liver tumours. In this procedure, the affected portion of the liver is removed surgically, while preserving the healthy liver tissue to maintain normal liver function.

Whipple Procedure

Whipple procedure, also known as pancreaticoduodenectomy, is a complex surgery used to treat cancers of the pancreatic head. The head of the pancreas, along with small intestinal parts, the bile duct, and the gallbladder, are removed.

Small Bowel Resection

In small bowel resection, the cancerous portion of the small intestine is removed. The healthy ends of the intestine are then reconnected.

Laparoscopic GI Cancer Surgery

Laparoscopic surgery is a minimally invasive technique used for GI cancer surgery. This process involves multiple small incisions, specialised instruments, and a high-definition camera to remove GI tumours.

Robotic-Assisted GI Cancer Surgery

Robotic-assisted surgery is an advanced minimally invasive approach for GI surgery. This provides surgeons with enhanced precision, improved visualisation, and greater instrument flexibility.

Open Surgery vs Minimally Invasive Gastrointestinal Cancer Surgery

Recovery After GI Cancer Surgery

Recovery after GI cancer surgery depends on factors like the extent of cancer, type of surgery and patient’s overall health. Most patients stay in the hospital for a few days, where pain is managed, digestive functions are restored, and recovery is closely monitored. There could be multiple side effects and complications after the surgery, so patients are advised to proactively report any concern they might have.

In general, here is what to expect during the recovery period:

• Weight Loss: Temporary weight loss is common because patients are advised to avoid food consumption while the incision is still healing. Even after healing, it can be difficult for them to eat without occasional heartburn, indigestion or nausea.
• Diet changes: Patients are advised to start with a liquid diet, then to slowly move towards soft and solid foods. Frequent meals after stomach resection can cause food to enter the digestive tract too quickly.
• Vitamin supplements: After stomach removal, nutrient absorption becomes difficult. Doctors can recommend oral or injectable supplements to overcome vitamin deficiencies.

Risks and Possible Complications of GI Cancer Surgery

Like any other major surgery, gastrointestinal cancer surgery can also have a few side effects and complications. Some of the most common complications can be the following:

• Bleeding
• Infection
• Blood clots (Deep Vein Thrombosis)
• Pain and discomfort
• Delay in wound healing
• Anastomotic leak (leakage at the surgical connection)
• Temporary bowel disorder
• Nausea, vomiting, or digestive issues
• Weight loss and reduced appetite
• Nutritional deficiencies
• Dumping syndrome
• Bowel obstruction
• Hernia at the incision region
• Temporary or permanent stoma
• Risks related to general anaesthesia
• Need for additional treatment if cancer resurfaces

Conclusion

Even though undergoing GI cancer surgery can feel overwhelming, many patients have achieved positive outcomes with proper treatment and expert surgical care. With the help of modern techniques, tailored treatment plans, and post-surgical support, the recovery rate and quality of life have improved.

Frequently Asked Questions

Q1. What is the survival rate for gastric cancer?

Ans: The survival rate depends on the stage of the cancer. Early-stage cancers have better chances than advanced stages.

Q2. What is life like after bowel cancer surgery?

Ans: With a temporary diet and bowel habit changes, life gets back to normal after recovery.

Q3. Can stomach cancer be cured without surgery?

Ans: Surgery is the best option for localised stomach cancer. But for advanced or inoperable cases, non-surgical treatment options are used.

Q4. Can stomach cancer come back after treatment?

Ans: Yes, just like any other cancer, stomach cancer can also return after its treatment.

Q5. Does gastric cancer spread quickly?

Ans: How quickly gastric cancer spreads depends on factors like the type of cancer and its stage.