A diagnosis of gastrointestinal cancer is life-changing, and figuring out your next step can seem scary, confusing and overwhelming. At Einstein, we are experts in the most advanced testing and treatment for cancer affecting the gastrointestinal organs, offering patients options including surgery, radiation therapy, chemotherapy, immunotherapy and access to promising clinical trials. Our gastroenterology team supports patients throughout diagnosis and treatment and helps them manage a variety of gastrointestinal cancers and their treatments, including:
Early-stage esophageal cancer does not often present with any symptoms, but symptoms of later-stage cancer may include difficulty swallowing, coughing, hoarseness, worsening heartburn or indigestion, chest pain or pressure, and unexplained weight loss. Risk factors include smoking, drinking alcohol, obesity and long-term gastroesophageal reflux disease (GERD). Treatment options include surgery, radiation therapy, chemotherapy, targeted therapeutic drugs, and laser therapy. Sometimes these cancers can cause complete blockage of the esophagus, which can be treated by placement of a stent through the endoscope or placement of feeding tubes.
Symptoms of stomach cancer may include bloating after eating or feeling full quickly; severe, persistent heartburn or indigestion; unexplained, persistent nausea and/or vomiting; stomach pain; fatigue and unintentional weight loss. Smoking, obesity, long-term GERD, stomach inflammation or polyps, a family history of stomach cancer, infection with Helicobacter pylori, and a diet high in salty or smoked foods or low in fruits and vegetables may increase your risk. Treatment options include endoscopic resection, surgery, radiation therapy, chemotherapy, and /or targeted therapies and immunotherapies.
Colon cancer is the third most common cancer in the US. A colonoscopy can be performed to detect and remove colon polyps, precursors to colon cancer. Colonoscopy is recommended every 10 years starting at age 50, or at age 45 for African Americans. If you have a family history of colorectal cancer, ulcerative colitis or Crohn's disease, or other risk factors you will likely need to start screening earlier. Symptoms may include persistent diarrhea or constipation, blood in the stool, narrow stools, bloating and abdominal cramps, fatigue and unexplained weight loss. Treatment options may include surgery, laparoscopic colon resection, radiation therapy, chemotherapy and/or immunotherapy.
Biliary cancer develops in the bile duct system, which connects your liver, gallbladder and small intestine. Symptoms are non-specific and may include abdominal pain, weight loss, and jaundice (yellowing of the skin and eyes). Risk factors include obesity, smoking, a history of gallstones (for gallbladder cancer) and liver infections. This can cause blockage of the biliary system requiring a plastic or metal stent to drain the system followed by possible surgery. Surgery is the most common treatment. Radiation and chemotherapy may also be prescribed along with surgery or if the cancer is inoperable.
Unfortunately, in early stage-pancreatic cancer, symptoms are often not present which means it is often not detected until later stages. When symptoms do appear, they may include upper abdominal pain that radiates to the back, new-onset diabetes, loss of appetite, unexplained weight loss, fatigue and jaundice (yellowing of the skin and eyes). Smoking, a family history of pancreatic cancer, and pancreatic cysts or inflammation may increase your risk. Diagnosis usually involves endoscopic ultrasound to stage the disease and to obtain a tissue diagnosis. Treatment includes surgery, chemotherapy, radiation, and immunotherapy or targeted treatments.
Diagnostic Testing & Treatment
The gastroenterology team at Einstein helps provide expert diagnosis of GI cancers, and works closely with our surgical, radiology and oncology teams to provide comprehensive cancer treatment. Diagnostic testing procedures, and treatment for GI conditions related to GI cancer include:
A colonoscopy is the most common procedure used in diagnosing colon and lower bowel conditions. A thin, flexible tube with a camera attached is inserted into your rectum and into the colon, allowing your doctor to look for abnormalities. During the procedure, your doctor can also perform treatments to stop bleeding, remove scar tissue, place stents, take biopsies to check for cancer and remove precancerous polyps. Your colonoscopy will be performed under sedation, and your gastroenterologist will provide further instruction regarding fasting and colon cleansing procedures prior to your scheduled appointment.
Preparing for a Colonoscopy
The most common procedure used in diagnosing esophageal and stomach conditions, endoscopy is a nonsurgical procedure that helps your gastroenterologist examine your esophagus, stomach and upper small intestine using a flexible tube with a camera attached. During an endoscopy, your doctor may take biopsies to check for infections, certain diseases and rule out cancer. If there is evidence of abnormalities that require treatment, such as bleeding or stretching of the esophagus for a narrowing, it will be performed. Your endoscopy will be performed under sedation, and you will need to fast for six to eight hours prior to the procedure.
A special endoscope that creates an ultrasound image of your upper gastrointestinal tract may be used to detect cancers that are difficult to see with a regular endoscopic camera.
Using an endoscope, your gastroenterologist will inject a dye to help view the pancreas, bile ducts and other organs using X-rays. This can help determine the cause of your abdominal pain or get a clearer picture of cancer in the pancreas, bile ducts, or liver.
If you have a cancerous or noncancerous blockage in the bile duct, esophagus, colon, gallbladder or small intestine, your gastroenterologist may place a thin plastic or metal stent to manage the blockage and relieve some of your symptoms.
This procedure allows nutrition, fluids and medications to be administered directly into the stomach through a flexible feeding tube placed through the abdominal wall and directly into the stomach, and is used for patients who have difficulty swallowing.
If you are experiencing chronic or recurring abdominal pain, diarrhea, constipation, incontinence, gastrointestinal bleeding or other symptom associated with inflammatory bowel disease or other gastrointestinal conditions, make an appointment with one of our specialists today.