Gastrointestinal Cancer Awareness Month

Did you know that March is Gastrointestinal Cancer Awareness month?

Check out some very interesting research from top physicians:

Gastrointestinal Cancers Awareness month

By Victoria Anderson Grey
As Published in the Cayman Reporter on April 5, 2014

Digestion is the complex process of turning food into energy needed for survival. The digestive system is made up of the alimentary canal, also known as the gastrointestinal (GI) tract, and other organs that play a part in digestion. The GI tract is the long tube of organs that runs from the mouth to the anus and is approximately 30 feet long (in an adult). It is responsible for releasing hormones that help regulate the digestion process.

The main organs of the digestive system are:

  • Mouth
  • Esophagus
  • Stomach
  • Small and large intestines
  • Rectum
  • Anus

Other organs include:

  • Salivary glands
  • Gallbladder
  • Liver
  • Pancreas

Gastrointestinal cancers include:

  • Anal cancer
  • Cholangiocarcinoma (cancer of the bile duct)
  • Bile is produced by the liver and helps the body absorb fat.
  • Colorectal cancer
  • Esophageal cancer
  • Gallbladder cancer
  • Gastric cancer (a.k.a. stomach cancer)
  • Liver cancer
  • Oral cancer
  • Pancreatic cancer
  • Small intestine cancer

This month we will focus on oesophageal and gastric cancers.


Esophageal cancer occurs when malignant cells form in the tissues of the esophagus. The esophagus is a muscular tube that connects the mouth to the stomach. It’s about 10 to 13 inches long and carries liquids and foods to the stomach. The wall of the esophagus has several layers. Cancer starts from the inner layer and grows outward.

The main types of oesophageal cancer are:

  • Squamous cell carcinoma – grows in the cells that form the inside layer of the lining of the oesophagus (called the squamous cells); accounts for about half of all cancers of the oesophagus
  • Adenocarcinoma- usually starts near the opening to the stomach; cannot start unless squamous cells have been changed by acid reflux

The latest global statistics for cancer of the oesophagus are:

• 6th most common cancer in men
• 9th most common cancer in women
• 5th leading cause of cancer death in men
• 7th leading cause of cancer death in women
• The Caribbean is one of the 3rd world regions most affected by the disease

The exact cause of oesophageal cancer is unknown, however, there are certain risk factors associated with the disease. A risk factor increases a person’s chances of getting a disease, however having one or more risk factors does not mean someone will get a disease. Likewise, someone with no known risk factors can still get it. Biological risk factors for this cancer include age and sex. The risk goes up with age; it is rarely found in people under age 55. Men are 3 times more likely to get it than women. Lifestyle risk factors include: diet, being overweight and the use of tobacco and alcohol products. Stay tuned, next week more risk factors will be discussed.

For more information on gastrointestinal or any cancers speak with your doctor or contact the Cayman Islands Cancer Society at 949-7618 or email

Colorectal Cancer Awareness

By Victoria Anderson Grey
As Published in the Cayman Reporter on April 5, 2014

The Cayman Islands Cancer Society is observing April as Gastrointestinal Cancer Awareness Month.

Gastrointestinal cancer (cancer of the digestive system) includes cancers of the esophagus, gallbladder, liver, pancreas, stomach, small intestine, large intestine (colon) and rectum. These cancers do not discriminate between men or women; as either gender can be afflicted by the disease.

General symptoms of all gastrointestinal cancers may include:

  •  Abdominal pain
  • Appetite loss
  • Blood in the stool
  • Unexplained fatigue or weakness
  • Unexplained weight loss
  • Nausea
  • Vomiting

To start off our discussion we will talk about Colorectal Cancer. Colorectal is a term that refers to the colon and the rectum. The colon, which is also called the large intestine or large bowel, is about six feet long and is the part of the body’s digestive system that moves waste material from the small intestine to the rectum, the last six inches of the colon. Though we at times shy away from talking about these parts of the body and their general functions, we must be aware that a healthy colon and rectum is critical to our overall health.

Colorectal cancer is a general term for both colon cancer and rectal cancer. Colon cancer and cancer of the rectum (colorectal cancer) generally starts in the large intestine or the rectum. Cancer develops when the cells that line the colon and rectum begin to grow out of control. Nearly all colon cancers start out as a small polyp. Generally polyps are not cancerous but finding and removing them early may keep it from becoming malignant (cancerous) over a period of time. Colorectal cancer can take from 10 years to 15 years to develop to an advanced stage.

According to the American Cancer Society, colorectal cancer is the third most common cancers in both men and women and the fourth leading causes of cancer-related deaths worldwide. Colorectal cancer is highly preventable, treatable and often curable. That’s why it’s very important to make regular screening for colorectal cancer a part of your routine health checks. Screening tests are used to look for disease in people who do not have any symptoms. In many cases, these tests can find colorectal cancers at an early stage and greatly improve the chances of successful treatment.

Risk factors and signs and symptoms of colorectal cancer

No one knows exactly what causes colorectal cancer. But there are certain risk factors that can increase a person’s chances of getting and dying from this type of cancer. Having one or more risk factor doesn’t necessarily mean one will get the disease; likewise, someone with no risk factors could still get it.

Some risk factors for colorectal cancer cannot be controlled, such as:

• Age: particularly after 50.

• A personal history of polyps or colorectal cancer

• Having a history of inflammatory intestinal conditions: such as ulcerative colitis and Crohn’s disease

• Family history of polyps or colorectal cancer – especially if the relative (parent, sibling, child) developed colorectal cancer at a young age (under 55). In some cases, this connection may not be hereditary or genetic. Instead, cancers within the same family may result from shared exposure to an environmental carcinogen or from diet or lifestyle factors.

• Race or ethnic background: Some racial and ethnic groups such as African Americans and people of Ashkenazi (Eastern European Jewish) descent have a higher colorectal cancer risk.

However, some lifestyle habits that increase the risks may be managed, such as:

• Diets: A diet that is high in red meats (beef, pork, goat, lamb, or liver) and processed meats such as hot dogs, ham, salami, bologna, and lunch meat can increase risk. Cooking meats at very high heat (frying, broiling, or grilling) can create chemicals that might increase risk as well.

• Lack of exercise: Someone who is physically inactive is more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.

• Being overweight

• Smoking

• Alcohol: Heavy use of alcohol has been linked to colorectal cancer.

• Diabetes: People with type 2 diabetes have an increased chance of getting colorectal cancer. They also tend to have a worse outlook (prognosis).

Colorectal cancer can strike without any symptoms. When symptoms do occur; seen with more advanced stage of the disease, they usually consist of the following: dark stool, rectal bleeding or blood in the stool (often though the stool will look normal); change in bowel habits (such as diarrhea, constipation, narrow stool) that lasts for more than a few days; frequent abdominal discomfort such as cramps, gas, pain or feeling full or bloated; a feeling that your bowel doesn’t empty completely; unexplained weight loss; nausea or vomiting and body weakness or extreme fatigue.

Although most of these symptoms are more likely caused by something other than colorectal cancer, it is still important to see a doctor right away if any of these problems are present so the cause can be found and treated, if needed.

The Cayman Islands Cancer Society is dedicated to increasing the level of awareness of everyone on the various ways of preventing colorectal cancer through presentations. These are offered free of cost to companies and their employees, schools, clubs and church groups. To schedule a presentation call 949-7618 or email


Gastrointestinal Cancers Part 2

By Victoria Anderson Grey
As Published in the Cayman Reporter on April 17, 2014

As mentioned last week, certain lifestyle factors are associated with the development of oesophageal cancer. A diet high in fruits and vegetables is linked to a lower risk as they provide a number of vitamins and minerals that may help prevent cancer. Overeating, which leads to being overweight, raises the risk. A diet high in processed meats may increase the risk (this claim has not yet been proven). Drinking a lot of very hot liquids might also increase risk.

Using any form of tobacco increases risk. The longer the use, the greater the risk. More than half of all squamous cell esophageal cancer is linked to smoking. Similarly, the chance of getting esophageal cancer increases the more a person drinks. Combining smoking and drinking alcohol raises the risk much more than using either alone.

Medical risk factors for cancer of the oesophagus include:

Heartburn (stomach acid and juices escaping into the esophagus): Long-standing heartburn, also called reflux (or GERD: gastroesophageal reflux disease) increases risk.

Barrett esophagus: Results from GERD and over time can change the cells at the end of the esophagus. Raises the risk of adenocarcinoma of the esophagus.

Achalasia: The muscle at the bottom of the esophagus does not open to release food into the stomach, the lower end of the esophagus expands and food collects there instead of moving into the stomach. Over time, raises the risk for squamous cell cancer.

Tylosis: A rare, inherited disease that causes extra skin to grow on the palms of the hands and soles of the feet. People with tylosis are at a very high and should be seen by a doctor regularly to watch for this cancer.

Esophageal webs: A web is an abnormal bulge of tissue that causes the esophagus to become narrow and can lead to a feeling like food gets stuck when it is swallowed. About 1 in 10 people with this problem will get oesophageal cancer.

Stomach bacteria: A certain bacteria called H. pylori can cause many stomach problems, including ulcers and even some types of cancer. Infection with these bacteria can be treated with antibiotics plus a drug to stop stomach acid. People who have had treatment to rid the stomach of H. pylori get adenocarcinoma of the esophagus more often than expected.

Other cancers: People who have had other cancers such as lung, mouth, and throat have a high risk of getting oesophageal cancer. Perhaps because of smoking.

There are often no signs or symptoms in the early stages of cancer of the oesophagus. They often appear at an advanced stage, and include:

– Trouble swallowing (dysphagia)

– Pain – especially in the mid-chest

– Unintended weight loss

– Hoarseness

– Hiccups

– Pneumonia

– High calcium levels


Gastrointestinal cancers – Part 3

By Victoria Anderson Grey
As Published in the Cayman Reporter on April 26, 2014

We’ ll finish up our discussion on oesophageal cancer by discussing protective factors. The exact cause of oesophageal cancer is unknown; therefore, there is no sure way to prevent it. Certain factors may reduce risk, however. These are called protective factors, and they include:

Not smoking

Limiting alcohol consumption Risk can be greatly reduced by avoiding tobacco and too much alcohol

Diet: Eating fruits and vegetables, especially raw, may offer some protection

Maintaining a healthy weight

Aspirin and ibuprofen: Some studies have found that the risk can be lowered in people who take aspirin or other drugs, such as ibu¬profen, that reduce inflammation. HOWEVER using these drugs every day can lead to other problems, such as kidney damage and bleeding in the stomach. For this reason, drugs like aspirin are not widely used to prevent cancer. If you are thinking of using one of these regularly, you first should talk to your doctor about the pros and cons of taking these drugs.

Monitoring Barrett esophagus

Treating reflux Doctors recommend that people with Barrett esophagus have certain tests done. Treating reflux may be able to prevent Barrett esophagus and oesophageal cancer.

There is no recommended screening test for oesophageal cancer in most countries at this time. A series of imaging tests are done for diagnosis, including an endoscope. Treatment may include surgery, chemotherapy and radiation therapy.


The stomach is a sack-like organ which holds food and mixes it with gastric juice for digestion. Stomach cancer occurs when malignant cells form in the tissues of the stomach. It can start in any part of the stomach and then spread to other organs through the lymph system and the blood system or by breaking through the outer layer of the stomach’s lining.

stomach cancer is the 2nd leading cause of cancer death globally and the 4th most common cancer worldwide rates of this cancer are highest in Japan, South America and the former Soviet Union and lowest in North America

The cause of stomach cancer is also unknown. Risk factors for this type of cancer can be categorized as biological, medical or lifestyle. This week we will focus on the biological and lifestyle risk factors.

Biological risk factors associated with stomach cancer include:

Sex: in general, stomach cancer is more common in men

Age: sharp increase after age 50. Most people are in their late 60s or older when it is found

Ethnicity: in the US, it is more common in Hispanic Americans and African Americans than in non-Hispanic whites. Most common in Asian/Pacific Islanders.

Type A blood: for unknown reasons, people with type A blood have a higher risk

Lifestyle risk factors include:

Diet: an increased risk is seen with diets high in salted fish and meats, smoked foods and pickled vegetables.

Tobacco use: smoking about doubles risk

Obesity: a possible cause, but the link not yet clear

Gastrointestinal cancers – Part 4

By Victoria Anderson Grey
As Published in the Cayman Reporter on May 3, 2014

In addition to the factors discussed last week, there are also medical factors linked to the development stomach cancer. These include:

Bacteria infection: Helicobacter pylori (H pylori) infection seems to be a major cause. Long-term infection may lead to inflammation and pre-cancerous changes to the inner layer of the stomach. This germ is also linked to some types of lymphoma of the stomach.

Earlier stomach surgery: Having had part of the stomach removed to treat problems like ulcers.

Pernicious anemia: In this disease, the stomach doesn’t make enough of a protein that allows the body to absorb vitamin B12 from food, potentially leading to a shortage of red blood cells (anemia).

Menetrier disease: changes in the stomach lining (rare).

Family history: If close relatives have had stomach cancer, risk increases. Some families have a gene change (mutation) that puts them at a slightly higher risk.

Some types of stomach polyps: Polyps are small mushroom-like growths on the lining of the stomach. Most do not increase the risk of stomach cancer, but one type (called adenomatous polyps or adenomas) sometimes changes into stomach cancer.

Epstein-Barr virus: Causes “mono” (infectious mononucleosis) and has been found in some stomach cancers.

Symptoms and signs often don’t appear until the cancer is advanced. These include:

• Unintended weight loss

• No desire to eat

• Abdominal pain or discomfort

• A sense of fullness just below the chest bone – even after eating a small meal

• Heartburn or indigestion

• Nausea

• Vomiting – with or without blood

• Swelling or fluid build-up in the abdomen

There is no sure way to prevent stomach cancer, but you can reduce your risk by:

• Increasing the use of refrigeration or food storage (rather than salting, pickling and smoking foods)

• Following a diet high in fruits and vegetables

– Citrus fruits (such as oranges, lemons and grapefruits) may be extra helpful.

• Using vitamins and minerals: some studies have found that some (vitamins A, C, and E and the mineral selenium) may reduce the risk of stomach cancer in people with poor diets to begin with.

– However, most studies looking at people who eat healthy diets have not found any benefit. Further research in this area is needed.

• Maintaining a healthy weight

• Staying away from tobacco!

• Getting treated for chronic H pylori infection

• Aspirin: although using aspirin or other drugs like it may lower the risk of certain cancers, they can also cause serious internal bleeding and other problems in some people. Most doctors think that the lower cancer risk is an added benefit for patients who take these drugs for other problems (i.e. arthritis), but do not recommend taking them just to reduce the risk of cancer.

Routine screening for stomach cancer takes place only in some countries where stomach cancer is very common, such as Japan and some South American countries. A series of imaging tests are done to diagnose stomach cancer including an endoscope. Treatment may include surgery, chemotherapy and radiation therapy.

For more information on gastrointestinal or any cancers speak with your doctor or contact the Cayman Islands Cancer Society at 949-7618.

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