Gastro intestinal Cancer
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Gastro-intestinal cancer
GI cancers in India are increasing due to dietary changes, infections, and genetic predisposition.
Stomach (Gastric) Cancer
Site:
- Most common: Distal stomach (antrum, pylorus)
- Also cardia and body
Risk Factors:
- H. pylori infection, dietary nitrites
- Smoking, family history
- Chronic gastritis, gastric polyps
- EBV (in some cases)
Treatment:
- Surgery: Total or subtotal gastrectomy
- Perioperative chemotherapy (e.g., FLOT regimen)
- Adjuvant chemoradiation (for selected high-risk cases)
RT Role:
- Adjuvant chemoradiation after suboptimal resection (e.g., INT-0116 trial)
- Dose: 45 Gy in 25 fractions + 5-FU based chemo
Colon Cancer
Site:
- Ascending, transverse, descending, and sigmoid colon
Risk Factors:
- Low fiber/high fat diet
- Family history, Lynch syndrome, FAP
- IBD (especially ulcerative colitis)
- Smoking, obesity
Treatment:
- Surgery is the mainstay
- Adjuvant chemotherapy for stage III/selected stage II
- Radiation is not routinely used
RT Role:
- Limited role; only in locally advanced unresectable tumors or palliation