Opinion Article, J Clin Exp Oncol Vol: 13 Issue: 2

Assessing Gastrointestinal Cancer: Epidemiology, Pathophysiology, and Therapeutic Strategies

Robeen Maxier^*

¹Department of Tumor Biology, Herlev-Gentofte University Hospital, Copenhagen, Denmark

*Corresponding Author: Robeen Maxier,
Department of Tumor Biology, Herlev-Gentofte University Hospital, Copenhagen, Denmark
E-mail: robeen_maxier@huh33.de

Received date: 25 March, 2024, Manuscript No. JCEOG-24-136966;

Editor assigned date: 27 March, 2024, PreQC No. JCEOG-24-136966 (PQ);

Reviewed date: 10 April, 2024, QC No. JCEOG-24-136966;

Revised date: 17 April, 2024, Manuscript No. JCEOG-24-136966 (R);

Published date: 24 April, 2024, DOI: 10.4172/2324-9110.1000400

Citation: Maxier R (2024) Assessing Gastrointestinal Cancer: Epidemiology, Pathophysiology, and Therapeutic Strategies. J Clin Exp Oncol 13:2.

Description

Gastrointestinal (GI) cancers encompass a group of malignancies that affect the digestive system, including cancers of the oesophagus, stomach, liver, pancreas, small intestine, colon, rectum, and anus. These cancers present significant health challenges globally due to their high incidence and mortality rates. It delves into the epidemiology, pathophysiology, and therapeutic strategies for gastrointestinal cancer, providing a comprehensive overview of this important health issue. Gastrointestinal cancers are among the most common types of cancer worldwide. According to the World Health Organization (WHO), colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer-related deaths globally. Stomach cancer ranks fifth in incidence and third in mortality, while liver cancer is the sixth most common and fourth leading cause of cancer deaths.

Pancreatic cancer, although less common, has a notably high mortality rate, often being diagnosed at an advanced stage. Several risk factors contribute to the development of GI cancers. High intake of red and processed meats, low fiber consumption, and a diet high in salt and smoked foods have been linked to increased risks of colorectal and stomach cancers. Smoking, excessive alcohol consumption, obesity, and physical inactivity are significant risk factors. Chronic infections with Helicobacter pylori are associated with stomach cancer, while hepatitis B and C viruses are linked to liver cancer. Familial Adenomatous Polyposis (FAP) and Lynch syndrome are hereditary conditions that significantly increase the risk of colorectal cancer. Exposure to aflatoxins, especially in certain regions, increases liver cancer risk. The pathophysiology of gastrointestinal cancers involves complex interactions between genetic, environmental, and lifestyle factors.

Mutations in oncogenes tumor suppressor genes and DNA mismatch repair genes play a key role in the initiation and progression of GI cancers. Chronic inflammation, such as that seen in Inflammatory Bowel Disease (IBD), can lead to DNA damage and cancer development. Cytokines and growth factors released during inflammation can promote cell proliferation and survival. Alterations in DNA methylation and histone modification can lead to the silencing of tumor suppressor genes and activation of oncogenes. The interaction between cancer cells and the surrounding stroma, including immune cells, fibroblasts, and blood vessels, influences tumor growth and metastasis. The tumor microenvironment can develop a supportive niche for cancer cells through angiogenesis, immune evasion, and extracellular matrix remodeling. Gastrointestinal cancers typically progress through a series of stages, starting with benign precancerous lesions that gradually evolve into malignant tumors.

For example, colorectal cancer often begins as a polyp, which can develop into an adenoma and eventually an invasive carcinoma. Understanding the progression of these cancers is vital for developing effective screening and early detection strategies. Surgery remains an essential component in the treatment of localized GI cancers. Depending on the cancer type and stage, different surgical procedures are employed. Removal of the tumor and surrounding tissue, commonly used in colorectal and stomach cancers. Considered for selected patients with early-stage liver cancer. A complex surgery for pancreatic cancer that involves removing parts of the pancreas, small intestine, and other nearby tissues. Radiation therapy uses high-energy radiation to kill cancer cells. It is often used in combination with surgery or chemotherapy to improve outcomes. For rectal cancer, neoadjuvant radiation (before surgery) can shrink tumors, making them easier to remove and reducing the risk of recurrence.

Chemotherapy involves the use of drugs to kill rapidly dividing cancer cells. Neoadjuvant therapy is used to shrink tumors before surgery. Targeted therapy uses drugs that specifically target molecular pathways essential for cancer cell survival and growth. Examples include EGFR inhibitors such as cetuximab for colorectal cancer. VEGF inhibitors like bevacizumab to inhibit angiogenesis in colorectal cancer. HER2 inhibitors like Trastuzumab for HER2- positive stomach cancer. Immunotherapy leverages the body's immune system to fight cancer. Checkpoint inhibitors, such as pembrolizumab and nivolumab, have shown potential in treating certain GI cancers, particularly those with High Microsatellite Instability (MSI-H) or Mismatch Repair Deficiency (MMR).

Conclusion

Gastrointestinal cancers represent a significant global health burden, characterized by diverse risk factors, complex molecular mechanisms, and varied clinical manifestations. Advances in understanding the epidemiology and pathophysiology of these cancers have led to improved diagnostic and therapeutic strategies. While traditional treatments like surgery, radiation, and chemotherapy remain essential, emerging therapies provide hope for more effective and personalized approaches. Ongoing studies and clinical trials continue to push the boundaries of cancer treatment, aiming to improve survival rates and quality of life for patients with gastrointestinal cancers.