Cancer FAQ

Gastro-Intestinal cancer is a broad term used to encompass all cancers of the Gastro-Intestinal tract (digestive system). This includes cancers of the oesophagus, stomach, liver, gallbladder, pancreas, bowel, rectal and anal. Following is a brief overview of each cancer:

Oesophageal cancer is a form of cancer that develops in the swallowing tube that passes from the mouth/throat to the stomach. Some risk factors for cancer of the oesophagus are long-term exposure to smoking, heavy alcohol intake and Barrett’s oesophagitis.

Gallbladder cancer affects the digestive organ that stores bile (produced in the liver). The gallbladder digests and absorbs fats in the intestines. One risk factor for cancer of the gallbladder is gallstones.

Pancreatic cancer is a malignant tumour that develops in the small glandular organ, approximately six inches long, located in the upper abdomen. The pancreas is connected to the small intestine and secretes enzymes and hormones such as insulin and glucagon. It’s often called a “silent disease” because during the early stages of the disease there are very few, if any symptoms.

Stomach cancer is commonly referred to as gastric cancer and can develop in any part of this organ. The symptoms of stomach cancer are not well defined – however, loss of appetite and weight loss are sometimes indicators. Stomach ulcers are not necessarily risk factors for the development of stomach cancer.

Liver cancers generally originate from other areas, such as the colon, breast or lung, and then spread to the liver. The liver is the largest glandular organ of the body and performs an important range of functions in the digestive system including detoxification and the storage of vitamins and minerals. Cancers originating in the liver do exist, and are more common in people of Asiatic origin.

Small intestine cancer affects the hose-like portions of the digestive system that winds back and forth within the abdominal cavity (approximately 6.7 meters). The small intestine’s primary function is to absorb nutrients.

Bowel (colorectal) cancer:

Colon (large intestine) cancer is a malignant tumour that develops from within the inner wall of the large intestine. The colon is the lower part of the hose-like portion of the digestive system, extending from the lower end of the stomach to the rectum. Risk factor for cancer of the colon include heredity, colon polyps, and long standing ulcerative colitis.

Rectal cancer develops as a malignant tumour arising from the inner wall of the end (rectum) of the large intestine. This type of cancer is commonly known as rectal or colo-rectal cancer.

Surgery to remove the primary tumour and surrounding tissue is necessary in the treatment of most tumours. The aim of surgery is to remove as much of the tumour as possible. Any remaining cells can be treated using radiation and/or chemotherapy. How much surgery is done depends on how far the cancer has spread and on the patient’s general health.

Radiation therapy is treatment with high level radiation to eliminate any remaining cancer cells. The radiation may come from outside the body (external radiation) or from radioactive materials placed directly in or near the tumour (internal radiation or brachytherapy).

Both tumour cells and healthy cells may be affected by radiation. The radiation injures the cancer cells so they can no longer continue to divide or multiply. With each treatment, more of the cells die and the tumour shrinks. The dead cells are broken down, carried away by the blood and excreted by the body. Most of the healthy cells are able to recover from this injury.

The dose of radiation is determined by the size, extent, type and grade of tumour along with its response to radiation therapy. Often, the treatment is given over several different angles in order to deliver the maximum amount of radiation to the tumour and the minimum amount to normal tissues.

Chemotherapy refers to the use of chemicals (natural or synthetic) to destroy infective organisms or cancer cells. Chemotherapy with cytotoxic drugs is the main method of treatment for only a few cancers but it is increasingly used as an adjunct to surgery or radiation.

Cancer care often involves a collaboration of specialists – including medical oncologists (specialising in cancer treatment), surgical oncologists (surgeons specialising in surgically removing cancers), and radiation oncologists (specialising in radiation therapy).

Whilst the objective of cancer treatment is to work against cancer, often treatment will also damage healthy cells and tissues, the outcome of which can sometimes result in unpleasant side-effects.Most side-effects of cancer treatment vary depending on the type of treatment and the extent of the cancer. However, it is important to remember that not everyone experiences the same side-effects; nor are they necessarily severe.

Surgery side-effects in general depend on the part of the body being treated, the type of surgical procedure, the patient’s general health, and a range of other factors. Just like any operation, patients will be uncomfortable during the first few days after surgery. In most cases post-surgical pain can be controlled with medicine.

Radiation therapy side-effects are determined by the actual dose of radiation and where the tumour is located. Tiredness, skin reactions, loss of appetite, and a decrease in the number of white blood cells are typical side-effects of radiation. Most of these side-effects will only last for a short period of time and can be treated.

Chemotherapy side-effects are dependent upon the type of medication and the dose administered. Chemotherapy affects blood cells, which may in turn, result in side-effects. Blood cells play an important role in fighting infection, helping the blood to clot, and carrying oxygen to different parts of the body. Without a constant and healthy supply of blood cells patients are more likely to develop infections, to bruise or bleed easily, and will often have less energy. Other side-effects of chemotherapy include a loss of appetite, nausea and vomiting, hair loss, mouth sores and sometimes impacts on fertility. In most cases medicine can help with side-effects and the majority of symptoms will cease once the treatment is discontinued.

Since September 2012, our Engage network of cancer survivors, patients and their family and friends have been sharing stories about cancer journeys and clinical trials information.There are many support groups, networks and information services within Australia. These groups provide various care options including home care, community-based programs and assisted living facilities. Below are some examples of potentially useful web sites. See more here.

The Cancer Council Australia
Cancer Voices Australia
Country Cancer Support
Bowel Cancer Australia
ACT Cancer Council
NSW Cancer Council
VIC Cancer Council
SA Cancer Council
WA Cancer Council
TAS Cancer Council
NT Cancer Council
QLD Cancer Council

If after talking to your doctor you decide to participate in a clinical trial then the next step would be to provide your informed consent. Informed consent involves more than signing a form and will continue throughout the clinical trial. Informed consent is a process in which you learn the key facts about a clinical trial before you decide whether or not to participate. You’ll learn new facts during the clinical trial to help you decide whether or not to continue to participate. Feel free to ask questions to the Research Staff at any time before, during, or after the clinical trial.

It’s important that you understand the clinical trial as fully as you can, including how the treatments and tests in the study are different from tests and treatments outside of the clinical trial. The Research Staff should explain the possible risks and benefits of participating in the study and how it will be determined which ‘treatment group’ you’ll be in.

The information about the clinical trial should be given to you verbally (explained aloud) and in writing. You should be given enough opportunities to ask questions and seek advice from people you trust. You are the person who must decide what is enough time to ask questions and get advice from people you trust.

You have the right to ask for this information to be provided to you in a language other than English, if this will help you understand it completely.

There’s also a consent form which will look something like this.

Clinical trials are classified into one of three phases, each phase representing a different step in the testing of a new clinical treatment. Each step allows researchers to ask and answer important questions about the type of treatment and its effectiveness for patients.

Phase I trials determine the most appropriate way to give a new treatment. For example, should it be given by mouth, injected into the blood or injected into the muscle? These studies also evaluate what dose is safe and how often it should be used. A Phase I trial focuses on the safety of a treatment and generally involves only a small number of patients.

A Phase II trial determines how well a new treatment works. These trials test the safety of the treatment at a more advanced level than Phase I trials and evaluate the anti-cancer effect of the treatment.

Phase III trials are studies that compare a new treatment with current standard treatments. For example, a Phase III trial would evaluate whether a new drug is better than a drug that is currently being used to treat patients with the same condition. Similarly, a new surgical procedure may be investigated to determine whether it’s better than a surgical procedure that is the general standard of treatment. Phase III trials are only ever initiated if the results of Phase I and II trials show that the new treatment is safe and effective and likely to be as good as, or better than, the standard treatment. Phase III trials involve hundreds of patients, often from around the world.

Randomised control trials are where the treatment that a participant receives is chosen by random allocation (i.e. the decision about which treatment to give which patient is randomly selected, usually by computer). When a patient is ‘randomised’ it means that they have been randomly selected to receive either a particular treatment or intervention (i.e. a new drug) or placebo – a pill that contains no active ingredient.