DONATEGI ONCOSURGERY AND LIVER TRANSPLANTATION
Overview
Rajiv Gandhi Cancer Institute and Research Centre is the first institute in Delhi NCR to have a specialized unit of gastrointestinal surgeons with special interest in GI cancers for the management of these cancers. Multidisciplinary team involved in the management of GI and HPB (hepatopancreatobiliary) cancers consists of gastrointestinal surgeon, medical oncologist, radiation oncologist, intervention radiologist, gastroenterologist, hepatologist, nuclear medicine experts, GI pathologist and a stoma therapist. All complex cases are discussed in multi-disciplinary GI and HPB tumor board which is conducted weekly.
For the last one decade this multi-disciplinary team has been providing state of art evidence-based cancer care, at par with international standards, for GI and HPB malignancies. As a result, RGCIRC is one of the highest volume centers for GI and HPB cancer surgeries in India. The department has also pioneered in starting minimally invasive surgery for GI malignancies especially laparoscopic/robotic resection of colorectal cancers and robotic esophagectomies .
What is GI Cancer
Gastrointestinal Oncosurgery is a subspecialty, which deals with the surgical management of cancer of esophagus, stomach, small bowel, colon, rectum, anal canal, gall bladder & biliary tract, pancreas and liver.
GI Cancer includes:
Liver Cancer
Gall Bladder Cancer
Pancreatic Cancer
Colorectal Cancer
Signs and Symptoms of GI Cancer
Symptoms depend on the site and stage of cancer
- Fullness of stomach
- Nausea and vomiting
- Altered bowel habits
- Abdominal pain
- Dysphagia
- Increasing constipation
- Distension of abdomen
- Loss of weight and loss of appetite
- Bleeding per rectum or black colored stool
- Lump abdomen
- Progressive anemia
Screening and Diagnosis of GI Cancer
History and clinical examination are stepping stones for any diagnosis. Family history of cancer is also important. Clinical Examination should also include nutritional assessment and evaluation of other systems. Investigations include following
- Ultrasound of abdomen
- CBC, Biochemical profile
- CT Scan of abdomen,pelvis and chest.
- PET Scan in selected cases
- Endoscopies—Upper GI Endoscopy, Colonoscopy, EUS depending on the area of interest
- Tumor Markers—CEA
- Endoscopic biopsy and special tests like MMR, MSI, PDL-1 in selected cases.
Treatment of GI Cancer
Focus is multimodal treatment. All cases are discussed in Multidisciplinary clinic.
Surgery for esophagus and GE junction cancers
Surgery for Gastric cancers
Surgery for pancreatic cancers
Multivisceral resection for retroperitoneal tumors
Very early cases may not need major surgeries. Only endoscopic mucosal resection for early stomach cancer and polypectomy for colonic polyp may be sufficient
Surgery for small bowel tumors
CRS & HIPEC for appendiceal, peritoneal, colorectal and gastric cancers with peritoneal metastases.
Surgery for gall bladder cancer
Surgery for liver cancers
Surgery for colorectal cancers
How is RGCI Different
Our GI Surgeons are dedicated to oncology services only. GI Oncosurgeons are expert in all types of laparoscopic, robotic surgeries. Surgical results are at par with international standards. All cases are discussed in tumor board with focus on multimodality treatment. Infrastructure for providing whole spectrum of GI cancer care(Non Invasive To Invasive Methods Including Liver Transplant) is available at RGCIRC
Teaching And Training
The department has been actively involved in teaching and training of DNB trainees as a part of the DNB surgical Oncology course of the institute. The GI and HPB Oncosurgery department also offers, Indian Medical Association accredited one year fellowship in GI and HPB Oncosurgery and have trained many national and international surgeons in the field of GI and HPB Oncosurgery. Our faculty has been participating in various capacities at national and international medical conferences.
Research And Publications
The department is also actively involved in research on various aspects of GI and HPB malignancies ranging from basic science to clinical studies. We have been part of many multicentric national and international trials The department is credited with a large number of national and international publications in reputed medical journals.
Risk Factors of GI Cancer
Hereditary
Smoking, alcohol
H.Pylori bacterial infection for stomach cancer
Reflux oesophagitis
Polyps in stomach and colon
Diet-high fat,low fiber diet
Obesity
Sedentary lifestyles
Viral infections HPV for anal cancers/ HCV for liver cancers
Persistent gall stones
Parasitic infections of biliary passage
Prevention & Cure of GI Cancer
Depending on your personal risk factors and family history, GIcancer risk assessment should be done. Consult a genetic counsellor.
Change your lifestyles
Abstain from tobacco and alcohol
Treat H.Pylori infection and other viral infections
Surgery for gall stones as advised by your surgeon
High fiber diet
Regular screening especially in genetically predisposed cases
DO’s after Surgery
- Follow doctor’s instructions
- Rest and sleep
- Take care of your diet
- Keep your incision site clean
- Stay hydrated
- Report immediately if bleeding or soakage of wound, or fever
DON'Ts after Surgery
- Lift heavy objects
- Smoke and take alcohol
- Skip your medications
- Drive too soon
- Over exert yourself
- Prolonged fasting
