QBA Meditours

Digestive (Gastrointestinal) System Cancers

Digestive system (also known as Gastrointestinal system or GI) is a tubular tract from the mouth to the anus. Its major function is to consume and digest the food, to provide energy from these and to get rid of wastes. The system contains esophagus, stomach, bowels, pancreas, gall bladder and liver. The gastrointestinal system cancers, the most common cancer type, express the canceous tumor development in any organ in the gastro-intestinal system.

Treatment

In the cancer treatment applied in Cuba, standard cancer treatment methods containing operation, radiation and chemotherapy are applied together with the immunotherapy. Treatment program depends on the cancer type, the stage of the cancer and general health condition of the patient.

Standard procedure is as follows


  • Initial assessment and preparation.
  • Pre-application health screening.
  • Cyclophosphamide 200mg
  • Nimotuzumab (CIMAher EGF); 24 double vials for 6 weeks of therapy.
  • Initial phase lasts for six weeks in such a way which will correspond to 24 double vials Cyclophosphamide and saline solution (4 vials x 6 vaccination administrations).
  • The first dose will be administered in the healthcare centers located in Cuba. The subsequent doses may be continued in Cuba or the country of the patient.

Colon Healthcare Programs


Colon is the largest part of the large intestine and constitutes the last part of the digestive system along with the rectum and anal channel. Its main responsibility is to send the undigested food residuals to the rectum fo storage together with the bacteria and digestive system fluids while sending the fluids and other foods back to the body by re-absorbing, then, these residuals are sent to the anal canal and discharged from the body.

Colon cancer is a term which is used for the cancers starting in the colon or rectum since they have generally more common points.


A list of the offered programs is given below

Hepatectomy: It is the removal of tumors in the liver. A section containing only tumor or larger part of the liver may be removed or the whole lobe may be removed by leaving an adequate liver tissue for the liver to maintain its function and thus, to regenerate. This operation depends on whether the cancer spreads to the next lymph nodes or not, the liver functions properly or not and size, number and location of the cancer.

Combined laparoscopic abdomino perineal resection for preservation of lower rectal tumors and anal sphincter in the anal canal: In abdominal perinal resection, anus, rectum and sigmoid colon are removed for the purpose of treating the cancer in the region nearby the sphincter muscle (muscle peripheral the anus controlling the intestinal motilities) in rectum or anus. Then, a section of the colon is bound to the surface of the abdomene by passing through the space called stoma for the wastes and gas to be discharged from the body with the colostomy process performed. In the laparoscopy process, a small incision where laparoscope will be placed (an optical instruement) is opened in the abdomen for providing the surgeon better view.

Abdominoperineal resection in the lower rectal tumors and anal canal by preserving anal sphincter: This procedure is the same as the above-mentioned process, but unlike the foregoing, sphincter muscle is preserved for avoiding from colostomy. The non-cancerous end of the sigmoid colon is bound to the anal sphincter for maintaining the normal intestinal operation. This procedure depends on the size, location of the tumor, how far it is located from the anus and how well the sphincter functions.

Abdominoperineal resection in lower rectal tumors and anal canal: A standard operation containing the removal of anus, rectum and sigmoid colon for treating the cancer nearby the sphincter muscle in the rectum or anus. It is performed by opening an incision both in abdomen and perineal field (space between the anus and vulva in women, but in men, space between the anus and scrotum). A permanent colostomy is performed for the waste and gas discharge from the body.

Partial colectomy: Surgical removal of the cancerous fragment of the colon or rectum and small fragments nearby the healthy tissue. Residuals from the healthy parts of the colon and rectum is combined.

Pre-proctosigmoidectomy: This operation is generally performed due to rectal cancer and it contains the removal of the rectum whooly or partially and a part of the sigmoid colon. Anus is not affected and thus, waste and gas activities are not damaged.

Protective resection belonging to central and lower rectal cancer: It is the least agressive operation for the rectal cancer and most of tissues are preserved.

Gastrectomy (Gastric) Healthcare Programs

  • Partial gastrectomy: Removal of any part of stomach and if necessary, parts of esophagus or a part of the small intestine. Though not always, lower section of the stomach is usually removed.
  • Partial gastrectomy with lymphadenectomy: In additional to the removal of the stomach partially, nearby lymph nodes containing cancerous cell belongin to the original tumor are also removed.
  • Total gastrectomy with lymphadenectomy: In case of cancer in the upper or central parts of the stomach or it spreads to the whole stomach, this procedure is generally used. It includes the removal of the complete stomach and nearby lymph nodes and the removal of esophagus, intestines and other nearby organs depending on the extent how much cancer spreads. Then, the esophagus is directly bound to the small intestines.

Gastric cancer starts in the inner layer of the stomach where cancerous cells grow and form tumor. The stomach in the left upper part of the abdomen is an integral part of the digestive system and is responsible for the digestion of the foods. 95% of the gastric cancers starts in the gland tissue of the inner layer of the stomach (gland tissue is responsible for generating of digestive liquids such as acid and enzymes). The cancer may spread throughtout the gastric wall or may spread to the other organs in the body by reaching to blood flow or lymph system. The gastric cancer generally affects the elderly people and is more prevalent in males.

Hepatectomy (Liver) Healthcare Programs


The liver which is in the right section of the abdomen, under the diaphragm is the biggest gland and the second largest organ in the body following the skin. It is responsible for over 300 functions having vital importance; some of which are production of many basic proteins, regulation of many hormones, regulation of cholesterol, conversion of fat into energy, gall production, assisting to blood coagulation and decomposition of hazardous substances. Even if 75% of which was unhealthy or removed, it is the only organ in the body which regenerate.

The liver cancer whose most examples are seen in Africa and East Asia, is the sixth prevalent cancer type in the world. Primary cancerous cells in the liver develop in blood veins, ligament and tissue belonging to the bile ducts. Many liver cancers are not primary, they are metastasis cancer spreading from generally colon, stomach, pancreas, rectum, kidney, lung and breasts. Since cancerous cells are treated by the original cancerous cells, it is very important to locate the origin of the primary cancer. For example, for the liver cancer originating from the breast, breast cancer treatment should be applied.

The following treatment program is offered


Hepatectomy: It is the removal of tumors in the liver. A section containing only tumor or larger part of the liver may be removed or the whole lobe may be removed by leaving an adequate liver tissue for the liver to maintain its function and thus, to regenerate. This operation depends on whether the cancer spreads to the next lymph nodes or not, the liver functions properly or not and size, number and location of the cancer.

Pancreas Cancer

Pancreas is in the deep sections of the abdomen and constitutes an integral part of both digestive and endocrine system. 90% of the pancreas is responsible for the production of enzymes assisting the digestion of fat, cholesterol and proteins, the remaining 10% is responsible for the production of hormones regulating the glucose metabolism such as insulin and glucagon. Since pancreas cancer is located in the deep sections of the body, generally it is a difficult disease to detect and it shows very few indications until it develops well. There are two types of pancreas cancer: first and the most prevalent of which is exocrine pancreas (part of the pancreas producing enzyme) cancer, the second is endocrine pancreas (part of the pancreas producing hormone) cancer.

The following treatment programs are offered:

  • Pancreatic duodenectomy: It is also known as whipple method and it is the most common operation applied for pancreas cancer. In this method, tumors in the head of the pancreas are removed (the widest section where there are maximum tumor). Since pancreas is in interaction with the other organs, duodenum (first section of small intestine), bile duct and sometimes a part of the stomach are removed and then, it is rebound to the digestive and bile system.
  • Distal Pancreatectomy: If tumors were within the body and tile (the narrowest section) parts of the pancreas, these sections would be removed by operation. This method contains the removal of spleen.
  • Total Pancreatectomy: It is performed when cancer is in the advanced stage or spreads to the most parts of the pancreas. It contains the removal of the whole pancreas, a part of small intestine, a part of the stomach, general bile duct, gall bladder, spleen and nearby lymph nodes. In case of obstructive jaundice (inhibition of bile flow from the liver to the duodenum and it is also known as mechanical jaundice), this method is not applied.