Digestive Tract Cancers Medical Program
Digestive (Gastrointestinal) Tract Cancers
The Digestive Tract Cancers Medical Program, also known as the gastrointestinal tract or GI, is a tubular passage extending from the mouth to the anus. Its main function is to consume and digest food, extract nutrition and energy from it and then eliminate waste. The tract includes the esophagus, stomach, the intestines, pancreas, gallbladder and the liver. Cancer in the gastrointestinal tract, which is the most common type of cancer, refers to the development of cancerous tumours in any organ in the digestive tract.
Cancer treatment in Cuba follows the traditional treatment for cancer by using surgery, radiation, and chemotherapy in combination with immunotherapy. Treatments are dependent on the type and stage of cancer as well as patient’s overall health.
The standard procedure is as follows:
Initial evaluation and preparation.
Pre-application medical checkup.
Cyclophosphamide 200 mg
Nimotuzumab (CIMAher EGF) 24 pairs of vials for 6 weeks treatment.
The induction phase lasts six weeks corresponding to the application of 24 pairs of vials (4 vials x 6 vaccine applications), Cyclophosphamide and saline solutions.
The first dose will be given in Cuban health centers. Follow-up doses can be continued the in Cuba or in the home country.
Colon Medical Programs:
The colon is the largest part of the large intestine (large bowel) and together with the rectum as well as the anal canal make up the last part of the digestive system. Its main responsibility is to reabsorb fluids and other nutrients and send it back into the body while sending the remainder of undigested food with bacteria and juices from the digestive system to be stored in the rectum which is later sent to the anal canal and released out of the body.
Colorectal cancer is a term often used for cancers that begins in the colon or the rectum due to the fact that they have much in common.
The following is a list of programs offered:
Combined laparoscopic abdominoperineal resection for low rectal tumors of the anal canal and anal sphincter preservation: abdominoperineal resection involves the removal of the anus, rectum and sigmoid colon in order to treat cancer low in the rectum or in the anus close to the sphincter muscle (the muscle surrounding the anus that controls bowel movement). A colostomy is then performed whereby a section of the colon is connected to the surface of the abdomen through an opening called the stoma so that waste and gas can pass out of the body. A laparoscopy, a surgical procedure in which a small incision is made in the abdomen to allow a laparoscope (an optic instrument) to be inserted, is performed in order to give the surgeon better exposure.
Abdominoperineal resections in lower rectal tumors and anal channel with anal sphincter preservation: this procedure is similar to the one described above with the difference of the preservation of the sphincter muscle in order to avoid a colostomy. Cancer free end of the sigmoid colon is attached to the anal sphincter for the continuation of normal bowel function. This procedure is dependent on the size of the tumour, its location, how far away it is from the anus and how well the sphincter is functioning.
Abdominoperineal resection in low rectal tumors and anal channel: the standard operation for the removal of the anus, rectum and sigmoid colon in order to treat cancer low in the rectum or in the anus close to the sphincter muscle. It is done by making an incision in both the abdomen and the perineal area (the area between the anus and vulva in women and the between the anus and scrotum in men). A permanent colostomy is then performed in order for waste and gas to be released out of the body.
Partial colectomy: is the surgical removal of the cancerous part of the colon or rectum as well as small parts of the nearby healthy tissue. The remaining healthy parts of the colon and rectum are joined together.
Anterior Proctosigmoidectomy: this is usually performed due to rectal cancer and involves the removal of a part or all of the rectum with part of the sigmoid colon. The anus is not affected and hence waste and gas movement remains unimpaired.
Conservative Resection of middle and lower rectal cancer: This is the least aggressive surgery for rectal cancer and the most tissue-conserving.
Gastrectomies (Stomach) Medical Programs:
Gastric cancer, commonly known as stomach cancer, begins in the inner lining of the stomach as cancer cells form and grow into tumors. The stomach, located on the left side of the upper part of the abdomen, is part of the digestive system and is responsible for the breakdown of food. About 95% of stomach cancer begin the glandular tissue that lines the stomach (glandular tissue is responsible for the production of digestive juices such as acid and enzymes). Cancer may spread across the stomach wall or may expand to the bloodstream or lymphatic system spreading to other organs in the body. Stomach cancer usually affects the elderly and is more common in men.
The following is a list of treatment programs offered:
Partial gastrectomy: the removal of only a part of the stomach and if necessary parts of the esophagus or part of the small intestine. Most often but not alway the lower part of the stomach is removed.
Partial Gastrectomy with lymphadenectomy: In addition to the removal of a part of the stomach nearby lymph nodes containing cancer cells from the original tumour are also removed in order to reduce the risk of cancer recurring.
Total Gastrectomy with lymphadenectomy: this procedure is usually put in practice if the cancer is in the upper or middle parts of the stomach or has spread throughout the stomach. It involves the removal of the whole stomach as well as nearby lymph nodes and depending on how far cancer has spread, the removal of parts of the esophagus, intestines and other nearby organs. The esophagus is then attached directly to the small intestines.
Hepatectomy (Liver) Medical Programs:
The liver, located under the diaphragm on the right side of the abdomen, is the largest gland and second largest organ in the body after skin. It is responsible for over 300 different functions vital to life some of which include the production of many essential proteins, regulation of a number of hormones, regulation of cholesterol, conversion of fat to energy, production of bile, helping blood clot and the breakdown of harmful substance. It is the only organ in the body that can regenerate even if 75% of it is diseased or removed.
Liver cancer is the sixth most common kind of cancer globally being most prominent within Africa and East Asia. Primary cancer of the liver develops in the tissues of the cells, blood vessels, connective tissue and bile ducts. Most cancer of the liver is not primary but is metastasized cancer usually spreading from the colon, stomach, pancreas, rectum, kidney, lungs and breasts. It is very crucial to determine the origins of primary cancer since cancer cells are treated in accordance with the original cancer cells. Cancer of the liver that originated in the breast, for example, must follow the treatment given for breast cancer.
The following treatment is offered:
Hepatectomy: The removal of tumours from the liver. This is done by the removal of only the part in which the tumour is in, a larger portion of the liver or an entire lobe leaving behind an enough portion of liver tissue in order for the liver to continue in its functions and so that it regenerates. This surgery is dependent on whether cancer has spread to nearby lymph nodes and whether the liver is in good working order as well as on the size, number, and location of cancer.
The pancreas is located deep in the abdomen and is part both the digestive system and the endocrine system. 90% of the pancreas is responsible for the production of enzymes that aid in digesting fat, cholesterol, and proteins the remaining 10% is responsible for the production of hormones, such as insulin and glucagon, that regulate glucose metabolism. Pancreatic cancer is often hard to detect due to its deep location within the body and because it gives off little symptoms until the cancer is well developed. There are two types of pancreatic cancers the first and most common is cancer of the exocrine pancreas (the part of the pancreas that makes the enzymes); the second is cancer of the endocrine pancreas (the part of the pancreas that makes the hormones).
The following treatment programs are offered:
- Pancreatoduodenectomy: also known as the Whipple procedure and is the most commonly performed surgery for pancreatic cancer. This procedure is the removal of tumours found in the head of the pancreas (the widest part and where most tumours are found). Due to the fact that the pancreas is intermingled with other organs, the duodenum (the first part of the small intestine), bile duct and at times part of the stomach are also removed and then are reconnected to the digestive and biliary system.
Distal pancreatoduodenectomy: the body and tail of the pancreas (the narrowest part) are surgically removed when tumours are located in one of these two areas. This procedure also includes the removal of the spleen.
Total pancreatoduodenectomy: performed if the cancer is in an advanced stage and has spread to many parts or the whole of the pancreas. It entails the removal of the entire pancreas, part of the small intestine, a portion of the stomach, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes. Please note that this procedure is inoperable with obstructive jaundice (a blockage of the flow of bile from the liver to the duodenum also known as mechanical jaundice).