Types of Gastrointestinal Cancer

Advanced Abdominal
Bile Duct
Esophagus
Liver

Neuroendocrine and Carcinoid Tumors
Pancreas
Small Intestine

Stomach

Advanced Abdominal 

Abdominal cancer refers to a variety of cancers affecting digestive system organs, including the stomach, liver, large and small intestines, pancreas, gallbladder and esophagus. Advanced stomach cancer means that a cancer that began in the stomach has spread to at least one other part of the body, such as the liver or lungs. The goals of treatment are to control it, help symptoms and improve quality of life. Sometimes cancer is advanced when it is first diagnosed or has come back and spread after treatment for the original cancer.

ASK THE EXPERT: FAQs About Treating Advanced Abdominal Cancer with Cytoreductive Surgery and HIPEC 
By George Georgakis, MD, PhD

Bile Duct

Bile duct cancer (also called cholangiocarcinoma) is a rare, but aggressive disease that begins in the bile ducts. These are thin tubes that carry bile, a digestive fluid, between the liver, bile ducts and small intestine. Cancer can start in any part of the bile duct system. 

It’s grouped into three types: intrahepatic, perihilar (also called hilar) and distal.

  • Intrahepatic starts in the smaller bile duct branches inside the liver.
  • Perihilar cancers start at the hilum, where the left and right hepatic ducts have joined and are just leaving the liver.
  • Distal cancers are found farther down the bile duct, closer to the small intestine. 

Perihilar and distal cancers are extrahepatic bile duct cancers because they start outside of the liver. Symptoms include jaundice, intensely itchy skin and white stool. 

Esophagus

Esophageal cancer forms inside the esophagus, a hollow, muscular tube about 10 inches long that carries food and drink from your mouth to the stomach. The cancer starts in the inner layer wall and grows outward through the other layers. Tumors can eventually metastasize (spread) to the lymph nodes and other organs. 

  • Squamous cell carcinoma. The cancer starts in the inner layer of the esophagus (the mucosa), which is normally lined with squamous cells. It is most common in the neck region (cervical esophagus) and in the upper two-thirds of the chest cavity (upper and middle thoracic esophagus). 

  • Adenocarcinomas. Cancer that starts in gland cells (cells that make mucus) that are often found in the lower third of the esophagus (lower thoracic esophagus).

Symptoms include difficulty swallowing, chest pain, weight loss and lack of appetite, hoarseness, a persistent cough, hiccups, pneumonia and bone pain.


Liver


Liver cancer begins in the cells of the liver, the football-sized organ in the upper right area of the belly. 

  • Hepatocellular carcinoma. The most common type of liver cancer that begins in the main type of liver cell (hepatocyte). 

  • Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common. 
  • It is more common to have cancer that spreads to the liver than cancer that begins in the liver cells. This is called metastatic cancer and is named after the organ in which it began.

It’s uncommon to have symptoms in the early stages of liver cancer. Later, symptoms may include weight loss, belly pain, vomiting and jaundice

ASK THE EXPERT: Understanding Liver Cancer

by Amna Sher, MD

Neuroendocrine and Carcinoid Tumors


A carcinoid tumor forms in the neuroendocrine system, which is made up of cells that are spread out over many organs in your body. They are called neuroendocrine cells because they act like both nerve and endocrine cells. Carcinoid tumors are slow growing and can start in a number of places in the body, which are broken down into three areas: 

  • Foregut, the lungs and stomach 

  • Midgut, the small intestine, appendix and the beginning of the large bowel (colon)
  • Hindgut, the end of the large bowel, rectum and the organs of the genitourinary tract (ovaries and testes) 

Symptoms often don't appear until late in the disease and are vague, such as diarrhea and skin flushing. 


ASK THE EXPERT: Therapy for Rare Tumors

Pancreas

Cancer of the pancreas is referred to as pancreatic cancer. It begins in the tissues of your pancreas, an organ in your abdomen that lies behind the lower part of your stomach, that releases enzymes that aid digestion and produces hormones that help manage your blood sugar.

  • Pancreatic ductal adenocarcinoma. This most common type of pancreas cancer that forms in the pancreas begins in the cells that line the ducts that carry digestive enzymes out of the pancreas.

Pancreatic cancer is seldom detected at its early stages because it often doesn't cause symptoms until after it has spread to other organs. Later stages are associated with non-specific symptoms, such as lack of appetite and weight loss.


ASK THE EXPERT: FAQs About Early Detection of Pancreas Cancer
by Aaron Sasson, MD 
 

Small Intestine

Small intestinal cancer occurs in the gastrointestinal (GI) tract or digestive tract. This cancer is less common than most other types of GI cancers. The small intestine is made up of many different types of cells, so different types of cancer can start here.

The four major types of small intestinal cancers are:

  • Adenocarcinomas. This type starts in the gland cells that line the inside of the intestine.
  • Carcinoid tumors. A type of neuroendocrine tumor that tends to be slow growing and is the most common type of small intestinal tumor.
  • Lymphomas. This type starts in immune cells called lymphocytes.
  • Sarcomas. This type starts in connective tissues, such as muscle. The most common sarcomas in the intestine are known as gastrointestinal stromal tumors (GISTs). 

The symptoms can have other, more common causes, such as belly pain, nausea and vomiting, unexplained weight loss, fatigue, dark-colored stools, anemia and jaundice.


Stomach

Stomach cancer, or gastric cancer, is a rare but potentially dangerous disease. The stomach refers only to the muscular, sac-like organ that sits in the upper abdomen. Stomach cancer occurs when the cells in the stomach’s lining divide uncontrollably, forming a tumor. As cancer progresses, the tumor may invade and destroy surrounding tissue, block the passage of food or break off and spread (metastasize) to other organs.

There are different types of stomach cancer, depending on the cells in which cancer starts, including:

  • Adenocarcinomas. The most common type of stomach cancer starts in gland cells

  • Gastrointestinal stromal tumors (GIST). Also called gastric sarcomas, and affect interstitial cells in the gastrointestinal tract, most often the stomach or small intestine.

  • Carcinoid tumors. This affects the hormone-producing stomach cells and are also called neuroendocrine tumors. 
    Because symptoms can be mistaken for less serious problems such as indigestion or heartburn, it is often not found until its advanced stages.