Together cancer of the gullet, stomach, bowel and pancreas are the commonest group of cancers, especially in the sixties onwards but they do occur before then.
Cancer of the colon or rectum is the third most common cancer in men, causing about 8,500 deaths a year.
It is more likely if there is a family history of bowel cancer or in sufferers of ulcerative colitis. Cancer of the pancreas causes 8,000 deaths a year, especially in smokers and diabetics.
Cancer of the gullet or stomach affect an older age group and are more common in smokers.
The symptoms of bowel cancer are a change in bowel habit - for example, unusual constipation or persistent diarrhoea or blood in the motions.
Cancer of the gullet causes difficulty swallowing. Stomach cancer begins as persistent indigestion, upper abdominal pain and loss of appetite, possibly with vomiting of blood.
Pain or weight loss are features of more advanced disease of any of the above.
Cancer of the pancreas is notoriously difficult to diagnose early; it may cause a vague abdominal pain, jaundice - and weight loss.
Prevention
See a doctor if your bowel habit alters for more than two weeks without some good reason. Always take seriously any difficulty in swallowing.
Indigestion beginning for the first time above the age of forty-five should be investigated, even though stomach cancer is relatively uncommon until the sixties.
Never ignore persistent weight loss and loss of appetite.
Treatment
Surgical removal of early bowel and stomach cancers gives excellent long-term results; this is why you should not delay in having any suspicious symptoms investigated.
The outlook for cancer of the gullet and pancreas is much poorer; even so much can be done to relieve discomfort.
My friend Tom was 41-year-old man has a history of drinking 1 to 2 liters of whisky per day for the past 20 years. He has had numerous episodes of nausea and vomiting in the past 5 years. He now experiences a bout of prolonged vomiting, followed by massive hematemesis. On physical examination his vital signs are T 36.9 C, P 110/min, RR 22/min, and BP 80/40 mm Hg lying down. His heart has a regular rate and rhythm with no murmurs and his lungs are clear to auscultation. There is no abdominal tenderness or distension and bowel sounds are present. His stool is negative for occult blood. Which of the following is the most likely diagnosis. Cystone
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