Sukham Blog – A monthly column focused on South Asian health and wellbeing.
Dr. Sundeep Jain is a highly-regarded gastrointestinal oncologist and surgeon at the Fortis Hospital in Jaipur, India. He is on a mission to increase public awareness about abdominal cancers – to educate people to recognize early warning signs and seek timely advice from their physicians so that these cancers can be detected early on, while they are still treatable.
“A significant majority of patients who came to see me and received a GI cancer diagnosis were already in a Stage 4 condition, with their cancer so advanced that no surgical or other treatment for cure, containment or remission was possible,” he told me on the phone from Jaipur. “The best I could do was to keep them comfortable and free of pain for the short life span they had left. If only they had come to me earlier,“ he added.
Since he began his practice in 2006, Dr. Jain has seen around 10,000 abdominal-cancer patients and conducted more than 7000 surgeries, covering a spectrum of gastro-intestinal cancers, obesity, and more. Like most diseases, cancer is more dangerous as it progresses. Earlier detection greatly increases the chances of recovery or remission with the right treatment. Dr. Jain found that only 15% of his patients were diagnosed when the cancer was still in the early first and second stages. For these patients, curative treatments enabled improved chances of survival and remission.
“People in all educational, financial and social strata of our society know that chest pains may be associated with a heart attack, and will usually consult a cardiologist out of fear of the possible risk to life that poses;” says Dr. Jain. “However, our society is not informed about the plausible dangerous connotations – including cancers – of persistent, nonspecific abdominal symptoms, and of morbid obesity.”
This drove Dr. Jain in 2019 to declare May 19th Abdominal Cancer Day (AbCD) – as a way to build awareness of the need for early detection, and to educate the community to watch for the warning signs of abdominal cancers.
Abdominal or GI (gastrointestinal) cancer refers to a variety of cancers that affect organs in the digestive system, including the esophagus, stomach, liver, kidney, pancreas, gallbladder, large intestine, small intestine, and rectum. According to the World Health Organization, cancer was the leading cause of death worldwide in 2020 with nearly 10 million deaths. All the abdominal cancers together were the second-highest in that list, accounting for around 60% of these deaths.
A recent report from the American Cancer Society estimates that almost two million new cancer cases will be diagnosed in the US in 2022, with more than 600,000 deaths. Cancer is the second-highest cause of death in the US, exceeded only by heart disease. Abdominal cancers account for 18% of new cases (second to genital cancers) and are responsible for the highest number of all cancer-related deaths, 28%, followed by cancers of the respiratory system.
Abdominal cancers are notoriously difficult to spot in their early stages. There are usually no clear or noticeable symptoms. It’s nearly impossible to feel GI tumors as they develop. These cancers are most often identified in health screenings, or after they have advanced to a more serious stage when they begin to cause noticeable symptoms. These include tiredness, weakness, weight loss, loss of appetite, difficulty in swallowing, digestive problems, nausea and vomiting, changes in bowel habits, diarrhea, constipation, changes in consistency or narrowing of the stool, swelling in the abdomen, abdominal cramping, or pain, signs of jaundice, and bloody or very dark stool. Lifestyle factors such as obesity, lack of exercise, smoking, unhealthy diets, consumption of red meat, and heavy alcohol use are all known to increase the risk of such cancers. Family history also plays a role, as do gastritis and hepatitis A or B infections.
March is Colorectal Cancer Awareness Month, and more adults in their 20s and 30s are being diagnosed with this disease, according to a recent report that urges people to get over their discomfort in talking about that part of their bodies. The article lists six symptoms one should never ignore: rectal bleeding, anemia, abdominal pain, narrow stools, unproductive urges to have a bowel movement, and unexplained weight loss. The American Cancer Society recommends that people at average risk of colorectal cancer start regular screening at age 45.
“Learn to look for symptoms that are ongoing, unexplained, or unusual for you,” Dr. Jain advises, “a change in bowel habits, bloating, anorexia, weight loss, or unexplained pain. If there is no obvious cause for a lump or bleeding without an injury, get it checked out.”
Dr. Jain has opened the door to awareness and education. His launch of AbCD Day in Jaipur on May 19th, 2019 was met with a lukewarm reception by about 600 participants. Attendance increased to around 16,000 the following year, including 1500 international attendees. Last year, 160,000 participants across India and abroad attended the 3rd AbCD Session which featured the launch of a free Abdominal Cancer Day app for Apple and Google Play devices. This app is available in 13 languages and provides valuable information in simple terms to help people to detect the early warning signs, and consult a doctor when they do occur, improving their chances for long-term survival at a lower cost and reducing the risk of complications during treatment. The AbCD theme for 2022 is “Awareness is Power.”
Let’s all do our part, learn to watch for the warning signs, and spread the word on the need to be watchful and proactive.
“Our life is our responsibility and we must take charge of it. We must invest some of our time towards our own health,” says Dr. Jain. Words to live by!
Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within the South Asian community. Sukham provides curated information and resources on health and well-being, aging, and life’s transitions, including serious illness, palliative and hospice care, death and bereavement.
Contact the author at sukhaminfo@gmail.com