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Interviewer: Abdominal cancers are one of the more common cancers that people can develop. Over 400,000 Americans will be diagnosed with abdominal cancer each year but it can be one of the more challenging ones to detect early and get the treatment needed.

So to help us kind of delve into the different types of cancers that can occur in that abdominal area, some of the symptoms, and maybe even some of the ways that we can prevent it, we're joined by Dr. Theresa Werner, the Deputy Director for the Huntsman Cancer Institute who specializes in certain abdominal cancers.

Now let's start with just kind of the real basics. What are some of the common types of abdominal cancers and why is early detection so crucial?

Types of Abdominal Cancers

Dr. Werner: I think when you think about abdominal cancers, people think about your gastrointestinal or your GI tract number one. So if you think about the anatomy, that could be your lower esophagus, your stomach, your small intestine or small bowel, your large intestine, or your colon and your rectum, for example. And your pancreas is another organ important to the GI tract that's in there.

So any of the cancers that start in any one of those areas is something that we would think about when we think about abdominal cancers. You can also think about other organs that are in there. Liver, for example. You can develop liver cancer. Your kidneys, for example, are there as well. And then if we think specifically of female patients, we think about the uterus as being a source of cancer, fallopian tubes, and ovaries, for example.

So there are predominantly GI cancers. There's genital/urinary if you think about kidneys, for example, and then lastly would be gynecologic cancer. So any of those organs could turn into cancer.

Prevention and Screening

Dr. Werner: The most important thing to do would be to prevent cancer from happening in the first place. And so the best example we could think about is doing a colonoscopy, for example. Patients who have a colonoscopy will have a direct visualization of the inside of their colon and the doctors will usually look for any polyps. Polyps are not cancer. They're actually benign lesions but certain polyps can turn into cancer if they're left in there long enough. So if you're great and you do your colonoscopies and they remove the polyps then you might not develop colon cancer and that would be a way to prevent cancer from even happening in the first place. So that's an easy thing and part of our routine cancer screening that we do for patients.

If we think about gynecologic cancers, for example, the cervix is the very bottom part of the uterus and so primary prevention of a cervix cancer would include getting an HPV vaccine. So again, available to adolescents, women and men, or girls and boys to prevent HPV which is a known cause of cervical cancer. So an easy way to prevent cancer.

Symptoms and Early Detection

Dr. Werner: If we think about some of the symptoms, these are things that . . . I really ask patients to be very aware of their bodies. Nobody's going to know your body and your symptoms and what's normal for you better than you yourself, right?

Gastrointestinal Cancer

So if we think about GI cancer, I think the tough thing is that many of these symptoms are really common in benign conditions. How many people have had a stomachache? How many people have cramping, bloating, or food poisoning? Maybe it's something that you ate and it turned into diarrhea. So I tell patients the thing to really think about is a new symptom that is unusual for them, especially one that persists. So something that lasts one day and you get better and it goes away... probably not worrisome, right? But if you're like "Oh I'm continuing to have this pain" or "I'm continuing to have blood in my stool" that is not normal. And so those are the things that would get you to go contact your physician right away and say "Hey this isn't normal."

I'm not saying that that would turn into cancer but it does warrant a further workup to make sure that we're not missing something more serious. So again change in the caliber of your stool, for example. If you have blood in the stool which we've already talked about or let's say your stools are pencil thin that may mean that there's something wrong in your colon, for example, that needs to be worked out. And again we talked about sort of vague GI symptoms which unfortunately is a presentation for a lot of abdominal cancer. So bloating, cramping, early satiety, meaning you get full faster, you can't eat as much, for example. Any of those symptoms that persist longer than a few days I think warrant a phone call or a discussion with your primary care doctor to talk about.

Then that can proceed to further workup. And that might be blood work, a lab test, or it could be some kind of imaging like an X-ray or a CAT scan to look and see if something is wrong.

Gynecologic Cancers

Also if we think about the gynecologic cancers that are in the lower abdomen or pelvis any abnormal bleeding, right? Women have menstrual cycles but if your bleeding pattern is different or if you're postmenopausal and then all of a sudden you develop bleeding that's a warning sign to come in and get checked out. That could mean that there's uterine cancer. So it would be an exam and maybe an ultrasound to look to see if something is going on.

One of the other common abdominal cancers that we talk a lot about is ovarian cancer. It unfortunately has a bad reputation in the sense that it usually is diagnosed at very late stages. The reason is number one we don't have good screening for ovary cancer like we do for breast cancer looking at a mammogram or a colonoscopy just what we talked about with colon cancers. We don't have great screening for ovarian cancer so we really rely on women to tell us if they're having symptoms. A lot of the ones that we talked about before which are nonspecific early satiety again getting full earlier not being able to eat as much, bloating, cramping, abdominal pain, abnormal bleeding all of these things. I've seen many patients that have come in and said "I've been having these symptoms for months and just thought they were normal."

So again it goes back to you knowing your body and a symptom like that that persists for longer definitely warrants further evaluation. So that would be the message I think to patients is it's always scary when you think about "Could I possibly have cancer?" But again the earlier we find it potentially the more treatable it is and the higher chance that there is of a cure.

So I just encourage patients to try to not be afraid and just come in and talk to their doctor about what could be going on. That's what we're here to do is to help sort of find out if there's anything serious going on that we need to intervene on.