Gastrointestinal Cancers

Gastrointestinal (GI) cancers that originate from outside the colon and rectum are common and distressing for reasons distinct from colorectal cancer. The GI tract includes the uniquely contributory organ functionality of the pancreas, liver, and stomach, which manifest as distinct cancer types with unique morbidity associations. While digestion is certainly the primary quality-of-life issue that is disrupted during the cancer experience and trajectory, there are various other important quality-of-life issues to consider. Unfortunately, these noncolorectal GI cancers tend to carry a worse overall prognosis and the morbidity is greatly influenced by cancer type, anatomic location, and treatment regimen (local and systemic). Pancreatic, esophageal, gastric, and hepatobiliary cancers affect digestion, nutrient absorption, and weight management and can cause significant pain and other physical morbidity such as edematous states. Aside from the stress of physical morbidity or unique treatment side effects, pancreatic cancer has a unique relationship with depression that should be explored for its biological implications in causing depressive symptoms. In addition, patients may be distressed by the novelty or rarity of many of these noncolorectal GI cancers (e.g., cholangiocarcinoma) that may fall into an orphan disease category without well-studied treatment paradigms. Understanding the key characteristics of the primary types of noncolorectal GI cancers (i.e., pancreatic, gastric, esophageal, and hepatobiliary cancers) allows the psycho-oncology clinician to approach these patients with appropriate concern and caring for the primary issues with which they are toiling.