Modern Molecular Treatments Of GI Cancers

When we speak about modern cancer therapies, especially gastrointestinal (GI) cancers, it’s easy to focus solely on the cutting-edge innovations of today. But to truly appreciate the evolution of treatment, we must travel back thousands of years to understand how far we’ve come.

 

The Origins: Cancer in the Ancient World

 

The earliest documented description of cancer dates back to 1550 BCE. Found in the ancient Egyptian medical text known as the Edwin Smith Papyrus, it described mysterious growths in the body, likely tumors, which afflicted the Egyptian noble Amenhotep. These ancient physicians, though without access to our modern tools, had already begun cataloguing the disease.

 

Fast forward to 460 BCE, and we encounter Hippocrates, the “Father of Medicine.” He introduced the term “cancer,” inspired by the Greek word karkinos (crab), after observing tumor projections that resembled crab legs. If the tumor had resembled a rabbit, as one physician jokingly noted, we might have called it something entirely different.

 

Centuries of Silence and the Dawn of Anesthesia

 

Following Hippocrates, little progress was made in cancer treatment for nearly two millennia. Surgeries were attempted, but without anesthesia, procedures were brutal, and survival was uncertain. Ancient healers, often referred to as “wise people”, resorted to using large quantities of alcohol or narcotics to sedate patients. It wasn’t until the mid-19th century that real advancements began. By 1846, anesthesia revolutionized surgery, giving doctors greater control and patients a fighting chance. But cancer itself remained elusive and largely untreatable until a breakthrough in 1949.

 

The Birth of Chemotherapy

 

The year 1949 marked a turning point in oncology. In England, the first dose of chemotherapy, 5-fluorouracil (5-FU) was administered to a patient with head and neck cancer. This treatment, developed by British scientist Dr. Edward Friedlander (often credited, though debated), laid the foundation for systemic cancer therapy. However, it was only the beginning of what would be a long and challenging battle.

 

Colorectal Cancer: A Closer Look

 

Globally, colorectal cancer ranks among the top three cancers in both incidence and mortality, for both men and women. In the UAE, recent data reports approximately 4,680 new cancer cases annually, translating to 13–14 new diagnoses every day. Of these, colorectal cancer accounts for a significant proportion, 413 cases yearly.

 

Gender-based data highlights that colorectal cancer is the leading cancer among men in the UAE, while in women, it follows breast and thyroid cancer. Regionally, Abu Dhabi reported a sharp rise in cancer cases, jumping to 1,775 new cases in 2023 alone.

 

Where in the GI Tract is Cancer Most Common?

 

Understanding which areas of the digestive system are most prone to malignancy can guide early detection strategies. Globally and locally, the sigmoid colon (lower part of the large intestine) accounts for 25% of colorectal cancer cases, followed by the rectum at 23%, and the rectosigmoid junction at 9%. The least affected parts include the transverse and descending colon.

 

Stomach cancers are more frequently found in the fundus (25%) and less so in the cardia (14.8%). In the small intestine, the jejunum and duodenum are more commonly involved than the ileum.

 

Modern Treatment for Metastatic Disease

 

While early-stage GI cancers can often be managed with surgery alone, the real complexity lies in treating metastatic cancer. This is where innovation has flourished. Cancer often spreads through blood or lymphatic channels, with the liver and lungs being the most frequent sites of metastasis.

 

Today, oncologists treat two patients with seemingly identical conditions using completely different protocols. Why? Because new data, trial outcomes, and treatment options are being released so frequently that even a month’s gap can lead to an entirely different clinical decision.

 

Advancements in Local Treatments: Ablation and AI

 

Local therapies like ablation, which uses heat or cold to destroy tumors, are gaining traction. But even more impressive is how Artificial Intelligence (AI) is transforming cancer care.

 

In radiotherapy, traditional methods relied on creating personalized plastic molds to ensure accurate delivery. This process involved a 45-minute simulation and careful patient positioning. Now, AI-supported radiotherapy machines in the UAE complete the simulation in under a minute, recalibrating in real time to target the tumor with unprecedented precision.

 

AI in Early Detection and Diagnostics

 

AI isn’t just refining treatment, it’s revolutionizing early detection. For example, in one case from Austria, a patient’s x-ray in 2017 was read as normal. Years later, a CT scan revealed lung cancer. Retrospective analysis using AI identified a suspicious shadow in the original x-ray, a shadow that human eyes missed.

 

Modern AI systems now "learn" from such patterns. Once a shadow is identified as malignant, future scans across different patients are automatically compared, improving diagnostic accuracy. The system becomes as accurate as a radiologist with 900 years of experience.

 

By 2017, immunotherapy emerged as a game-changer. Drugs like nivolumab, pembrolizumab, and camrelizumab began offering hope to patients with advanced disease. These therapies work by training the immune system to recognize and destroy cancer cells, turning the body’s defense into its best weapon.

 

From Hopelessness to Remission

 

Perhaps the most hopeful shift is the increase in complete remissions, something rarely discussed even a decade ago. With AI, immunotherapy, precision radiotherapy, and better targeted drugs, doctors now see patients return to normal lives, cancer-free. Treatments are more personalized than ever, guided by real-time data, molecular profiling, and ongoing clinical trials.

 

From ancient scrolls to AI-guided machines, the journey of cancer treatment, especially for GI cancers, has been long, complex, and awe-inspiring. We’ve moved from helplessness to hope, from crude surgeries to precision medicine, and from alcohol sedation to intelligent machines. While cancer remains a formidable foe, it’s no longer the death sentence it once was.

 

The story isn’t over. With continued research, technological advancement, and global collaboration, the next chapter may just bring us closer to a cure.

Empowering the Next Generation of Cancer Specialists

 

As cancer treatment evolves from ancient empiricism to molecular precision, the role of continuous medical education becomes increasingly vital. For healthcare professionals aiming to stay at the forefront of Oncology and Gastroenterology, structured learning is no longer optional; it’s essential. Medvarsity offers specialized certificate programs in Gastroenterology and Oncology that are designed to equip practitioners with the latest clinical knowledge, diagnostic tools, and treatment strategies. These programs delve into complex GI malignancies, immunotherapies, and precision medicine, bridging the gap between traditional training and modern, evidence-based care. With cancer therapies advancing rapidly, upskilling ensures clinicians are not just observers of change but active contributors to improved patient outcomes.