Side effect management during treatment of gastrointestinal (GI) cancers
A multidisciplinary approach integrating surgery, radiotherapy and systemic treatment has gained importance in the treatment of gastrointestinal (GI) cancer. Significant progress in curing localized cancer and prolonging lives in metastatic cancer has been reached. However, side effects, predominantly GI toxicity, are frequent and often dose-limiting. Patients encounter mucosal injuries resulting in oesophagitis, gastritis, nausea and vomiting, colitis causing diarrhoea or constipation. In rarer cases drugs cause hepatotoxicity or pancreatitis. Nausea, vomiting and diarrhoea are the main digestive toxicities in GI cancer patient undergoing chemo- and/or-radiotherapy. Quick relief from these side effects is important to improve the quality of life and also to prevent hospitalization. Professional prophylactic and on demand care to prevent or treat these toxicities are warranted. Supportive care should be tailored to the individual patient and to the underlying pathophysiology. This review focuses on the acute side effects in gastrointestinal cancer treatment and emphasizes therapeutic approaches which could ameliorate severity and incidence of toxicities.