by Dr. Sadir Al Rawi, Director of Surgical Oncology Services Colorectal cancer (CRC), also known as bowel cancer, is the development of cancer from the colon or rectum (parts of the large intestine). It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body.]Signs and symptoms may include blood in the stool, a change in bowel movements, weight loss, and feeling tired all the time. Most colorectal cancers are due to old age and lifestyle factors with only a small number of cases due to underlying genetic disorders. Some risk factors include diet, obesity, smoking, and lack of physical activity. Dietary factors that increase the risk include red and processed meat as well as alcohol. Another risk factor is inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis. Some of the inherited genetic disorders that can cause colorectal cancer include familial adenomatous polyposis and hereditary non-polyposis colon cancer; however, these represent less than 5% of cases. It typically starts as a benign tumor, often in the form of a polyp, which over time becomes cancerous. Bowel cancer may be diagnosed by obtaining a sample of the colon during a sigmoidoscopy or colonoscopy. This is then followed by medical imaging to determine if the disease has spread. Screening is effective for preventing and decreasing deaths from colorectal cancer. Screening is recommended starting from the age of 50 to 75. During colonoscopy, small polyps may be removed if found. If a large polyp or tumor is found, a biopsy may be performed to check if it is cancerous. Aspirin and other non-steroidal anti-inflammatory drugs decrease the risk. Their general use is not recommended for this purpose, however, due to side effects. Treatments used for colorectal cancer may include some combination of surgery, radiation therapy, chemotherapy and targeted therapy. Cancers that are confined within the wall of the colon may be curable with surgery while cancer that has spread widely are usually not curable, with management focusing on improving quality of life and symptoms. Five year survival rates in the United States are around 65%. This, however, depends on how advanced the cancer is, whether or not all the cancer can be removed with surgery, and the person’s overall health. Globally, colorectal cancer is the third most common type of cancer making up about 10% of all cases. In 2012, there were 1.4 million new cases and 694,000 deaths from the disease. It is more common in developed countries, where more than 65% of cases are found.  It is less common in women than men.

by Dr. Ali Aldameh Consultant Foregut Surgeon Lose Weight: Obesity is the leading cause of GERD, Extra stomach fat places pressure on your abdomen, pushing gastric juices up into your esophagus. “Lose weight if you’re overweight, and don’t gain weight if you’re not,”. Eat smaller meals: Large meals fill the stomach and put pressure on the Lower Esophageal Sphincter LES, making reflux and GERD more likely. Don’t lie down after eating: Wait at least three hours before you lie down after a meal. Gravity normally helps keep acid reflux from developing. When you eat a meal and then stretch out for a nap, you’re taking gravity out of the equation. As a result, acid more easily presses against the LES and flows into the esophagus. Elevate your bed: Raising the head of your bed six to eight inches can help gravity keep gastric acid down in your stomach. You could also use a wedge-shaped support. Don’t use extra pillows, as they only raise your head and will not help with GERD. You need your entire upper body elevated to get relief. Review your medications: There are a number of medications that can increase your risk of GERD, either by relaxing the LES, interfering with the digestive process, or further irritating an already inflamed esophagus. These medications include: If you are taking any of these medications, talk to your doctor about switching to another drug that does not have the same effect on the upper digestive tract. However, never stop taking a prescribed medication without first consulting your doctor. Quit smoking:  Some studies have found that nicotine can relax the muscles of the LES and can also interfere with your saliva’s ability to clear acid out of the esophagus. Cut back on alcohol: As with smoking, alcohol can cause the LES to relax. Alcohol can also cause the esophageal muscles to spasm. Wear loose-fitting clothes: Do not wear tight clothing or belts that can constrict your stomach. Try a gluten-free diet: At least one study has found that gluten, a protein found in grains like barley, rye, and wheat, may cause or exacerbate GERD symptoms. Try eliminating gluten from your diet and see if it makes a difference. If after trying the above tips, you are still experiencing GERD, see your doctor. There are medications you can take to ease the symptoms of GERD. Or you can ask for surgical consultation to one of our expert team in FOREGUT TASK FORCE

Raising pancreatic cancer awareness can be done as an individual or group all year long, but it is especially important during Pancreatic Cancer Awareness Month in November. It is a time of the year when we have the most voices speaking about out pancreatic cancer. World Pancreatic Cancer Day is November 17 One-day campaign aims to raise awareness about only major cancer with five- Pancreatic cancer is the only major cancer with a five-year survival rate in the single digits. Despite advancements in treating other major cancers, there is still no early detection method for pancreatic cancer. Every day, an estimated 1,006 people worldwide are diagnosed with pancreatic cancer, and an estimated 985 die from it. “While we’ve seen continued improvement in survival rates among most major cancers in the past decade, the five-year survival rate for pancreatic cancer has remained unchanged for nearly 50 years,” said Sadir Alrawi, Director of the Surgical Oncology Services @ Alzahra Cancer Center, Dubai. “Global awareness is the first step to demand more research funding and develop better resources to improve patient outcomes.” World Pancreatic Cancer Day organizers are encouraging people to raise awareness and show that we are #InItTogether by doing the following on Nov. 17: According to a global survey, almost 60 percent of people know “almost nothing” about pancreatic cancer. Advocates hope greater awareness will lead to the following: Global awareness will be increased by people joining the World Pancreatic Cancer Day campaign through social media and local activities. To learn more about how you can show the world that we’re in it together to improve outcomes and create a brighter future for those fighting the deadly disease, please visit worldpancreaticcancerday.org. About World Pancreatic Cancer Day World Pancreatic Cancer Day (WPCD), a day dedicated to raising global awareness of pancreatic cancer, occurs in November during Pancreatic Cancer Awareness Month. WPCD is an initiative of the World Pancreatic Cancer Coalition, a committee of patient advocacy organizations from around the world. The goal of WPCD is to drive an online conversation about awareness of the disease and the need for more research and funding to fight it. Contacts Dina Moustafa Abd alster Oncology Navigator of Alzahra Cancer Center Tel: +971 55 101 0169 Email:dina.moustafa@azhd.ae