What Are Gastric & Colorectal Cancers?
Gastric cancer (stomach cancer) and colorectal cancer (cancer of the colon and rectum) are among the most prevalent gastrointestinal malignancies worldwide, with particularly high incidence rates across East Asia. China has some of the world's most experienced surgical oncology teams for these cancers, and Shanghai's Ruijin Hospital is a nationally recognized center of excellence for gastrointestinal tumor surgery.
Symptoms
Gastric Cancer:
- Persistent indigestion, heartburn, or stomach discomfort
- Nausea and vomiting, sometimes with blood
- Unexplained weight loss and loss of appetite
- Feeling full after eating small amounts
- Black or tarry stools (indicating bleeding)
- Abdominal pain or swelling
Colorectal Cancer:
- Change in bowel habits (diarrhea, constipation, or narrowing of stool)
- Rectal bleeding or blood in the stool
- Persistent abdominal cramping or pain
- Feeling that the bowel does not empty completely
- Unexplained fatigue and weight loss
- Iron-deficiency anemia
Causes & Risk Factors
- Helicobacter pylori infection — a major risk factor for gastric cancer
- Diet — high salt, smoked, or processed food intake; low fiber diet
- Family history and hereditary syndromes (Lynch syndrome, FAP for colorectal cancer)
- Inflammatory bowel disease — ulcerative colitis and Crohn's disease increase colorectal cancer risk
- Obesity and physical inactivity
- Smoking and alcohol consumption
- Age — risk increases significantly after age 50
Diagnosis
Early detection dramatically improves outcomes. Shanghai's gastrointestinal oncology teams use:
- Gastroscopy and colonoscopy — direct visualization and biopsy of suspicious lesions
- CT scan of chest, abdomen, and pelvis — for staging and metastasis assessment
- Endoscopic ultrasound (EUS) — to assess tumor depth and lymph node involvement
- PET-CT scan — for comprehensive staging in selected cases
- Tumor marker testing — CEA, CA19-9, CA72-4
- Molecular profiling — MSI/MMR status, HER2 testing (gastric), RAS/BRAF mutations (colorectal)
- Diagnostic laparoscopy — to rule out peritoneal metastasis before major surgery
Treatment Options
Ruijin Hospital's gastrointestinal surgical oncology team offers comprehensive, multidisciplinary treatment:
- Laparoscopic and robotic gastrectomy — minimally invasive total or subtotal stomach removal with D2 lymph node dissection, the gold standard in East Asia
- Laparoscopic colectomy and rectal resection — including sphincter-preserving low anterior resection and abdominoperineal resection
- HIPEC (Hyperthermic Intraperitoneal Chemotherapy) — for peritoneal metastasis, a specialized procedure available at select Shanghai centers
- Neoadjuvant chemotherapy — FLOT, FOLFOX, XELOX regimens to downstage tumors before surgery
- Adjuvant chemotherapy and chemoradiation — post-surgical treatment to reduce recurrence
- Targeted therapy — Trastuzumab for HER2-positive gastric cancer; Cetuximab, Bevacizumab for RAS wild-type colorectal cancer
- Immunotherapy — Pembrolizumab, Nivolumab for MSI-high or PD-L1 positive tumors
- Endoscopic submucosal dissection (ESD) — for early-stage gastric and colorectal cancers without surgery
Why Treat GI Cancer in Shanghai?
- Ruijin Hospital performs among the highest volumes of gastrectomy and colorectal surgery in China, with outcomes that benchmark against leading global centers
- D2 lymphadenectomy expertise — a technically demanding procedure that significantly improves survival and is routinely performed in Shanghai
- Access to HIPEC for peritoneal disease — a specialized treatment not widely available in many Western hospitals
- Multidisciplinary tumor boards with surgeons, medical oncologists, radiation oncologists, and gastroenterologists
- Treatment costs 60–80% lower than comparable care in the US or Europe
Our Specialist
Professor Zhu Zhenggang (朱正纲) — Chief of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Professor Zhu is one of China's foremost authorities on gastric cancer surgery, with particular expertise in D2 gastrectomy, laparoscopic techniques, and peritoneal metastasis management. He has led landmark national clinical trials on gastric cancer treatment and is a key contributor to Chinese and Asian gastric cancer guidelines.
How CMCS Can Help
China Medical Concierge Shanghai (CMCS) provides comprehensive support for international patients seeking gastric or colorectal cancer treatment in Shanghai. From reviewing your endoscopy and pathology reports to arranging specialist consultations, coordinating surgical scheduling, providing medical interpretation, and supporting post-operative recovery and follow-up, we are with you every step of the way.
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