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Management of bleeding GI tumors

      GI bleeding (GIB) in the cancer patient is a common and challenging clinical problem. Although the majority of bleeding episodes stem from traditional, noncancer causes of GIB, the source of hemorrhage may also be the cancer itself (primary or metastatic) or a consequence of its treatment. Tumors primary and metastatic to the GI tract are at risk of bleeding.
      • Lightdale C.J.
      • Kurtz R.C.
      • Sherlock P.
      • et al.
      Aggressive endoscopy in critically ill patients with upper gastrointestinal bleeding and cancer.
      The neutropenia and thrombocytopenia often present in cancer patients complicate the approach to diagnosis and therapy. Treatment options involve the interventional radiologist, radiation oncologist, or surgeon, as well as the gastroenterologist. Clinical care is optimized by access to a multidisciplinary team.

      Abbreviations:

      APC (argon plasma coagulation), EH (endoscopic hemostasis), GIB (GI bleeding), Nd:YAG (neodymium-yttrium aluminum garnet), RFA (radiofrequency ablation), RT (radiation therapy), VEGF (vascular endothelial growth factor)
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      Linked Article

      • Ankaferd hemostat for the management of tumoral GI bleeding
        Gastrointestinal EndoscopyVol. 73Issue 5
        • Preview
          Heller et al1 brilliantly outlined the “difficult-to-manage” situation of tumoral GI bleeding in their review article in Gastrointestinal Endoscopy. The authors mentioned a novel hemostatic agent developed in our country, Ankaferd Blood Stopper (ABS; Ankaferd, Istanbul, Turkey), with several potential applications.1 We herein would like to share our previous experience2-4 with ABS in GI bleeding. The authors preferred to classify ABS within the context of a “mechanical method for hemostasis.” On the other hand, they correctly pointed out that the unique hemostatic effect of ABS presents itself through the rapid promotion of a protein network that anchors erythrocyte aggregation without a direct effect on coagulation factors or platelets.
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