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Stomach Cancer

The stomach is an organ that lies between the esophagus and the small intestine. It mixes food with stomach acid and helps in protein digestion. People over 60 years of age are commonly affected. Men are more likely to be diagnosed with stomach cancer than women.

What are the symptoms of stomach cancer?

Stomach cancer may not show signs and symptoms in the early stages. There are several possible symptoms:

  • Unintended weight loss
  • Loss of appetite.
  • Difficulty in swallowing.
  • Indigestion (burning sensation or pain in the abdomen, burping often, reflux).
  • Persistent nausea and/or vomiting with no apparent cause.
  • Pain in the stomach.
  • Feeling full, even after a small meal.
  • Swelling of the abdominal area or feeling bloated.
  • Feeling lethargic.
  • Vomit that contains blood.
  • Bloody or black-colored stools.

 

 

What causes stomach cancer, and who is at risk?

The exact cause of stomach cancer is unknown. However, certain risk factors will increase the chances of developing stomach cancer.

  • Being at an age older than 60.
  • Having infection with the bacteria Helicobacter pylori (type of bacteria found in the stomach).
  • Having a part of the stomach removed to treat some non-cancerous conditions.
  • Smoking.
  • Low red blood cell count (pernicious anemia).
  • A family history of stomach cancer.
  • Having an inherited genetic condition such as Lynch syndrome, familial adenomatous polyposis (FAP), hereditary diffuse gastric cancer (HDGC), proximal polyposis of the stomach (GAPPS) and gastric adenocarcinoma,
  • Chronic inflammation of the stomach (chronic gastritis).
  • Being overweight.
  • Drinking alcohol.
  • Eating foods preserved by salt.

 

 

 

 

How is stomach cancer diagnosed?

Stomach cancers are challenging to diagnose in the early stages. When you visit the doctor with symptoms, he will examine you to identify the problem.

 

  • Physical examination: The doctor will take your health history, including eating habits, problems related to bloating, acidity, etc. He will do a physical check-up and feel your belly to look for any abnormality.

 

Based on the observations from the physical examination, he will suggest some tests that will help confirm the diagnosis.

  • Endoscopy: In this procedure, a doctor passes a long and flexible tube with a light and tiny camera fitted at the end of the tube into your mouth, down to your stomach, and small bowel. This will help the doctor to look inside your digestive tract to examine the lining and help identify any abnormality.
  • Biopsy: In this procedure, a sample tissue is taken from the suspicious site and sent to the laboratory to look for any cancer cells. The biopsy can also be done along with endoscopy.
  • Endoscopic ultrasound: During this procedure, a doctor passes an endoscope with an ultrasound probe into your mouth, down to your stomach, and small bowel. The ultrasound probe uses sound waves to create a picture of your stomach and helps the doctor check for any abnormality sign.

 

What are the next steps after confirmation of stomach cancer?

After confirmation of cancer, your doctor may ask you to go for additional tests to determine the spread of cancer to the lymph nodes or other areas of your body. These tests also help in determining the grade of cancer. These tests may include:

 

  • Blood tests: Your doctor will suggest some blood tests to check for the overall health status.
  • Laproscopy: It is a surgical procedure that allows your doctor to look inside and examine the outer layer of your stomach for signs of cancer spread.
  • Computerized tomography (CT scan): This test uses a special dye medium that helps with a clear image of the body parts from different angles. It can help in seeing detailed images of soft tissue and blood vessels. CT scan is used to measure the tumor size and helps look for the spread of the tumor to different body organs.
  • Positron emission tomography (PET) or PET-CT scan: A PET scan uses a small amount of radioactive sugar substance injected into the patient's body. This sugar substance is then used by cells, and a scanner then detects this substance to make images of the organs inside the body.

 

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What are the stages of stomach cancer?

 

  • Stage 0: There are severe abnormal cells present in the inner lining of the stomach.
  • Stage 1: Cancer has not spread beyond the thick muscle in the stomach wall.
  • Stage 2: Cancer might have spread into or through the inner, supportive, or muscle layer of the stomach. It may have also invaded the nearby lymph nodes.
  • Stage 3: Cancer may have grown through or the inner, supportive muscle or outer layer of the stomach. It may have also invaded the nearby lymph nodes.
  • Stage 4: Cancer has spread into nearby organs, or it has spread to distant body parts.

 

How is stomach cancer treated?

Treatment of cancer depends on factors like the stage of the disease, the patient's age, and his overall health. A combination of treatments like surgery, radiation therapy, chemotherapy, etc., are planned for patients which are best suited for them.

  • Surgery: Surgery is the primary treatment considered for stomach cancer in patients where cancer has not spread. The main type of stomach cancer surgeries are:
  • Endoscopic resection: This surgery is considered for early-stage tumors that have not spread from the stomach walls; they may be resected using a long, flexible tube (endoscope) that is passed down your throat into your stomach.
  • Gastrectomy: This procedure involves removing all or part of the stomach, leaving healthy tissue as much as possible.
  • Radiation therapy: Radiation therapy utilizes high-energy x-rays or other types of radiation to kill cancer cells. Radiation therapy can be used in a targeted area or whole body; the doctor carefully directs the energy to the affected area that focuses on killing the cancer cells.
  • Chemotherapy: Chemotherapy uses drugs that stop the cancer cells from multiplying, either by killing the cancer cells or by inhibiting them from multiplying. These drugs are administered through the vein or can be given in the form of pills.
  • Targeted therapy: This treatment uses drugs and other substances that identify and attack the cancer cells. As this treatment focuses on cancer cells, it is less harmful in comparison to radiation and chemotherapy.

 

What to expect after stomach surgery?

You may have to stay in the hospital on an average of 3-5 days post partial gastrectomy and for a week post total gastrectomy. This is the time when the body is in the recovery phase. You may experience some complications like pain and discomfort around the incision that will be managed by pain medications, and it will gradually heal.

Once you are discharged from the hospital, please follow the below-mentioned guidelines:

  • Rest: Allow yourself to have extra rest for the first few weeks after the surgery. Avoid doing strenuous activity.
  • Medicine: Take all the medications on time as suggested by the doctor. This will help you to recover well.
  • Sponge bath: Till all your drains are removed and sutures healed, take a sponge bath. Once your doctor approves for regular bath, you may go for it.
  • Exercise: Regularly do activities that your physiotherapist has recommended you. In case you experience pain or difficulty doing it, get in touch with a physiotherapist.
  • Diet: Prefer eating smaller and frequent meals since stomach resection can cause food to enter the digestive tract too quickly.
  • Vitamin supplements: Removal of the stomach makes nutrient absorption more difficult. Your doctor may prescribe oral or injectable supplements to avoid any vitamin deficiencies.

 

 

What is the survival rate of stomach cancer?

The survival rate of the patient depends on the factors like type and stage of cancer.

  • 5-year survival rate for patients with localized (cancer is limited to the area where it has started) cancer is 70%.
  • 5-year survival rate for patients with regional (cancer has spread to the nearby lymph nodes) cancer is 32%.
  • 5-year survival rate for patients with distant (cancer has moved farther, such as liver, brain, etc.) cancer is 6%.

 

How to keep a check on reoccurrence?

Stomach cancer tends to recur after the initial treatment. It is advisable to be vigilant with the follow-up protocol, and in case of any problem you experience, inform your doctor immediately. The doctor will physically examine you and then recommend you to go for tests to learn as much as possible about the recurrence. After this testing is done, your doctor may plan the best treatment option available that might include previous treatment as well.

 

Prevention tips

Prevention of cancer is not possible. However, by making some lifestyle modifications, you can lower the risk.

  • Avoid drinking alcohol and do not use tobacco products.
  • Avoid eating pickled and smoked foods and salted meats and fish.
  • Prefer eating fresh vegetables and fruits and plenty of whole-grain foods, such as cereals, whole-grain bread, pasta, and rice.
  • Maintain a healthy weight.

 

 

 

 

 

 

Symptoms of stomach cancer

Signs and symptoms of stomach cancer are:

  • Fatigue
  • Feeling bloated after eating
  • Feeling satiated after consuming small amounts of food
  • Severe, persistent heartburn
  • Severe indigestion that is always present
  • Unexplained, persistent nausea
  • Stomach pain
  • Persistent vomiting
  • Unintentional weight loss

Cause of stomach Cancer

The stomach (along with the esophagus) consists of just one part of the upper section of our digestive tract. The stomach aids in digesting food and then transporting the nutrients along to the rest of your digestive organs, namely the small and large intestines.

Stomach cancer usually occurs when healthy normal cells that are present in the upper digestive system become cancerous and multiply out of control. Habitually, this process occurs gradually, and stomach cancer takes time to develop after many years.

Risk factors of stomach cancer

These risk factors in stomach cancer include certain diseases and conditions, such as:

  • lymphoma (a group of blood cancers)
  • H. pylori bacterial infections (it is a standard stomach infection which results in ulcers)
  • tumours in other parts of the digestive system
  • stomach polyps

 

 

Stomach cancer is also more common among:

  • Older adults
  • smokers
  • people having a family history of the disease
  • people who are of Asian heritage particularly  Korean, Japanese, South American, or Belarusian descent

Also, you may be more likely to get stomach cancer if you:

  • Eat a lot of salty or processed foods
  • overeating meat
  • have a history of alcohol abuse
  • don't exercise
  • don't store or prepare food properly

If you show specific symptoms, get a screening test if you believe that you are at a considerable risk of developing stomach cancer.

Diagnosis of Stomach Cancer

Various Tests and procedures that are used to diagnose stomach cancer include:

  • Upper Endoscopy: The doctor will insert a thin tube containing a tiny camera from your throat and into the stomach to see inside your stomach. The doctor will look at signs of cancer. However, if any suspicious areas are detected, then a piece of tissue can be extracted for analysis (biopsy).
  • Imaging tests: The doctor may recommend imaging tests such as computerized tomography (CT) scans and a particular type of X-ray exam sometimes called a barium swallow to look for stomach cancer inside your stomach.

Exploratory surgery: If your cancer has spread beyond your esophagus or stomach, within your chest or abdomen, then the doctor will recommend exploratory surgery. This surgery is performed laparoscopically. A compact and special camera is inserted through several small incisions in your abdomen that will transmit images to a monitor in the operating room.

Treating stomach cancer

  • Surgery for Stomach Cancer: The surgeon will extract all or some cancerous tissue inside the esophagus or stomach where the tumour is located. Surgery aims to remove all of cancer and a margin of active tissue, when possible. Nearby lymph nodes are also removed.
  • Radiation treatments: A powerful beam of energy, such as X-rays is used to target and eliminate cancerous cells before and after surgery. Radiation therapy can be used before surgery (neoadjuvant radiation) to limit a tumour so that it's more deftly removed. Radiation therapy can also be used after surgery (adjuvant radiation) to eliminate any cancer cells that might have remained in the area around your esophagus or stomach.
  • Chemotherapy: Chemotherapy is implemented to kill cancer cells and limit the growth of cancer cells that may have spread beyond the stomach. Chemotherapy is frequently combined with radiation therapy. Chemotherapy can in addition be used in people who have advanced stomach cancer to help relieve signs and symptoms.
  • Targeted Therapy: These drugs primarily affect cancer cells and not active cells. These drugs block the abnormalities causing cancer cells to die.

Preventing Stomach Cancer

You can prevent Stomach cancer per se. However, you can considerably lower your risk of developing all cancers by:

  • Maintaining a healthy weight
  • following a balanced, low-fat diet
  • quitting smoking
  • exercising regularly

Talk to your doctor to get medicines that will help you in lowering the risk of stomach cancer. These medications usually help those individuals who suffer from other diseases that may contribute to cancer.

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