Gastric Cancer

What is
Stomach Cancer / Gastric Cancer?

Cancer that starts anywhere in the stomach is called gastric or stomach cancer. The stomach has three parts, cardia (Upper portion which connects with esophagus – the food pipe), fundus / corpus (Middle part that is the body of the stomach) and antrum and pylorus (The lower part of stomach).

The stomach, as we all know, has a very important role as it mixes and breaks down the food by releasing gastric juices and digests the food so that our body can absorb it. Then the food moves into the small intestine for further digestion. Gastric juices and acid are secreted by the glands in the wall of the stomach.

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Symptoms of stomach cancer

The warning, that something is not right!

If we know the symptoms, we can be more cautious and report to our doctor for evaluation at the earliest. As the survival depends on the stage of the cancer, earlier it is detected, better the survival outcome! The following are the typical nonspecific gastric cancer / stomach cancer symptoms:

  • Fatigue – an overall feeling of tiredness or lack of energy
  • Feeling bloated after eating – due to excess intestinal gas and digestive contents
  • Feeling full after eating small amount
  • Severe and persistent heartburn
  • Severe and unrelenting indigestion
  • Chronic unexplained nausea and vomiting
  • Unexplained Stomach pain
    Unexplained Weight loss

Types of stomach cancer

The evaluation, treatment and prognosis, all depend on the type of the gastric cancer, which is determined by the cells that make up the tumour:

  • Adenocarcinoma (originates in the glandular cells) – accounts for the majority of stomach cancers. It is of various subtypes -intestinal, diffuse, indeterminate or mixed type
  • Lymphoma (originates in the cells of the immune system) – a relatively rare form of stomach cancer
  • Carcinoid cancer or cancer that begins in hormone-producing cells-rare cancer which originates in the hormone-producing cells
  • Gastrointestinal stromal tumour (GIST, originates in nervous system tissues) – another relatively rarer form of gastric cancer.

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Diagnosis & Assessment

Tests for the diagnosis of stomach cancer include:

  • Gastroscopy – This is the test most often done to diagnose stomach cancer. During this test, the doctor puts an endoscope (a long flexible tube with a camera and light) into the mouth and down into the stomach. This allows the doctor to look at the inside of the stomach.
  • Biopsy – This test is performed during a gastroscopy. In a biopsy, a small sample of tissue from an abnormal-looking area of the stomach is taken and later examined under a microscope.
  • Imaging tests of the stomach – Imaging tests such as computed tomography (CT) and ultrasound scans create pictures of the inside of the body to see if the cancer has spread.
    Doctors will also check for H. pylori infection. This can be done in different ways, including breath tests, blood tests, and other laboratory tests.


Treatment & Care

Stomach cancer is usually treated with one or more of the following approaches:

This can be an effective method to treat early stage stomach cancer. During surgery, the doctor may remove part or all of the stomach. In the advanced stages of stomach cancer, surgery may still be advised to reduce complications such as blockage of the stomach or bleeding from the cancer.

Radiation Therapy
After surgery, radiation therapy, also known as radiotherapy, may be given together with chemotherapy to destroy any remaining cancer not removed during surgery. In patients with advanced stomach cancer, radiotherapy may be useful for relieving stomach blockage. It may also be used to stop bleeding from cancers that cannot be operated on.

Chemotherapy is the use of drugs to help kill cancer cells and shrink the size of the tumour. It can be given by itself or combined with radiotherapy after surgery. It may also be used to reduce symptoms or lengthen the lifespan of patients with advanced stomach cancer that cannot be operated upon.

Targeted Therapy
Some stomach cancers have too much of a growth-promoting protein called HER2 on the surface of the cancer cells. Tumours with increased levels of HER2 are called HER2-positive. Trastuzumab (Herceptin®) is a man-made antibody which targets the HER2 protein. Using this drug with chemotherapy can help patients suffering from advanced, HER2-positive stomach cancer live longer than with just chemotherapy alone.

How to Prevent Stomach Cancer?

In many developed countries, where refrigeration allows a greater intake of fresh rather than salt-preserved foods, rates of stomach cancer have fallen over the years. Here are some steps that can be taken to reduce the risk of developing stomach cancer:

  •  Consume more fresh fruits and vegetables
  • Reduce intake of salted and smoked foods
  • Stop smoking
  • Know your medical history (eg. past H. pylori infection) and go for regular gastroscopy screening