Stomach Cancer
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Stomach Cancer: Understanding the Disease and Its Implications
Stomach cancer, also known as gastric cancer, is a serious and often life-threatening condition that develops in the lining of the stomach. It is the fifth most common cancer worldwide and a leading cause of cancer-related deaths.
Early detection and treatment are crucial for improving outcomes, as stomach cancer is often diagnosed at an advanced stage due to its subtle and non-specific early symptoms.
What is Stomach Cancer?
Stomach cancer occurs when malignant (cancerous) cells form in the lining of the stomach. The most common type of stomach cancer is adenocarcinoma, which begins in the glandular cells of the stomach lining. Other, less common types include lymphoma, gastrointestinal stromal tumors (GIST), and neuroendocrine tumors, which can also develop in the stomach.
Stomach cancer typically begins in the innermost layer of the stomach and can spread to deeper layers as it progresses. If not detected and treated early, it can invade nearby organs, spread to lymph nodes, and metastasize (spread) to distant parts of the body, such as the liver, lungs, or bones.
Risk Factors for Stomach Cancer
- Helicobacter pylori Infection: Chronic infection with H. pylori, a bacterium that causes ulcers, is a major risk factor for stomach cancer. It can lead to chronic inflammation and changes in the stomach lining that may increase cancer risk.
- Diet: A diet high in smoked, salted, or pickled foods and low in fruits and vegetables has been associated with an increased risk of stomach cancer.
- Smoking: Tobacco use is linked to a higher risk of stomach cancer. The risk of stomach cancer rises with both the number of cigarettes smoked daily and the duration of regular smoking. However, quitting smoking can help decrease the future risk of stomach cancer.
- Alcohol: The risk of stomach cancer was higher in individuals with any alcohol consumption relative to those with no consumption.
- Family History: Individuals with a family history of stomach cancer or certain genetic conditions, such as hereditary diffuse gastric cancer (HDGC), are at higher risk.
- Age and Gender: Stomach cancer is more common in older adults, particularly those over 60, and is more prevalent in men than in women.
- Autoimmune Disorders: Autoimmune gastritis, which can lead to pernicious anemia in its severe form due to impaired vitamin B12 absorption, is also linked to an increased risk of stomach cancer.
- Previous Stomach Surgery: The risk of stomach cancer is increased after stomach surgery. Both the level of risk and the time between the initial surgery and the development of remnant stomach cancer depend on the reason for the surgery and the type of reconstruction performed.
Symptoms of Stomach Cancer
Stomach cancer can be challenging to diagnose early because its symptoms are often vague and similar to those of less serious conditions. Common symptoms of stomach cancer include:
- Indigestion or Heartburn: Persistent discomfort or a burning sensation in the upper abdomen.
- Bloating: Feeling full after eating small amounts of food.
- Nausea and Vomiting: Unexplained nausea or vomiting, sometimes with blood.
- Loss of Appetite: A decrease in appetite or early satiety (feeling full quickly).
- Unintentional Weight Loss: Losing weight without trying.
- Abdominal Pain: Persistent pain or discomfort in the stomach area.
- Difficulty Swallowing: A sensation of food getting stuck in the throat or chest.
- Fatigue: Unexplained tiredness or weakness.
These symptoms can often be mistaken for other gastrointestinal conditions, such as ulcers or acid reflux. If you experience persistent symptoms, it is important to consult a healthcare provider for evaluation.
Diagnosis of Stomach Cancer
- Upper Endoscopy: A procedure in which a thin, flexible tube with a camera (endoscope) is inserted through the mouth to examine the stomach lining. Biopsies (tissue samples) can be taken during this procedure for laboratory analysis.
- Imaging Tests: Tests such as computed tomography (CT) scans, and positron emission tomography (PET)-CT scans can help determine the size and spread of the cancer.
- Endoscopic Ultrasound (EUS): This test combines endoscopy with ultrasound to obtain detailed images of the stomach and surrounding tissues, helping to assess the depth of tumour invasion.
- Laparoscopy: A minimally invasive surgical procedure in which a camera is inserted through small incisions in the abdomen to examine the stomach and nearby organs. This can help determine if the cancer has spread.
Treatment of Stomach Cancer
1. Endoscopic resection:
For patients with early stomach cancer who meet criteria for endoscopic resection, endoscopic submucosal dissection (ESD) can be performed.
2. Surgery:
- Subtotal Gastrectomy: Removal of part of the stomach, typically for localised tumours.
- Total Gastrectomy: Removal of the entire stomach, often with nearby lymph nodes, parts of the oesophagus, or small intestine, depending on the extent of the cancer.
- Lymph Node Dissection: Removal of nearby lymph nodes to check for cancer spread.
3. Chemotherapy:
The use of drugs to kill cancer cells or slow their growth. Chemotherapy may be used before surgery (neoadjuvant) to shrink tumours or after surgery (adjuvant) to eliminate any remaining cancer cells.4. Radiation Therapy:
The use of high-energy rays to target and kill cancer cells. Radiation therapy may be combined with chemotherapy for more effective treatment.5. Targeted Therapy:
Drugs that specifically target the molecules involved in cancer growth and spread. This type of therapy is often used for advanced stomach cancer or for tumours with specific genetic mutations.6. Immunotherapy:
A treatment that helps the body’s immune system recognise and attack cancer cells. Immunotherapy may be an option for certain types of advanced stomach cancer.Conclusion
Stomach cancer is a serious condition that requires prompt diagnosis and treatment. While the symptoms of stomach cancer can be subtle, early detection is key to improving outcomes. Understanding the risk factors, recognising the symptoms, and seeking timely medical care can make a significant difference in the management of this disease.
If you have concerns about your risk for stomach cancer or are experiencing persistent digestive symptoms, it’s important to consult with a healthcare provider to discuss your symptoms and the appropriate steps for evaluation and care.
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