Understanding Stomach Cancer

Stomach cancer, also known as gastric cancer, is a serious and often deadly form of cancer that affects the stomach's lining. This disease develops when malignant cells form in the inner layer of the stomach, potentially spreading throughout the organ and to other parts of the body. This article delves into various aspects of stomach cancer, including its causes, risk factors, symptoms, diagnosis, treatment options, and preventive measures.

Causes and Risk Factors

The exact cause of stomach cancer is not fully understood, but several factors are known to increase the risk of developing this disease:

  • 1. Helicobacter pylori Infection: Chronic infection with H. pylori bacteria is one of the most significant risk factors. This bacterium can cause inflammation and ulcers in the stomach lining, potentially leading to cancer.
  • 2. Diet: Consuming a diet high in salty, smoked, or pickled foods and low in fruits and vegetables is associated with an increased risk of stomach cancer. Nitrites and nitrates found in these foods can convert into carcinogenic compounds.
  • 3. Smoking and Alcohol: Tobacco use and excessive alcohol consumption are major risk factors. Smoking doubles the risk of stomach cancer, while heavy drinking can damage the stomach lining.
  • 4. Genetics and Family History: A family history of stomach cancer increases the risk, suggesting a genetic component. Specific inherited conditions like hereditary diffuse gastric cancer (HDGC) also elevate the risk.
  • 5. Age and Gender: Stomach cancer is more common in older adults, particularly those over 50. Men are twice as likely as women to develop this type of cancer.
  • 6. Previous Stomach Surgery: Individuals who have had part of their stomach removed for benign conditions have a higher risk of developing stomach cancer later in life.
  • 7. Medical Conditions: Certain medical conditions, such as pernicious anemia, chronic gastritis, and gastric polyps, can increase the risk of stomach cancer.

Symptoms of stomach cancer

Stomach cancer symptoms often do not appear in the early stages, making early detection challenging. As the disease progresses, symptoms may include:

  • Persistent indigestion or heartburn
  • Feeling bloated after eating
  • Nausea and vomiting, sometimes with blood
  • Stomach pain or discomfort
  • Unintended weight loss
  • Difficulty swallowing
  • Loss of appetite
  • Fatigue

These symptoms can be vague and are often mistaken for less serious conditions, delaying diagnosis.

Diagnosis

Diagnosing stomach cancer involves several steps:
  • 1. Medical History and Physical Exam: A doctor will review the patient's medical history and perform a physical examination to check for signs of cancer.
  • 2. Endoscopy: An endoscope, a thin, flexible tube with a camera, is inserted through the mouth into the stomach to examine the lining and take biopsies of suspicious areas.
  • 3. Biopsy: A sample of stomach tissue is examined under a microscope to confirm the presence of cancer cells.
  • 4. Imaging Tests: Tests such as CT scans, PET scans, and X-rays help determine the extent of the cancer and whether it has spread.
  • 5. Blood Tests: Blood tests can detect anemia (a common issue in stomach cancer patients) and tumor markers, substances produced by cancer cells.

Staging

Once stomach cancer is diagnosed, it is staged to determine the extent of the disease:
  • Stage 0: Cancer is confined to the inner lining of the stomach.
  • Stage I: Cancer has spread to the inner layer and possibly nearby lymph nodes.
  • Stage II: Cancer has spread to deeper layers and more lymph nodes.
  • Stage III: Cancer has penetrated all layers of the stomach and spread to nearby organs and lymph nodes.
  • Stage IV: Cancer has spread to distant parts of the body, such as the liver, lungs, or bones.

Treatment Options

Treatment for stomach cancer depends on the stage and location of the tumor, as well as the patient's overall health. Options include:

  • 1. Surgery: The primary treatment for stomach cancer, especially in the early stages. Surgical options include: β—‹ Subtotal Gastrectomy: Removal of part of the stomach. β—‹ Total Gastrectomy: Removal of the entire stomach, with the esophagus connected to the small intestine.
  • 2. Chemotherapy: Uses drugs to kill cancer cells. It can be administered before surgery (neoadjuvant) to shrink tumors or after surgery (adjuvant) to eliminate remaining cancer cells.
  • 3. Radiation Therapy: Uses high-energy rays to target and kill cancer cells. Often combined with chemotherapy.
  • 4. Targeted Therapy: Involves drugs that target specific molecules involved in cancer growth. For example, trastuzumab targets HER2-positive stomach cancer.
  • 5. Immunotherapy: Helps the immune system recognize and attack cancer cells. Pembrolizumab is one such drug used for advanced stomach cancer.
  • 6. Palliative Care: Focuses on relieving symptoms and improving quality of life for patients with advanced cancer. This can include pain management, nutritional support, and psychological support.
  • Prognosis and Survival Rates

    The prognosis for stomach cancer varies based on the stage at diagnosis and other factors. Early-stage stomach cancer has a better prognosis than advanced-stage disease. The five-year survival rate for localized stomach cancer is about 69%, but this drops significantly if the cancer has spread to distant organs.

    Prevention While not all cases of stomach cancer can be prevented, several measures can reduce the risk:
    • 1. Dietary Changes: Eating a diet rich in fruits, vegetables, and whole grains while reducing intake of salty, smoked, and pickled foods can lower the risk.
    • 2. Avoiding Tobacco and Alcohol: Quitting smoking and limiting alcohol consumption are crucial preventive steps.
    • 3. Treating H. pylori Infections: Early detection and treatment of H. pylori infections can reduce the risk of developing stomach cancer.
    • 4. Regular Screening: For those at high risk (e.g., family history, genetic predispositions), regular screening can help detect cancer early.
    • 5. Healthy Lifestyle: Maintaining a healthy weight, staying physically active, and managing chronic medical conditions can also reduce the risk.

    Research and Advances

    Ongoing research is crucial in the fight against stomach cancer. Scientists are exploring new treatments, including

    • 1. Precision Medicine: Tailoring treatment based on genetic mutations specific to the patient's cancer.
    • 2. Advanced Imaging Techniques: Improving early detection and monitoring of treatment response.
    • 3. Combination Therapies: Testing new combinations of existing treatments to enhance effectiveness.
    • 4. Cancer Vaccines: Developing vaccines to prevent stomach cancer or boost the immune response against existing tumors
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