Stomach cancer, also called gastric cancer, starts in the stomach. Stomach cancer usually begins in the mucus-producing cells that line the stomach. This type of cancer is called adenocarcinoma. Cancers starting in different sections of the stomach may cause different symptoms and tend to have different outcomes. The cancer's location can also affect the treatment options.
What causes stomach cancer?
Stomach cancer occurs when normally healthy cells within the upper digestive system become cancerous and grow out of control, forming a tumor. This process happens slowly. Stomach cancer tends to develop over many years.
Stomach cancer develops when cells in the lining of the stomach grow and divide in an abnormal way. Tumours can begin anywhere in the stomach, although most start in the glandular tissue found on the stomach's inner surface (mucosa). This type of cancer is called adenocarcinoma of the stomach (also known as gastric cancer).
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Here, you will find information about signs and symptoms, causes and risk factors, types, diagnosis, staging and prevention about stomach cancer.
Signs and symptoms of stomach cancer may include:
Indigestion (such as heartburn, bloating or burping)
A sense of fullness in the upper abdomen after eating a small meal
Nausea or vomiting (with or without blood)
Pain and difficulty swallowing
Unexplained tiredness or weakness
Stomach pain, blood in vomit
Weight loss or loss of appetite - more likely in very advanced cancer
Blood in the stool
Swelling or fluid build-up in the abdomen
A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Factors that increase your risk of stomach cancer located in the stomach body include:
Gender: Stomach cancer is more common in men than in women.
Age: There is a sharp increase in stomach cancer rates in people over age 50
Helicobacter pylori infection: Infection with Helicobacter pylori (H pylori) bacteria seems to be a major cause of stomach cancer, especially cancers in the lower (distal) part of the stomach.
Stomach lymphoma: People who have had a certain type of lymphoma of the stomach known as mucosa-associated lymphoid tissue (MALT) lymphoma have an increased risk of getting adenocarcinoma of the stomach.
Diet: An increased risk of stomach cancer is seen in people with diets that have large amounts of smoked foods, salted fish and meat, pickled vegetables and low in fresh fruit and vegetables.
Tobacco and Alcohol use: Smoking increases stomach cancer risk, particularly for cancers of the upper portion of the stomach near the esophagus.
Being overweight or obese: Being overweight or obese is a possible cause of cancers of the cardia (the upper part of the stomach nearest the esophagus).
Previous stomach surgery: Stomach cancers are more likely to develop in people who have had part of their stomach removed to treat non-cancerous diseases such as ulcers. These cancers typically develop many years after the surgery.
A family history of stomach cancer
The types of stomach cancer are:
Adenocarcinoma: Most (about 90% to 95%) cancers of the stomach are adenocarcinomas. A stomach cancer or gastric cancer almost always is an adenocarcinoma. These cancers develop from the cells that form the innermost lining of the stomach (the mucosa).
Lymphoma: These are cancers of the immune system tissue that are sometimes found in the wall of the stomach. The treatment depend on the type of lymphoma.
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Since people with stomach cancer rarely show symptoms in the early stages, the disease is often not diagnosed until it's more advanced. Diagnostic tests specifically look for suspected tumors and other abnormalities in the stomach. Stomach cancer is usually diagnosed using a number of tests, including:
An upper gastrointestinal endoscopy
A stool sample
Imaging tests, such as CT scans and X-rays
Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Knowing the stage helps to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery.
There are different stage descriptions for stomach cancer.
TNM (stands for tumour, node and metastasis) staging system:
The extent (size) of the tumor (T): How far has the cancer grown into the 5 layers of the stomach wall? Has the cancer reached nearby structures or organs?
The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes?
The spread (metastasis) to distant sites (M): Has the cancer spread to distant lymph nodes or distant organs such as the liver or lungs?
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You can take steps to reduce your risk of stomach cancer by making small changes to your everyday life.
Exercise: Regular exercise is associated with a reduced risk of stomach cancer. Try to fit physical activity into your day most days of the week.
Eat more fruits and vegetables: Try to incorporate more fruits and vegetables into your diet each day. Choose a wide variety of fruits and vegetables.
Reduce the amount of salty and smoked foods you eat: Protect your stomach by limiting these foods.
Stop smoking and alcohol consumption: If you smoke, quit. If you don't smoke, don't start. Smoking and alcohol consumption increase your risk of stomach cancer, as well as many other types of cancer.
Treating H pylori infection
Stomach cancer can be treated in a variety of different ways, depends on where in the stomach your cancer is, how big it is, whether it has spread anywhere else in your body and your general health. At CAN-C, we provide the most suitable stomach cancer treatment (in Bangalore) and an exceptional level of care to every patient.
The treatment you have for stomach cancer depends on the stage of your cancer. You might have one or more treatments, including surgery, radiotherapy, chemotherapy or targeted cancer drugs.
Surgery is part of the treatment for many different stages of stomach cancer if it can be done. Surgery may be done to remove the cancer and part or all of the stomach and some nearby lymph nodes, depending on the type and stage of stomach cancer. The type of operation usually depends on what part of the stomach the cancer is in and how much cancer is in the surrounding tissue. Different kinds of surgery can be used to treat stomach cancer:
Endoscopic resection: The surgeon will use endoscopy to remove tiny tumors from the mucosal layer. This type of treatment is for early stage stomach cancer where the chance of spread to the lymph nodes is very low.
Subtotal (partial) gastrectomy: This operation is often recommended if the cancer is only in the lower part of the stomach. It is also sometimes used for cancers that are only in the upper part of the stomach. This involves removing part of the stomach.
Total gastrectomy: This operation is done if the cancer has spread throughout the stomach. It is also often advised if the cancer is in the upper part of the stomach, near the esophagus. This involves removing the whole stomach.
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Radiation therapy uses high-energy rays or particles to kill cancer cells in a specific body area. Radiation therapy is used with chemotherapy before surgery to shrink the tumors. This allows for easier surgical removal. They may also use radiation after surgery to kill any remaining cancer cells around the stomach.
Radiation can be used in different ways to help treat stomach cancer:
Before surgery for some cancers, radiation can be used along with chemotherapy (chemo) to try to shrink the tumor to make surgery easier.
After surgery, radiation therapy can be used to kill very small remnants of the cancer that cannot be seen and removed during surgery.
Radiation therapy - especially when combined with chemo drugs may delay or prevent cancer recurrence after surgery and may help patients live longer.
Radiation therapy can be used to slow the growth and ease the symptoms of advanced stomach cancer, such as pain, bleeding, and eating problems.
External beam radiation therapy is often used to treat stomach cancer. This treatment focuses radiation on the cancer from a machine outside the body. Often, special types of external beam radiation, such three-dimensional conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) are used.
Chemotherapy (chemo) uses anti-cancer drugs that are injected into a vein or given by mouth as pills. These drugs enter the bloodstream and reach all areas of the body, making this treatment useful for cancer that has spread to organs beyond where it started. Chemotherapy is a specialist treatment that uses drugs to stop rapidly-growing cancer cells from dividing and multiplying. Chemo can be used in different ways to help treat stomach cancer:
Chemo can be given before surgery for stomach cancer. This, known as neoadjuvant treatment, can shrink the tumor and possibly make surgery easier. It may also help keep the cancer from coming back and help patients live longer. For some stages of stomach cancer, neoadjuvant chemo is one of the standard treatment options. Often, chemo is then given again after surgery.
Chemo may be given after surgery to remove the cancer. This is called adjuvant treatment. The goal of adjuvant chemo is to kill any cancer cells that may have been left behind but are too small to see. This can help keep the cancer from coming back. Often, for stomach cancer, chemo is given with radiation therapy after surgery. This combination is called chemoradiation. This may be especially helpful for cancers that could not be removed completely by surgery.
Chemo may be given as the primary (main) treatment for stomach cancer that has spread (metastasized) to distant organs. It may help shrink the cancer or slow its growth, which can relieve symptoms for some patients and help them live longer.
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Targeted drugs may work in some cases when standard chemo drugs don't. Targeted therapies recognize and attack specific proteins that cancer cells produce. While chemotherapy targets rapidly dividing cells in general, targeted medications home in on cancer cells with other characteristics.
Trastuzumab (Herceptin): Some stomach cancers produce an excess of HER2. This targets HER2, a protein that promotes cell growth.
Ramucirumab (Cyramza): This medication focuses on blocking a protein called VEGF that tells the body to produce the new blood vessels that tumors need to grow.
Other targeted therapy drugs are being used against stomach cancer.
This is a treatment that uses medicines to encourage the body's immune system to attack cancer cells. People with advanced stomach cancer who have received two or more other treatments are candidates for immunotherapy.
Immune checkpoint inhibitors:
An important part of the immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses "checkpoints" - molecules on immune cells that need to be turned on (or off) to start an immune response.
Pembrolizumab (Keytruda) targets PD-1, a protein on immune system cells called T cells that normally helps keep these cells from attacking other cells in the body. By blocking PD-1, this drug boosts the immune response against cancer cells. This can shrink some tumors or slow their growth.
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