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Stomach Cancer and its treatment is not often talked about like other more common cancer types. Here, we will discuss the causes, risk factors, types, expected health implications, and management. We will also discuss the life expectancy and quality of life one can expect with this health challenge.
What is stomach cancer?
To understand stomach cancers properly, let us first briefly revisit the anatomy and physiology of the stomach. The stomach is a sack-like organ that is located in the abdominal area. It is a crucial part of the digestive system due to its function.
Masticated food follows the esophagus, which joins the stomach at the gastroesophageal junction beneath the diaphragm. The stomach then secretes gastric juice, which mixes with the food and begins digesting it. The digested food then enters the first part of the small intestine, the duodenum, where further digestion and absorption occur.
Stomach cancers occur when there is an abnormal growth of cells in the stomach, also known as gastric cancer. Stomach cancer can occur in any part of the stomach. However, they mainly occur in the body of the stomach. Stomach cancers tend to develop very slowly, and it can be many years before any symptom is noticed. This makes it difficult to detect and diagnose. It also makes its therapy hard due to the fact that it would have already spread to other parts of the body before its detection. The part of the stomach affected by the cancer may cause different types of symptoms and may have different resolutions or outcomes.
Types of stomach cancers
Adenocarcinomas – this accounts for up to 90-95% of stomach cancers. They usually develop from the gland cells in the mucosa of the stomach (its innermost lining).
Gastrointestinal tumors – these start in the particular nerve cells located in the wall of the stomach. It is a type of tissue sarcoma.
Neuroendocrine tumors (carcinoids) – they originate in the neuroendocrine cells present in a lot of areas in the body.
Lymphomas – originate from the cells in the immune system. Most lymphomas that start in the stomach are some types of non-Hodgkin’s lymphoma.
Other cancers of the stomach – these types of cancers can start in the stomach but are very rare in occurrence. They include leiomyosarcomas, squamous cell carcinomas, small cell carcinomas, etc.
What are the risk factors of stomach cancer?
It is not clear what causes stomach cancers; experts believe they start when the lining of the stomach has been injured. However, there are some factors that increase the risk of an individual developing stomach cancer. They include:
- Gastroesophageal reflux disease
- Infections in the stomach due to Helicobacter pylori
- Growth of polyps in the stomach
- High diets of salty and smoked food
After the stomach lining has been damaged, these cancer cells multiply quickly. They quickly form a mass of cells that outlive the normal stomach cells, this causes a lot of extra cells in the stomach, and a tumor may form. These cells may break away and invade other body tissues, which is called metastasis.
What are the symptoms of stomach cancer?
Stomach cancer may not present with any symptoms in the initial stages. Mild sensations like indigestion or upper belly pain that occur are usually dismissed or blamed on other conditions. In the later stages, the symptoms are noticed, some of which include:
- Black stool
- Weight loss
- Feeling bloated after meals
- Heartburn and indigestion
Metastatic stomach cancers can spread to other parts of the body where they cause symptoms relative to where they spread.
Depending on the progression of the cancer, a healthcare practitioner may be able to feel a mass in your stomach during a physical examination. Your stomach may also feel full frequently, swollen, or even painful. This pain may be mild, but it will get more severe with the progression of cancer.
Diagnosis of stomach cancer
When you visit the hospital due to your symptoms, the healthcare provider will enquire about your medical history and symptoms and carry out a physical examination. They may also order various tests to determine the severity of the cancer. Staging allows the healthcare provider to determine the severity of the cancer. With stomach cancer, staging ranges from 0-IV (0-4). Stage 0 is when the cancer is still restricted to the stomach lining, and IV is when it has spread to other organs of the body. Some of the techniques used to diagnose stomach cancers include:
- Upper endoscopy – involves inserting a thin tube with a camera at its tip (endoscope) into the stomach. This tube can also allow the excision of small tissues from the mass with surgical tools. These samples can then be tested in the lab. Another type of endoscopy has an ultrasound probe at the end instead of a camera. They enable images to be taken of the cancer to ascertain its spread in the stomach.
- Blood tests – this can give information on the functioning of the body organs. This may give insight into the spread of cancer.
- Laparoscopy – this allows access to the mass through surgery. It is usually used when less invasive methods do not provide clear information on the cancer.
- Imaging tests – these include CT scans, MRI, and barium meal radiology. A PET scan can also reveal the spread of cancer.
Therapy in stomach cancer
This largely depends on the cancer’s spread and the individual’s health and preferences. The individual will often be attended to and advised by a care team, which includes the primary health care provider, a cancer specialist, and a gastroenterologist. They also help in directing the therapy of the patient. Some of the therapies may be done together in order to achieve better results. They include:
Surgery – this is aimed at removing either the precancerous cells, a tumor, or even a part of the stomach. An upper endoscopy surgery is employed when cancer has not invaded the inner lining of the stomach, it can be done through endoscopy, and the tumor is removed through the tube. A gastrectomy is used when the tumor has spread beyond the superficial layer of the stomach. It might be subtotal or total gastrectomy.
Chemotherapy – this technique is aimed at using drugs to target and shrink the cancer cells, which makes them easier to remove during surgery or kill the remaining cells after surgery. It can be combined with radiation or targeted drug therapy.
Radiation – this is when targeted energy beams like X-rays are used to destroy cancer cells. This technique alone is not adequate for eliminating stomach cancers, but it can be combined with chemotherapy and surgery. It can also help in relieving symptoms.
Targeted drug therapy – when weaknesses in the cancer are identified, and drugs targeted at those weaknesses are administered. This therapy is often combined with chemotherapy in advanced or recurring cancer.
Palliative care – this is targeted at making the patient feel comfortable and easing the side effects of the treatment administered. It helps improve the quality of life of the patient.
What are the chances for someone with stomach cancer?
This depends on when it was detected. If it is caught in its initial stages, the prognosis is better than when it is detected late. The 5-year survival rate is usually high for minimally spread cancers and low for advanced spread. Your healthcare provider will inform you of the prognosis, which is defined by the type of stomach cancer, your general health, its spread, and its response to the administered treatment.
Some tips on avoiding stomach cancers
Stomach cancers cannot be prevented, but you can reduce the risks through the following ways:
- Promptly treating gastritis, ulcers, and other stomach conditions
- Healthy eating
- Avoiding smoking
- Regular exercises
- Maintaining a healthy weight
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