Gastric Cancer

Overview of Gastric Cancer

Gastric cancer is also known as (Meday ka sartan/  معدے کا سرطان ) is an abnormal replication of gastric cancer cells produced in the lining of the stomach. It is also called stomach cancer.

Gastric cancer is slow-growing cancer and difficult to diagnose because of not appearing any symptoms at the earlier stages. 

Prevalence of Gastric Cancer

Gastric cancer is the 4th most common cancer among all and 2nd leading cause of death worldwide. About 6 out of 10 cases were reported with gastric cancer over the age of people 65 years.  

In Pakistan, the incidence rate of gastric cancer accounts for as low as 1.4% and as high as 1.8% in people. People with stomach cancer recover in the early stages. The average survival rate is about 30% of people who can survive this cancer for at least about 5 years.

Signs and Symptoms of Gastric Cancer

Generally, there are no early signs or symptoms of stomach cancer until it becomes malignant and affects other organs of the body.

Common signs and symptoms of malignant stomach cancer are as follows:

  • Nausea and vomiting
  • Frequent heartburn
  • Loss of appetite, sometimes accompanied by sudden weight loss
  • Constant bloating
  • Feeling of fullness
  • Bloody stools
  • Jaundice
  • Excessive fatigue
  • Stomach pain worsens after a meal

Types of Gastric Cancer

The types of gastric cancer are further categorized into the following forms, on the basis of the different parts of the stomach, type of cells, and how these cells spread to other areas of the body.

  • Adenocarcinoma

Adenocarcinoma is the most common type of gastric cancer among all. It affects the innermost lining of the stomach (mucosa) due to which abnormal growth of gastric cells is observed.

  • Lymphoma

Lymphoma is a type of cancer that affects the tissue of the immune system that is present in the wall of the stomach. Later on, the cells in the tissues form a cancerous cell lump over there.

  • Gastrointestinal Stromal Tumour (GIST)

It is a rare type of tumor that results from the impaired growth of interstitial cells named Cajal. These cells are located on the wall of the stomach. It can affect anywhere in the digestive tract but mostly in the stomach. GIST tumors are either benign or malignant.

  • Carcinoid Tumour

These types of tumors begin to stimulate hormone-making cells of the stomach. They are mostly benign, which means; do not spread to other parts of the body.

  • Other Cancer Types

Other types of cancer, such as squamous cell carcinoma, small cell carcinoma, and leiomyosarcoma, can also cause stomach cancer. These cancers rarely exist.

Causes of Gastric Cancer

Researchers are still investigating the exact cause of gastric cancer but some triggers increase the risk of stomach cancer. For example, high smoked or salted food, processed meat, less eating of vegetables, smoking or drinking alcohol can cause stomach cancer. 

Another way of increasing cancer is Helicobacter pylori, a microorganism secreted in the inner lining of the stomach, if any abnormality in it, may lead to cancer development.

Stomach cancer is common in the following groups of people:

  • Older adults, above 50 years and older
  • Men
  • Smokers
  • People had a family history of the disease
  • Mostly Asian people (especially Korean or Japanese), South American, or Belarusian ancestry

Other conditions that may increase the risk of cancer are below:

 

  • Ulcer or sores forms in the lining of the stomach
  • Lymphoma (a group of blood cancers)
  • Tumors in other parts of the digestive system
  • Stomach polyps (abnormal growths of tissue that form on the lining of the stomach)
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Risk Factors of Gastric Cancer

Some of the important risk factors for gastric cancers include:

  • Family History
  • Age (more common in older age)
  • Gender as males are more affected
  • Being overweight
  • GERD 
  • Poor dietary habits (too much salty and smoked food)
  • Stomach inflammation
  • Smoking and alcohol consumption
  • Stomach polyps
  • H.pylori infection

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Prevention

In order to minimize the risk of gastric cancer are as follows:

  • Maintain a healthy weight
  • Eat a healthy diet full of fruits and vegetables
  • Less amount of salts use in food
  • Eat smoked or oily foods in a balanced amount
  • Avoid smoking

Seek medical care if a person is feeling the following signs and symptoms:

  • Nausea and vomiting
  • Frequent heartburn
  • Loss of appetite
  • Constant bloating
  • Feeling of fullness
  • Bloody stools
  • Excessive fatigue
  • Stomach pain, worsens after a meal
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Diagnosis

The involvement of several factors leads to gastric cancer at the specific site of the stomach. Although this cancer diagnosis is difficult to identify, usually a person gets to know until it is at an advanced stage or performing the tests for another disease.

After getting a complete medical history, doctors usually recommend the following diagnostic tests:

  • Upper Endoscopy Test- A flexible thin tube attached to a camera passes through the throat into the stomach for checking the signs of cancer in endoscopy.
  • Biopsy- Doctors scrap off the sample of tissue from the affected area for analysis in the biopsy. This is done for the determination of cancer cells in the sample.
  • Imaging Studies- The imaging tests are performed to check the clear and detailed scans of the stomach at various angles. This includes CT scans, MRIs, and a special type of X-ray exam called a barium swallow.

If doctors determine the extent (stage) of gastric cancer, then the following tests are performed.

  • Blood Tests- Blood tests are used to measure the function of the organ whether the stomach or other parts of the body are working properly or not such as the liver. 
  • Endoscopic Ultrasound- A thin tube with a camera is inserted through the throat to the stomach. A special ultrasound instrument creates images of the stomach. This is helpful for the identification of the extent of cancer to the stomach wall and other areas of the body.
  • Imaging Tests- Along with the above tests as aforementioned in imaging studies, positron emission tomography (PET) also includes them.
  • Exploratory Surgery- This surgery may recommend identifying the signs of gastric cancer if it expands beyond the stomach like the chest or abdomen area. This surgery is operated laparoscopically. It means, surgeons, make small holes in the abdomen and insert a special camera through them. This is used for monitoring the growth of abnormal cells through images. 

 

All these staging tests are the approach to finding the stages of cancer that range from benign to malignant.

 

Treatment of Gastric Cancer | When to Consult a Doctor

The treatment of gastric cancer is done through either natural remedies or medical treatment. Mainly, if any symptoms appear in affected patients, they usually try to treat it naturally.

1. Natural Remedies

The following are the best herbs used for the natural cure of gastric cancer symptoms:

  • Foods containing Quercetin
  • Indian gooseberry
  • Pineapple
  • Turmeric
  • Avoid high protein diet
  • Curcumin
  • Green vegetables

2. Medical Treatment

The medical treatment is used for gastric cancer after being diagnosed. The treatment options are efficient for gastric cancer metastasis to the liver. It means, as the tumour starts to metastasize, the following treatment options are the best approach for the patients.

  • Surgery

In this procedure, the removal of a tumor from the stomach either completely or partially depends on the extent of gastric cancer. This procedure is known as a gastrectomy.

In some cases, oncologists may recommend chemotherapy or radiation therapy after surgery to prevent the recurrence.

  • Chemotherapy

In some cases, it is conducted along with other treatments. It involves cancer-killing drugs that help to control the growth of cells. This is helpful to prevent the tumor at gastric cancer metastasis sites, such as the liver.

Chemotherapy may be used alone or in combination with targeted drug therapy for the treatment of metastatic gastric cancer.

  • Radiation Therapy

Gastric cancer radiotherapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. It can be used before the surgery to shrink or remove the tumor from the stomach. Also, be used after surgery to kill remaining cancer.

It can also be combined with chemotherapy to give better outcomes to the patients.

For metastatic gastric cancer, radiation therapy is more effective than surgery because of causing fewer side effects such as pain and bleeding.

  • Targeted Drug Therapy

In this therapy, cancer drugs or other measures are used to target the specific site of cancer cells and destroy them. For gastric cancer, targeted drug therapy is given with chemotherapy for advanced treatment of cancer.

Mostly, surgeons may test the cancer cells to check which targeted drugs are most effective.

  • Immunotherapy

Immunotherapy is a drug treatment that makes the immune system kill cancer efficiently. This is done by interfering with the cancer cells producing proteins due to gastric cancer. 

For gastric cancer, immunotherapy might be used for advanced cancer but stop the relapse of it.

  • Supportive (Palliative) Care

After the treatment, palliative care is provided to the patients to reduce the after-effects of it. This helps to improve the quality of life of patients. 

During or after treatment, the patients should attend follow-up sessions for careful monitoring of them. Otherwise, the chance of relapse may occur.

 

In case you exhibit any concerning signs and symptoms of gastric cancer, consult an oncologist as soon as possible.