Gastric (Stomach) Cancer

Stomach cancer, also known as gastric cancer, is a serious and potentially life-threatening disease that affects the cells lining the stomach. It is one of the most common types of cancer worldwide, with a higher incidence in certain regions and populations. To understand stomach cancer, it is important to have an overview of its characteristics and risk factors. 

If you suspect you or someone else is experiencing Stomach cancer, it is crucial to seek immediate medical attention by calling emergency services or consult with a Cancer Specialist.

Causes of Gastric (Stomach) Cancer

• Helicobacter pylori Infection: The bacterium Helicobacter pylori is one of the leading causes of stomach cancer. This infection can cause chronic inflammation in the stomach lining, leading to ulcers and changes that increase the risk of cancer. Long-term infection with H. pylori is a known risk factor for gastric cancer.

• Dietary Factors: A diet high in salty, smoked, or pickled foods, and low in fruits and vegetables, can increase the risk of developing gastric cancer. The consumption of processed meats and food with high levels of nitrates is also linked to an elevated risk. Additionally, a low intake of antioxidants like vitamin C can make the stomach lining more susceptible to cancer-causing substances.

• Family History and Genetics: A family history of gastric cancer increases an individual's risk. Inherited genetic mutations can play a role in predisposing individuals to stomach cancer. Conditions such as hereditary diffuse gastric cancer syndrome, caused by mutations in the CDH1 gene, can significantly increase the risk.

• Age and Gender: Gastric cancer is more common in individuals over the age of 50, with men being more likely to develop the disease than women. As people age, their risk of stomach cancer increases, likely due to the accumulation of genetic mutations over time.

• Smoking: Smoking is a well-established risk factor for many cancers, including gastric cancer. The chemicals in tobacco can damage the stomach lining, leading to an increased risk of cancer development.

• Obesity: Being overweight or obese has been associated with a higher risk of developing stomach cancer, particularly in the upper part of the stomach (cardia). Obesity can lead to chronic inflammation and increase the likelihood of conditions that can promote cancer growth.

• Chronic Stomach Conditions: Conditions like gastric ulcers, gastritis (inflammation of the stomach lining), and stomach polyps can increase the risk of gastric cancer. Chronic atrophic gastritis, which results in thinning and inflammation of the stomach lining, is particularly concerning for cancer development.

• Previous Stomach Surgery: People who have had stomach surgery, such as partial gastrectomy, for ulcers or other medical reasons, may have an increased risk of stomach cancer later in life. The changes in the stomach after surgery can sometimes promote cancerous growth.

• Exposure to Workplace Chemicals: Certain occupations expose individuals to chemicals that may increase the risk of gastric cancer. For example, workers in industries such as rubber, coal, and metal may be at higher risk due to exposure to toxic substances.

• Alcohol Consumption: Excessive alcohol consumption can damage the stomach lining, increase inflammation, and potentially lead to the development of gastric cancer over time.

Risk Factors of Gastric (Stomach) Cancer

• Helicobacter pylori infection
• Smoking
• Poor diet (high in salty, smoked foods)
• Family history
• Age (50+)
• Gender (more common in men)
• Chronic gastritis
• Obesity
• Previous stomach surgery
• Genetic mutations (e.g., Lynch syndrome)

Symptoms of Gastric (Stomach) Cancer

• Persistent indigestion: Discomfort in the upper abdomen, bloating, and feeling full after eating even small amounts of food.
• Loss of appetite: A significant reduction in appetite, often accompanied by early satiety (feeling full quickly).
• Unexplained weight loss: Losing weight without changes in diet or physical activity.
• Nausea and vomiting: Ongoing nausea, sometimes with vomiting, especially if the cancer causes obstruction.
• Abdominal pain or discomfort: Cramping, pressure, or aching pain in the upper abdomen, which may worsen after eating.
• Frequent heartburn or acid reflux: Symptoms that don't respond well to antacids or over-the-counter treatments.
• Blood in stool or vomit: Vomiting blood (bright red or dark, coffee-ground material) or black, tarry stools.
• Swelling or fluid buildup in the abdomen (ascites): Bloating or distention of the abdomen due to fluid accumulation.
• Fatigue: Unexplained tiredness or weakness, often due to nutrient malabsorption or the effects of the cancer.
• Difficulty swallowing (dysphagia): Feeling like food is stuck in the chest or throat, especially if the cancer is near the stomach-esophagus junction.
• Anemia: Symptoms like pale skin, dizziness, or shortness of breath due to low red blood cell count from internal bleeding.

Diagnosis for Gastric (Stomach) Cancer

• Medical History and Physical Exam: The doctor will first take a detailed medical history and perform a physical exam to check for symptoms such as abdominal pain, lumps, or signs of anemia or jaundice.

• Endoscopy (Gastroscopy): This is one of the primary methods for diagnosing stomach cancer. A flexible tube with a light and camera (endoscope) is inserted through the mouth to examine the stomach lining. The doctor can look for abnormal areas and take biopsies (tissue samples) for further analysis.

• Biopsy: During an endoscopy, the doctor may take small tissue samples (biopsies) from suspicious areas of the stomach lining. These samples are examined under a microscope to determine if cancer cells are present.

• Imaging Tests: Imaging studies help assess the size of the tumor and whether cancer has spread to other areas. Common imaging tests include:

  • CT Scan (Computed Tomography): A CT scan provides detailed cross-sectional images of the stomach and surrounding organs, helping doctors determine the extent of the cancer and check for metastasis.
  • Ultrasound: In some cases, an ultrasound may be used to detect tumors or fluid buildup in the abdomen.
  • X-rays: A special type of X-ray called a barium swallow can be used to visualize the upper gastrointestinal tract. The patient swallows a barium solution, which highlights the stomach on X-ray images.
  • Positron Emission Tomography (PET) Scan: PET scans can help detect cancer spread by showing areas of high metabolic activity, which are typically associated with cancer cells.

• Endoscopic Ultrasound (EUS): This procedure combines endoscopy with ultrasound. The endoscope has an ultrasound probe at its tip, which helps assess the tumor’s size and whether it has invaded nearby tissues or lymph nodes.

• Laparoscopy: In some cases, a laparoscopy (a minimally invasive surgery) is performed to examine the abdomen more closely and take biopsy samples from areas that may not be easily accessed through an endoscopy. This method is particularly useful for detecting metastasis.

• Blood Tests: While there is no specific blood test to diagnose stomach cancer, certain blood tests can provide valuable information. These tests can help assess general health, detect anemia (common in stomach cancer), or indicate the presence of tumor markers (such as CEA or CA 19-9) that may be elevated in some patients with stomach cancer.

• Genetic Testing: In cases where stomach cancer may have a genetic link (such as hereditary diffuse gastric cancer), genetic testing may be done to look for inherited mutations that increase the risk of developing the disease.

Treatments for Gastric (Stomach) Cancer

Surgery is a key component in the treatment plan for stomach cancer. It involves removing part or all of the stomach, nearby lymph nodes, and sometimes other surrounding tissues. This

Surgery

Surgery is the primary treatment for early-stage stomach cancer, where the cancer is confined to the stomach or surrounding tissues. The types of surgery include:

• Partial Gastrectomy: In this procedure, the portion of the stomach containing the tumor is removed. The remaining part of the stomach is reattached to the small intestine.
• Total Gastrectomy: In cases where the cancer has spread throughout the stomach, a total gastrectomy may be performed, which involves the removal of the entire stomach. Afterward, the esophagus is connected directly to the small intestine.
• Lymph Node Removal: Often, lymph nodes near the stomach are removed to check for cancer spread.

Surgery is typically followed by other treatments to address any remaining cancer cells.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells or stop their growth. It may be used:

• Before surgery (Neoadjuvant chemotherapy): To shrink tumors and make them easier to remove surgically.
• After surgery (Adjuvant chemotherapy): To kill any remaining cancer cells and reduce the risk of recurrence.
• For advanced cancer: If the cancer is not operable or has spread to other parts of the body, chemotherapy can help control its growth and relieve symptoms.

Chemotherapy drugs can be given orally, intravenously, or directly into the abdominal cavity in some cases.

Radiation Therapy

Radiation therapy uses high-energy rays to kill or shrink cancer cells. It is not often used as the primary treatment for stomach cancer but may be helpful in certain situations:

• After surgery: To kill any remaining cancer cells that might not have been removed.
• Palliative care: To relieve symptoms, such as pain or obstruction, caused by advanced cancer.

procedure aims to remove the tumor and any affected areas to prevent further spread. Another common treatment option is chemotherapy. This involves using drugs to kill cancer cells throughout the body. Chemotherapy can be administered before surgery (neoadjuvant) to shrink tumors or after surgery (adjuvant) to destroy any remaining cancer cells. Radiation therapy may also be used in combination with surgery or chemotherapy. It uses high-energy beams to target and kill cancer cells. This can help reduce tumor size before surgery or destroy any remaining cancer cells after surgery. In some cases, targeted therapy may be recommended. This type of treatment uses drugs that specifically target certain genetic mutations or proteins present in stomach cancer cells. By targeting these specific abnormalities, targeted therapy can slow down tumor growth and improve patient outcomes. Immunotherapy is another emerging approach in treating stomach cancer. It works by boosting the body's immune system to recognize and attack cancer cells more effectively. This type of treatment has shown promising results in certain cases where other treatments have been less effective. It's important for patients diagnosed with stomach cancer to work closely with their healthcare team to determine the most appropriate treatment plan based on their specific situation. Each case is unique, and a personalized approach is crucial for achieving optimal outcomes in managing this disease.

Preventive Measures for Gastric (Stomach) Cancer

• Increase intake of fruits and vegetables: A diet rich in fruits and vegetables provides antioxidants and vitamins, which may help reduce the risk of stomach cancer. Cruciferous vegetables (like broccoli, cauliflower, and cabbage) are particularly beneficial.
• Limit consumption of smoked, salted, and pickled foods: These foods contain compounds, such as nitrates and nitrites, which may increase the risk of stomach cancer. Processed meats, like bacon and sausages, are also associated with a higher risk.
• Avoid excessive alcohol consumption: Drinking large amounts of alcohol can increase the risk of stomach cancer, especially in combination with smoking. Limiting alcohol intake to moderate levels or avoiding it altogether can help reduce risk.
• Choose lean meats and low-fat cooking methods: Cooking meats at high temperatures (such as grilling or barbecuing) can produce carcinogenic substances. Opting for lean cuts of meat and using healthier cooking methods, like baking or steaming, may lower risk.
• Increase fiber intake: A high-fiber diet, particularly from whole grains, may protect against stomach cancer by promoting a healthy digestive system.

• Avoid tobacco use: Smoking is a major risk factor for many cancers, including stomach cancer. Quitting smoking can significantly reduce the risk of developing the disease. Avoiding exposure to secondhand smoke is also important.

• Treat H. pylori infections: Chronic infection with the bacterium Helicobacter pylori is a known risk factor for stomach cancer. If you are diagnosed with an H. pylori infection, it is important to follow through with antibiotic treatment as prescribed by a healthcare provider to eradicate the bacteria and reduce cancer risk.
• Regular check-ups for at-risk individuals: People with a family history of gastric cancer or those from regions where H. pylori infection is common may benefit from regular screening for the infection.

Do's & Don’t's

When it comes to stomach cancer, knowing the do's and don'ts can make a significant difference in managing the condition and improving overall health. By following these guidelines, individuals can take proactive steps to support their well-being and potentially reduce the risk of complications. 

If you suspect you or someone else is experiencing Stomach cancer, it is crucial to seek immediate medical attention by calling emergency services or consult with a Cancer Specialist.