Stomach cancer: What patients should know about

Introduction, what is stomach cancer

Stomach cancer, also known as gastric cancer, is a type of cancer that starts in the stomach. The stomach is a muscular, sac-like organ located in the upper abdomen, just below the ribs. It plays a crucial role in the digestive system, breaking down food and liquids before they move into the small intestine.

Stomach cancer begins when the cells lining the stomach start to grow and divide uncontrollably, forming a tumor. Over time, this tumor can grow and spread to other parts of the body, making it more difficult to treat.

Causes and risk factors

The exact cause of stomach cancer is not fully understood, but several risk factors have been identified:

1. Helicobacter pylori (H. pylori) infection: This bacterial infection in the stomach lining is a major risk factor for gastric cancer. H. pylori can cause chronic inflammation and ulcers, which may eventually lead to cancer. Not all people with H. pylori infection will develop stomach cancer, but it significantly increases the risk.
2. Age: The risk of gastric cancer increases with age, with most cases occurring in people over the age of 60.
3. Diet: A diet high in smoked, salted, or preserved foods, and low in fruits and vegetables, may increase the risk of gastric cancer.
4. Smoking: Tobacco use is a significant risk factor for gastric cancer.
5. Obesity: Being overweight or obese may increase the risk of developing gastric cancer.
6. Family history: Having a close relative with gastric cancer may increase an individual’s risk.
7. Previous stomach surgery: People who have undergone certain types of stomach surgery, such as partial gastrectomy, may have a higher risk of developing gastric cancer.
8. Chronic gastritis: Long-term inflammation of the stomach lining, known as chronic gastritis, can increase the risk of gastric cancer.

It’s important to note that having one or more risk factors does not necessarily mean that an individual will develop stomach cancer. However, being aware of these risk factors can help in early detection and prevention.

Subtypes

Stomach cancer can be classified into several subtypes based on the location and characteristics of the tumor:

1. Adenocarcinoma: This is the most common type of stomach cancer, accounting for about 90-95% of all cases. Adenocarcinomas develop from the glandular cells that line the stomach’s inner surface.
2. Intestinal type: This subtype of adenocarcinoma is more common in older individuals and is often associated with chronic inflammation or precancerous conditions like intestinal metaplasia.
3. Diffuse type: This subtype of adenocarcinoma is more common in younger individuals and tends to spread more rapidly throughout the stomach wall.
4. Gastroesophageal junction (GEJ) cancer: This type of cancer starts at the junction where the esophagus meets the stomach and may be treated similarly to esophageal cancer.
5. MALT Lymphomas: These are cancers that start in the lymphatic system of mucosal membranes and can sometimes involve the stomach.
6. Gastrointestinal stromal tumors (GISTs): These rare tumors start in the connective tissue cells of the stomach wall.

Understanding the subtype of stomach cancer is important for determining the most appropriate treatment approach.

Symptoms

In the early stages, stomach cancer may not cause any noticeable symptoms. As the cancer grows and spreads, however, various symptoms may appear:

Indigestion or Heartburn

Persistent indigestion, bloating, or a burning sensation in the upper abdomen or chest may be an early sign of stomach cancer. This happens because the cancer can cause irritation and inflammation in the stomach lining, leading to these uncomfortable sensations.

Loss of Appetite

Feeling full quickly after eating or losing interest in food can be a symptom of stomach cancer. This occurs because the tumor can take up space in the stomach, reducing its capacity and making you feel full sooner than usual.

Unintentional Weight Loss

Unexplained weight loss, even without changes in diet or exercise, may be a sign of stomach cancer. Cancer cells consume a lot of the body’s energy and nutrients, leading to weight loss. Additionally, the cancer can cause a loss of appetite and difficulty eating, further contributing to weight loss.

Abdominal Pain

Persistent pain or discomfort in the upper abdomen can be a symptom of stomach cancer. This pain is often due to the tumor pressing against other organs or nerves, causing discomfort.

Nausea and Vomiting

Frequent nausea or vomiting, especially if it occurs after eating, may be a sign of stomach cancer. The tumor can obstruct the normal passage of food through the digestive tract, leading to nausea and vomiting.

Difficulty Swallowing

If the cancer is located near the esophagus, it may cause difficulty swallowing solid or liquid foods. This happens because the tumor can narrow the passageway, making it hard for food to pass through.

Blood in Vomit or Stool

Vomiting blood or passing black, tarry stools may indicate bleeding from the stomach, which can be a sign of stomach cancer. The tumor can erode blood vessels in the stomach lining, leading to bleeding. When this blood is digested, it turns black, resulting in tarry stools.

It’s important to note that these symptoms can also be caused by other, less serious conditions. However, if any of these symptoms persist, it’s crucial to consult a healthcare professional for proper evaluation and diagnosis.

This image is taken from dradityakulkarni.com

Diagnosis

If stomach cancer is suspected, several diagnostic tests may be performed:

1. Physical examination: A healthcare professional may perform a physical examination to check for any abnormalities in the abdomen or other areas of the body.
2. Blood tests: Blood tests may be ordered to check for signs of anemia or other abnormalities that could indicate stomach cancer.
3. Endoscopy: An endoscopy is a procedure in which a thin, flexible tube with a camera on the end is inserted through the mouth and into the stomach. This allows the doctor to examine the stomach lining and take tissue samples (biopsy) for further analysis.
4. Imaging tests: Imaging tests such as computed tomography (CT) scans, positron emission tomography (PET) scans, or magnetic resonance imaging (MRI) may be used to determine the extent of the cancer and whether it has spread to other parts of the body.
5. Biopsy: A biopsy involves taking a small sample of tissue from the stomach for examination under a microscope. This is typically done during an endoscopy and is essential for confirming the diagnosis of stomach cancer.

Once the diagnosis is confirmed, additional tests may be performed to determine the stage of the cancer, which helps guide treatment decisions.

Prevention

While it’s not always possible to prevent stomach cancer, there are several steps that can be taken to reduce the risk:

1. Maintain a healthy diet: Eat a diet rich in fruits, vegetables, and whole grains, and limit the consumption of smoked, salted, or preserved foods.
2. Quit smoking: Smoking is a significant risk factor for stomach cancer, so quitting smoking can greatly reduce the risk.
3. Manage weight: Maintaining a healthy body weight through a balanced diet and regular exercise can help reduce the risk of stomach cancer.
4. Treat H. pylori infection: If an H. pylori infection is detected, it’s important to receive appropriate treatment to reduce the risk of stomach cancer.
5. Regular check-ups: For individuals at high risk, such as those with a family history of stomach cancer or chronic gastritis, regular check-ups and screening may be recommended.
6. Limit alcohol consumption: Excessive alcohol consumption has been linked to an increased risk of stomach cancer, so it’s advisable to limit or avoid alcohol.

By adopting a healthy lifestyle and addressing any underlying risk factors, individuals can potentially reduce their risk of developing stomach cancer.

Prognosis

The prognosis, or outlook, for stomach cancer depends on several factors, including the stage of the cancer at the time of diagnosis, the subtype of the cancer, and the individual’s overall health. In general, the earlier stomach cancer is detected and treated, the better the prognosis.

This image is taken from rabab.org.lb

Treatment, side effects

The treatment for stomach cancer depends on various factors, including the stage of the cancer, the individual’s overall health, and the specific subtype of the cancer. Treatment options may include:

1. Surgery: Surgery is often the primary treatment for stomach cancer, especially in the early stages. The goal of surgery is to remove the tumor and any affected lymph nodes. Depending on the extent of the cancer, a partial or complete removal of the stomach (gastrectomy) may be performed.
2. Chemotherapy: Chemotherapy involves the use of anti-cancer drugs to kill cancer cells. It may be given before surgery (neoadjuvant chemotherapy) to shrink the tumor, after surgery (adjuvant chemotherapy) to kill any remaining cancer cells, or as the primary treatment for advanced or metastatic stomach cancer.
3. Radiation therapy: Radiation therapy uses high-energy beams to kill cancer cells. It may be used in combination with chemotherapy (chemoradiation) before or after surgery, or as a palliative treatment to relieve symptoms in advanced cases.
4. Targeted therapy: Targeted therapies are drugs that specifically target certain molecules or pathways involved in cancer cell growth and survival. These therapies may be used in combination with chemotherapy for certain types of stomach cancer.
5. Immunotherapy: Immunotherapy is a treatment that helps the body’s immune system recognize and attack cancer cells. It may be used in combination with other treatments for certain types of stomach cancer.

Each treatment option carries its own set of potential side effects, which can vary depending on the specific treatment and the individual’s response. Common side effects of stomach cancer treatment may include:

• Fatigue
• Nausea and vomiting
• Loss of appetite
• Hair loss
• Mouth sores
• Diarrhea or constipation
• Increased risk of infection
• Skin changes
• Nerve damage (neuropathy)

It’s important to discuss the potential side effects with a healthcare professional and to report any side effects promptly. In many cases, medications or other interventions can help manage or alleviate side effects.

Additional interventions

In addition to the primary treatments mentioned above, other interventions may be used to manage symptoms or improve the quality of life for individuals with stomach cancer:

1. Nutritional support: Stomach cancer and its treatments can often lead to nutritional deficiencies or difficulties with eating and digestion. Nutritional support, such as dietary modifications, supplements, or feeding tubes, may be recommended to ensure adequate nutrition.
2. Pain management: Pain is a common symptom in advanced stomach cancer, and various pain management strategies, including medications, radiation therapy, or nerve blocks, may be employed to provide relief.
3. Palliative care: Palliative care focuses on relieving symptoms and improving quality of life for individuals with serious illnesses, such as advanced stomach cancer. It can be provided alongside curative treatments or as the primary focus of care when curative treatments are no longer an option.
4. Supportive care: Supportive care services, such as counseling, support groups, or complementary therapies (e.g., massage, acupuncture), can help individuals cope with the physical, emotional, and practical challenges of stomach cancer and its treatment.

Newest options and ongoing trials

Research into stomach cancer is ongoing, and new treatment options and clinical trials are continuously being developed and evaluated. Some of the newest and most promising areas of research include:

1. Targeted therapies: Researchers are working to identify new molecular targets and develop targeted therapies that can more precisely attack stomach cancer cells while minimizing harm to healthy cells.
2. Immunotherapies: Immunotherapy has shown promising results in treating certain types of stomach cancer, and ongoing research is exploring new immunotherapy agents and combinations with other treatments.
3. Personalized medicine: With advances in genomic profiling and molecular testing, researchers are working to develop personalized treatment approaches tailored to the specific genetic and molecular characteristics of an individual’s cancer.
4. Novel drug delivery systems: New drug delivery systems, such as nanoparticles or targeted drug delivery methods, are being explored to improve the effectiveness and reduce the side effects of existing cancer treatments.
5. Combination therapies: Researchers are investigating the potential benefits of combining different types of treatments, such as chemotherapy, targeted therapy, and immunotherapy, to achieve better outcomes.
6. Early detection and screening: Efforts are underway to develop better methods for early detection and screening of stomach cancer, which can significantly improve treatment outcomes.

Many clinical trials are currently underway to evaluate the safety and effectiveness of these new approaches. Participation in clinical trials can provide access to cutting-edge treatments and contribute to the advancement of stomach cancer research.

More information about ongoing clinical trials can be found on clinicaltrials.gov

Patient survivorship

Surviving stomach cancer is a significant achievement, but the journey does not end with the completion of treatment. Individuals who have undergone treatment for stomach cancer may face various challenges and long-term effects, including:

1. Physical effects: Stomach cancer and its treatments can have lasting physical effects, such as fatigue, digestive issues (e.g., diarrhea, constipation, malabsorption), weight loss, and changes in appetite or taste.
2. Emotional and psychological effects: The experience of cancer diagnosis and treatment can take an emotional toll, leading to anxiety, depression, or post-traumatic stress disorder (PTSD). Counseling, support groups, or mental health services may be beneficial.
3. Nutritional challenges: Depending on the extent of stomach surgery or other treatments, individuals may face long-term nutritional challenges and may require dietary modifications or supplementation.
4. Risk of recurrence: There is always a risk of cancer recurrence, which can cause anxiety and stress. Regular follow-up appointments and monitoring are essential for early detection of any potential recurrence.
5. Fertility and sexual health concerns: Certain treatments for stomach cancer can affect fertility and sexual function, which may require additional support or interventions.
6. Financial and practical concerns: The costs associated with cancer treatment and the potential impact on employment or daily activities can create financial and practical challenges for survivors and their families.
7. Lifestyle adjustments: Survivors may need to make lifestyle adjustments to accommodate the long-term effects of stomach cancer and its treatments, such as changes in diet, exercise routines, or daily activities.

Survivorship care plans, which outline the specific follow-up care and support services needed for each individual, can help address these challenges and promote overall well-being for stomach cancer survivors.

This informative video is taken from Hope For Stomach Cancer

Conclusion

Stomach cancer is a serious condition that requires prompt diagnosis and appropriate treatment. While the causes are not fully understood, several risk factors have been identified, and adopting a healthy lifestyle can help reduce the risk.
Early detection and timely treatment are crucial for improving the prognosis and increasing the chances of survival. Treatment options may include surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy, depending on the stage and subtype of the cancer.
Throughout the journey, individuals with stomach cancer may face various challenges, including physical, emotional, and practical concerns.

Supportive care services, such as nutritional support, pain management, palliative care, and counseling, can play a vital role in improving the quality of life and addressing the unique needs of each individual.
Ongoing research and clinical trials offer hope for new and more effective treatment options, as well as improved methods for early detection and personalized care. By working closely with a multidisciplinary team of healthcare professionals and staying informed about the latest developments, individuals with stomach cancer can navigate their treatment journey with greater confidence and support.

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