Stomach cancer – Best oncologist in Delhi

What Is Stomach Cancer?

It occurs when abnormal cells or cancerous cells start on the linings of the stomach, and the most common stomach cancer is adenocarcinoma.

 Types

• Adenocarcinoma: one of stomach cancer  types that develop from the inner linings of the stomach; the most common type of it
• Lymphoma: a cancer of the immune system that starts where the lymphatic tissues are situated, such as the stomach; it occurs rarely
• A gastrointestinal stromal tumor (GIST): a type of cancer in the stomach that develops in the cells (interstitial cells of Cajal) of the stomach wall; it can be a benign or metastatic form of cancer.
• Carcinoid tumor: is a type of neuroendocrine tumor that develops in the digestive tract; it grows slowly and manifests symptoms on its later stage

 Stages

How many stages of it are there? There are five stomach cancer stages, which define the severity and extent of cancer.

• Stage 0 (Carcinoma in situ): a group of abnormal cells (high-grade dysplasia) is present in the lining of the stomach, or on the top layer of cells of the mucosa
• Stage I: the tumor from the top layer of cells of the mucosa has reached the layers below: lamina propria, muscularis mucosa, or submucosa; it may not or may have lymph node involvement (1-2 nodes)
• Stage II: cancer cells have extended to the deeper layers of the stomach and may not or may have lymph node involvement (1-15 lymph nodes)
• Stage III: it can involve all stomach layers, has spread to nearby organs and structures, or adjacent lymph node involvement (1to > 16 lymph nodes)
• Stage IV: cancer cells have spread to all stomach layers, and may not or may have lymph node involvement. But has already reached distant organs such as the brain, lungs, liver, or peritoneum.

 Symptoms

• The bloated feeling after food ingestion
• Heartburn
• Indigestion
• Mild nausea
• Loss of desire for food

symptoms in advance stages:

• Persistent vomiting
• Stomach pain
• Blood in the stool- a sign of bleeding in the digestive tract
• Unexplained weight loss
• Difficulty in swallowing
• Jaundice- the skin, eyes, and mucous membranes become yellow
• Ascites- accumulation of fluid in the abdomen

 Risks

Who Gets it? There are various factors on how a person can develop cancer in the stomach. Here are some risks:

• Family history of stomach cancer
• Male gender
• Obesity
• Old age
• Diet high in salt and smoked foods
• Less intake of fruits and vegetables
• Eating foods that are not prepared well and improperly stored
• Smoking
• Stomach diseases
  • Chronic gastritis: chronic inflammation in the stomach
  • Polyps in the stomach
  • Helicobacter pylori infection in the stomach
  • Pernicious anemia
  • Intestinal metaplasia
  • Epstein-Barr Virus

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 Diagnosis

How it is detected? Cancer in the stomach is detected by an assessment from the doctor and undergoing tests or procedures that will guide doctors in stomach cancer diagnosis and staging.

1. Obtaining history and physical assessment: the physician will ask about stomach cancer symptoms that you have experienced and obtain data if you have stomach cancer risk factors. The physician will perform a physical assessment such as palpation of the abdomen to determine if you have stomach cancer signs.
2. Upper Endoscopy: the leading test for stomach cancer diagnosis. Through upper endoscopy, the doctor can visualize the linings of the esophagus, stomach, and part of the small intestines.
3. Biopsy If any unusual growth or abnormal areas is seen during endoscopy, the doctor can take a small sample of tissues that will be sent to the laboratory to check for the presence of cancer cells.
4. Laboratory tests
   • Complete blood count (CBC): to check for decreased hemoglobin levels, it could be due to bleeding in the digestive tract
   • Fecal occult blood test: to determine the presence of blood in the stool that cannot be seen by the naked eyes
5. Imaging tests: done to determine if a suspected part of the body is cancerous, the extent of cancer, or to evaluate if the treatment has been effective to it.
   • Chest X-ray
   • Positron Emission Tomography (PET) Scan
   • Magnetic Resonance Imaging (MRI)
   • CT-scan
   • Upper GI series

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 Treatment

• Surgery
  • Endoscopic resection: it treatment that is performed to a very early stage of cancer in the stomach. The doctor will use an endoscope and pass it through the mouth going down the stomach, and then surgical instruments are inserted into the endoscope to remove the tumor and some adjacent healthy cells on the stomach linings.
  • Subtotal (Partial) Gastrectomy: surgical removal of the part of the stomach with cancer including adjacent lymph nodes, organs, and structures close to the tumor.
  • Total Gastrectomy: surgical removal of the whole stomach, adjacent lymph nodes, some parts of the esophagus, some part of the small intestine or the duodenum, and nearby tissues. The remaining esophagus will be connected to the small intestine.
• Radiation therapy: it treatment that utilizes high energy x-rays to eradicate cancer cells and stop their growth
  • External radiation therapy
  • Internal radiation therapy
• Chemotherapy: uses chemicals to eliminate cancer in the stomach
  • Neoadjuvant chemotherapy: causes the tumor to shrink for easy removal
  • Adjuvant chemotherapy: used after surgical intervention to eliminate remaining cancer cells in the stomach
• Targeted therapy: another stomach cancer treatment that uses medications that strike specific cancer cells and refraining healthy cells.
  • Monoclonal antibody therapy: uses antibodies from a laboratory, and they attach to substances that sustain the growth of cancer cells, thus killing the cancer cells and inhibiting their growth and reproduction.
  • Multikinase inhibitors are small-molecule drugs that go inside the cancer cells to disrupt the multiple protein signals to stop their growth and reproduction. Other drugs have angiogenesis inhibitor effects that stop new blood vessel formation, which tumors needed to flourish.

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