What is stomach cancer?
Stomach cancer tends to grow slowly over many years. Before cancer actually develops, precancerous changes usually occur in the inner lining (mucosa) of the stomach. These early changes rarely cause symptoms and are therefore often undetected.
Cancer that starts in different parts of the stomach can cause different symptoms and tend to have different results. The location of cancer can also affect treatment options. For example, cancer that begins at GE junction is organized and treated like esophageal cancer.
Types of stomach cancer
- Almost 90% to 95% of stomach cancers are adenocarcinoma. Stomach cancer is almost always gland cancer.
- These cancers develop from the cells that form the innermost lining of the stomach (mucosa).
- These are cancers of the immune system tissue that are sometimes found in the stomach wall.
- The treatment and outlook depend on the type of lymphoma.
Gastrointestinal stromal tumor (GIST)
- These rare tumors begin in a very early cell form in the stomach wall called interstitial cells of Cajal.
- Some of these tumors are not cancer, although GIST can be found anywhere in the digestive tract, most often found in the stomach.
- These tumors begin in the hormone-producing cells of the stomach. Most of these tumors do not spread to other organs.
- Other types of cancer, such as squamous cell carcinoma, small cell carcinoma and leukemia, can also start in the stomach, but these cancers are rare.
The cause of stomach cancer
- The stomach is only part of the upper part of the digestive tract. The stomach is responsible for digesting food and then moving the nutrients along the rest of the digestive organs, namely the small and large intestines.
- Stomach cancer occurs when normal healthy cells in the upper digestive system mutate into cancer cells and grow out of control, forming a tumor. This process is slow. Stomach cancer tends to develop over many years.
Risk factors for stomach cancer
Stomach cancer is directly related to tumors in the stomach. However, there are several factors that can increase your risk of developing these cancer cells. These risk factors include certain diseases and conditions, such as:
- Lymphoma: a group of leukemia
- H. pylori infection: a common gastric infection that can sometimes lead to an ulcer
- tumors in other parts of the digestive system
- Gastric polyps: Abnormal growth of patterns formed on the stomach lining
Stomach cancer is also more common among:
- Older people, usually 50 years old or older
- people with a family history of stomach cancer
- Asians: especially Korean or Japanese, South American or Belarusian
While your personal medical history may affect your risk of developing stomach cancer, some lifestyle factors may also play a role. You may be more likely to get stomach cancer if:
- Eat more salty or processed foods
- eat too much meat
- have a history of alcohol abuse
- Do not exercise
- Do not store or cook food properly
You may want to consider screening if you believe you are at risk for stomach cancer. Screening tests are done when people are at risk for some diseases but have no symptoms.
Symptoms of stomach cancer
There are several symptoms associated with stomach cancer. However, because they also exist in many other less serious conditions, stomach cancer may be hard to recognize at first. It is for this reason that many people with stomach cancer are undiagnosed until the disease has advanced.
Early symptoms of stomach cancer may include:
- feeling full after eating only a small amount
- Difficulty swallowing
- feeling bloated after a meal
- Burping often, heartburn
- Indigestion without disappearing
- Stomach pain or pain in the sternum
- vomiting, may contain blood
The following signs and symptoms should be considered urgent in people at risk of stomach cancer:
- Indigestion, fast weight loss
- tired and breathless
People over 55 with persistent indigestion should see a doctor.
Individuals with indigestion and at least one of the following in their medical history should also see a doctor:
- Relatives have stomach cancer
- Barret’s esophagus
- dysplasia, or an abnormal set of typical precancerous cells
- gastritis, or inflammation of the lining of the stomach
- Malignant anemia, where the stomach does not properly absorb vitamin B12 from food
- history of peptic ulcer
As stomach cancer becomes more advanced, the following signs and symptoms often become more obvious:
- the accumulation of fluid in the stomach
- Black feces contain blood
- loss of appetite
- weight loss
Stages of stomach cancer
Stages of adenocarcinoma of the stomach or esophagus include:
- Stage I: At this stage, the tumor is confined to the top layer of tissue located inside the esophagus or stomach. Cancer cells may also have spread to a limited number of nearby lymph nodes.
- Stage II: Cancer at this stage has spread, developing into a deeper muscle layer of the esophagus or stomach wall. The cancer may also have spread to more lymph nodes.
- Stage III: At this stage, the cancer may have spread through all layers of the esophagus or stomach and spread to nearby structures. Or it may be a smaller cancer that has spread to the lymph nodes more.
- Stage IV: This stage indicates that the cancer has spread to remote areas of the body.
Treatment will depend on how big the tumor has grown, how deeply it has spread to the layers of the stomach and whether it has spread to nearby organs, lymph nodes or organs. other body or not.
Surgery is a common treatment in all stages of stomach cancer. The main treatment is gastrectomy:
- Subcutaneous gastrectomy: removal of the stomach containing cancer, nearby lymph nodes and parts of tissues and other organs near the tumor. The spleen may also be removed.
- Complete gastrectomy: The complete removal of the stomach, nearby lymph nodes and parts of the esophagus, small intestine and other tissues near the tumor. The spleen may be removed. The esophagus is connected to the small intestine so the patient can continue to eat and swallow.
If the tumor is blocking the stomach but the cancer cannot be completely removed by standard surgery, the following procedures may be used:
- Endometrial stenting: a procedure for stenting a thin, expandable stent to keep an opening open such as the esophagus.
- Endoscopic laser treatment: a procedure in which an endoscope is a thin tube, illuminated with a laser attached to the body.
Recent studies show that the combination of surgery, chemotherapy and radiation therapy offers the highest chance of survival for patients with stomach cancer:
- Chemotherapy may be given when the cancer has invaded the layers of the stomach wall, nearby lymph nodes and nearby organs. It may also be given before surgery to shrink a tumor.
- Radiation is most commonly used in combination with chemotherapy.
Prevent stomach cancer
Treatment of stomach infections
If you have an ulcer caused by an H. pylori infection, treat it. Antibiotics can kill bacteria and other medications that will heal ulcers in your stomach lining to reduce the risk of cancer.
Add fresh fruits and vegetables in your daily diet. They are high in fiber and in some vitamins can reduce your risk of cancer.
Avoid very salty, pickled or smoked foods such as sausages, lunch meats, or smoked cheese.
Keep your weight healthy. Being overweight or obese may also increase the risk of disease.
Do not smoke
Your risk of stomach cancer doubles if you use tobacco.
See aspirin or NSAID use
If you take aspirin daily to prevent heart problems or NSAIDs for arthritis, talk to your doctor about these medications that may affect your stomach.
Prospects of treatment for patients with stomach cancer
Your chances of recovery are better if the diagnosis is made at an early stage. About 30% of all people with stomach cancer survive at least five years after being diagnosed.
The majority of these survivors have a local diagnosis. This means the stomach is the source of cancer. With unknown origin, it can be difficult to diagnose and stage cancer. This makes cancer more difficult to treat.
Treatment of stomach cancer is also more difficult once it reaches a later stage. If your cancer is more advanced, you may want to consider participating in a clinical trial.
Clinical trials help determine whether a new medical procedure, device or other treatment is effective to treat certain diseases and conditions.
Reference Source of Stomach Cancer:
- Source mayoclinic.org article Stomach Cancer : https://www.mayoclinic.org/diseases-conditions/stomach-cancer/symptoms-causes/syc-20352438 , updated May 19, 2018.
- Source en.wikipedia.org article Stomach Cancer : https://en.wikipedia.org/wiki/Stomach_cancer , updated November 17, 2019.
- Source of prestige index-china.com summarizes the article on Stomach cancer: https://index-china.com/stomach-cancer/, updated on 13/3/2020.
Assoc.Prof.Dr. Tran Ngoc Anh is currently Hanoi Medical University Hospital, Associate Professor, Department of Internal Medicine, Gastroenterology and Head of Department of General-Uematology of Hanoi Medical University. Consulting doctor at ThuocLP Vietnamese health.
Professional qualifications, Academic degrees – Education:
Graduated from General Practitioner System, Hanoi Medical University
Graduated with a Master degree in Internal Medicine, Hanoi Medical University
Graduated from the training program specialized in Gastrointestinal, Henri Mondor Institute Center, University of Paris 6, French Republic 1996-1997; 1999
Graduated from the training program specialized in Gastrointestinal, North Royal Sydney Hospital, Australia; 2002
Graduated from a training program specialized in chronic liver diseases, Pizza, Italy 2009
Graduated with a PhD in Gastrointestinal, Hanoi Medical University
Associate Professor, Gastroenterology, Hanoi Medical University
Training and Scientific Research:
Published more than 200 articles in domestic and international specialized journals
Editor of many monographs and participates in compiling 2 textbooks.
Guide many students and graduate students of Hanoi Medical University
Manager of many grassroots research projects
Certificate of Good Clinical Practice (GCP: 2012, 2015), Ministry of Health
Specialized certificates: General gastrointestinal endoscopy, Interventional gastrointestinal endoscopy, General gastrointestinal ultrasound, Interventional gastrointestinal ultrasound (Bach Mai BV), Chronic liver disease.