Stomach Cancer or Gastric Adenocarcinoma
Stomach cancer is characterized by a growth of cancerous cells within the lining of the stomach. Also called gastric cancer, this type of cancer is difficult to diagnose because most people typically don’t show symptoms in the earlier stages.While stomach cancer is relatively rare compared to other types of cancer, one of the biggest dangers of this disease is the difficulty of diagnosing it. Since stomach cancer usually doesn’t cause any early symptoms, it often goes undiagnosed until after it spreads to other parts of the body. This makes it more difficult to treat.
The National Cancer Institute (NCI) estimates there’ll be approximately 28,000 new cases of stomach cancer in 2017. The NCI also estimates that stomach cancer is 1.7 percent of new cancer cases in the United States.
Stomach Cancer or Gastric Adenocarcinoma
CAUSES:
In general, cancer begins when an error (mutation) occurs in a cell’s DNA. The mutation causes the cell to grow and divide at a rapid rate and to continue living when a normal cell would die. The accumulating cancerous cells form a tumor that can invade nearby structures. And cancer cells can break off from the tumor to spread throughout the body.
Gastroesophageal junction cancer is associated with having gastrointestinal reflux disease (GERD) and, less strongly, with obesity and smoking. GERD is a condition caused by frequent backflow of stomach acid into the esophagus.
There is a strong correlation between a diet high in smoked and salted foods and stomach cancer located in the main part of the stomach. As the use of refrigeration for preserving foods has increased around the world, the rates of stomach cancer have declined.
RISK FACTORS:
Factors that increase your risk of stomach cancer located in the stomach body include:
- A diet high in salty and smoked foods
- A diet low in fruits and vegetables
- Family history of stomach cancer
- Infection with Helicobacter pylori
- Long-term stomach inflammation
- Pernicious anemia
- Smoking
- Stomach polyps
SYMPTOMS:
- nausea and vomiting
- frequent heartburn
- loss of appetite, sometimes accompanied by sudden weight loss
- constant bloating
- early satiety (feeling full after eating only a small amount)
- bloody stools
- jaundice
- excessive fatigue
- stomach pain, which may be worse after meals
DIAGNOSIS:
Tests and procedures used to diagnose gastroesophageal junction cancer and stomach cancer include
- A tiny camera to see inside your stomach (upper endoscopy). A thin tube containing a tiny camera is passed down your throat and into your stomach. Your doctor can look for signs of cancer. If any suspicious areas are found, a piece of tissue can be collected for analysis (biopsy).
- Imaging tests. Imaging tests used to look for stomach cancer include computerized tomography (CT) scans and a special type of X-ray exam sometimes called a barium swallow.
Determining the extent (stage) of gastroesophageal or stomach cancer
The stage of your stomach cancer helps your doctor decide which treatments may be best for you. Tests and procedures used to determine the stage of cancer include:
- Imaging tests. Tests may include CT and positron emission tomography (PET).
- Exploratory surgery. Your doctor may recommend surgery to look for signs that your cancer has spread beyond your esophagus or stomach, within your chest or abdomen. Exploratory surgery is usually done laparoscopically. This means the surgeon makes several small incisions in your abdomen and inserts a special camera that transmits images to a monitor in the operating room.
Other staging tests may be used, depending on your situation.
Stages of Stomach Cancer:
The stages of adenocarcinoma of the stomach or oesophagus include:
- Stage I. At this stage, the tumour is limited to the top layer of tissue that lines the inside of the Oesophagus or stomach. Cancer cells also may have spread to a limited number of nearby lymph nodes.
- Stage II. The cancer at this stage has spread deeper, growing into a deeper muscle layer of the Oesophagus or stomach wall. Cancer may also have spread to more of the lymph nodes.
- Stage III. At this stage, the cancer may have grown through all the layers of the Oesophagus or stomach and spread to nearby structures. Or it may be a smaller cancer that has spread more extensively to the lymph nodes.
- Stage IV. This stage indicates that the cancer has spread to distant areas of the body.
TREATMENT:
Surgery
Gastroesophageal junction cancer that has not spread requires surgery to remove the part of the esophagus or stomach where the tumor is located. The goal of surgery is to remove all of the cancer and a margin of healthy tissue, when possible. Nearby lymph nodes are typically removed as well.
The goal of surgery for cancer in the body of the stomach is also to remove all of the stomach cancer and a margin of healthy tissue, when possible. Options include:
- Removing early-stage tumors from the stomach lining. Very small cancers limited to the inside lining of the stomach may be removed using endoscopy in a procedure called endoscopic mucosal resection. The endoscope is a lighted tube with a camera that’s passed down your throat into your stomach. The doctor uses special tools to remove the cancer and a margin of healthy tissue from the stomach lining.
- Removing a portion of the stomach (subtotal gastrectomy). During subtotal gastrectomy, the surgeon removes only the portion of the stomach affected by cancer.
- Removing the entire stomach (total gastrectomy). Total gastrectomy involves removing the entire stomach and some surrounding tissue. The esophagus is then connected directly to the small intestine to allow food to move through your digestive system.
- Removing lymph nodes to look for cancer. The surgeon examines and removes lymph nodes in your abdomen to look for cancer cells.
- Surgery to relieve signs and symptoms. Removing part of the stomach may relieve signs and symptoms of a growing tumor in people with advanced stomach cancer. In this case, surgery can’t cure advanced stomach cancer, but it can make you more comfortable.
Surgery carries a risk of bleeding and infection. If all or part of your stomach is removed, you may experience digestive problems.
Stomach cancer is also treated with one or more of the following:
- chemotherapy
- radiation therapy
- immunotherapy, such as vaccines and medication.
Supportive (palliative) care
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing aggressive treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.
