Overview:
- It is abnormal cells grow out in uncontrollable way at stomach wall cells, which leads bulging within lumen of stomach causing obstructive symptoms, and may extend to outside of stomach wall giving pressure symptoms over another organs.
- Gastric cancer occurs in any part of stomach (40% in distal third, 40%in middle third, 10% in proximal third, 10% involving more than one section)
Etiology:
- Cancer cells are normal cells in origin, but have undergone changes or mutations in their DNA
- The changes caused an imbalance in how they grow and divide and a disorder in their functions
Symptoms:
- Abdominal pain
- Weight loss
- Nausea and vomiting
- Heartburn
- Bloating
- Feeling full just by eating a small amount of food
- Difficulty swallowing
- general systemic symptoms of cancer (weakness, fatigue, pallor, fever and night sweating )
Causes:
risk factors for stomach cancer are:
- Family history
- Chronic gastritis
- gastric polyps
- Smoking
- Obesity
- Gastroesophageal reflux
- Helicobacter pylori (H. pylori) infection
- Unbalanced diet: salted and smoked foods , less vegetables and fruits.
Diagnosis:
- Careful clinical examination
- Laboratory tests: to assess anemia, liver and pancreas function, and screening tumor markers
- Upper gastrointestinal endoscopy with biopsy
- Barium swallow evaluates gastric cavity
- Endoscopic ultrasound evaluates invasion of stomach wall
- CT abdominal, pelvic and chest, MRI evaluates tumor stage
- diagnostic laparoscopy may be required with biopsies in some cases
Treatment:
- A very early tumor in the gastric mucosa can be treated with endoscopic upper gastrointestinal resection with close monitoring
- Other options include:
- Partial gastrectomy with adjacent lymph nodes (usually cancer is in distal part of the stomach)
- total gastrectomy with adjacent lymph nodes and esophageal anastomosis procedure.
- Chemotherapy:
- Pre surgery: to decrease tumor size
- Post-surgery: as a supportive adjuvant therapy to kill any remaining cancer cells
- Radiotherapy:
- Pre surgery: to decrease tumor size
- Post-surgery: as a supportive adjuvant therapy to kill any remaining cancer cells
- Radiotherapy and chemotherapy are often both involved in gastric cancer.
