Stomach Cancer

The stomach is part of the digestive system. It is a muscular sac located at the top of the abdomen, just below the ribs, between the chest and the hips. After food is chewed and swallowed, it moves from the mouth through the esophagus, and into the stomach. Once in the stomach, the food mixes with gastric juice to begin the digestive process. The muscles within the stomach then push the liquid into the small intestine.

Another term for stomach cancer is gastric cancer. It is a malignant tumor that forms in the tissues in the lining of the stomach. The cancer can start in any section of the stomach. Symptoms, treatment options and survival outlook depend on the location of the cancer in the stomach.

The wall of the stomach consists of five layers. As the cancer grows deeper into the wall the outlook diminishes. The cancer can spread over time, deeper into the stomach wall. A stomach tumor can eventually grow through the stomach’s outer layer and extend into other organs such as the pancreas, esophagus, liver, and intestine. lungs and lymph nodes. The distant spread of cancer is called metastasis. The five layers of the stomach, starting from the inside out are:

Stomach cancer can develop in any part of the stomach and is typically develops slowly over several years. Pre-cancerous changes occur in the lining of the stomach before a cancer develops. These early changes rarely cause symptoms and it is for that reason that stomach cancer is rarely detected in the early stages.

While stomach cancer is common worldwide, it is uncommon in the United States. Over the past 60 years there has been a significant decrease in the number of people diagnosed with this and the numbers continue to decline. This is mainly attributed to the fact that people in this country are eating less salted, cured and smoked food and the increased use of refrigeration for food storage. Some doctors also attribute the decline in stomach cancers in the United States to the use of antibiotics to treat infections. These
antibiotics kill the H. Pylori bacteria which may be a major cause of stomach cancer. When diagnosed and treated in its early stage, stomach cancer can often be cured. If it is in a more advanced stage when it is discovered the outlook can become less favorable.

The cancers are classified according to the type of tissue from which they originate. When the term stomach cancer is used it is generally referring to adenocancarcinoma since the other forms are stomach cancer are rare.

The different types of stomach cancer include:

Cancer begins in cells that are the building blocks that make up tissues. Tissues then make up the various organs in the body. When the body requires it, new cells are formed as normal cells grow and divide. When normal cells get old or damaged, they will die, and new cells will take their place. There are times when the process goes wrong. New cells may form when the body doesn’t require them, and old and damaged cells will not die, as they should. A mass of tissue called a growth (nodule or tumor) is formed as a result of the buildup of these extra cells. These growths can be benign or malignant.

Stomach cancer can spread to other parts of the body by invading other tissues, shedding cancer cells into the abdomen or spreading to other organs.

Risk Factors

The causes of stomach cancer are still largely unknown. However, it has been found that individuals predisposed to certain factors, will more likely develop stomach cancer than those without them.

Most people who have the increased risk factors do not develop stomach cancer. However, there are some patients who develop stomach cancer without having any of the increased risks.

The following are potential risk factors, some of which can be controlled, that may contribute to the potential development of stomach cancer:

Symptoms

Stomach cancer usually does not display any symptoms in its early stages. As the cancer grows symptoms begin to develop. By the time the symptoms have developed, the cancer is usually in an advanced stage. However, symptoms from stomach cancer are very often indicative of other health issues unrelated to stomach cancer. Your doctor should be advised of these symptoms when they are present. If there is stomach cancer, it will be more susceptible to being treated successfully. The symptoms at different stages of the cancer include:

Early Stage Symptoms

Middle Stage Symptoms

Late Stage Symptoms

Tests & Diagnosis

In addition to discussing your family history and ordering some blood or lab tests, the following tests may be ordered to determine the presence of stomach cancer:

Treatment

Unless stomach cancer is diagnosed at an early stage, before it has spread, it is difficult to cure. The difficulty with finding it at the early stage, is that early stomach cancer has few symptoms. When the disease is diagnosed it is most often in an advanced stage. Advanced stomach cancer can be treated and the symptoms can be relieved.

Several factors determine the treatment that will be selected to manage the stomach cancer. They include the stage of the cancer, as well as the size and location of the tumor. The patient’s age, overall health and personal preferences are also considered when developing a treatment plan. The primary goal is to eliminate the cancer when possible. If that is not an option then the goal is to prevent the cancer from growing and spreading. When treatments aren’t an option because the cancer is advanced and the treatments will not offer any benefits, other means may then be suggested to relieve the symptoms and help make the patient as comfortable as possible.

Surgery

The location, type and stage of the cancer are the determining factors for the type of surgery that will be required. The entire stomach may be removed or just the part that is affected by the cancer. The goal of surgery is to remove all of the stomach cancer and a portion of healthy tissue. There are risks associated with including the risk of infection and bleeding. Digestive problems may arise when all or part of the stomach is removed. The surgical options available include:

Chemotherapy

Chemotherapy is given to most patients who have stomach cancer. Unfortunately, stomach cancer has not been particularly sensitive to chemotherapy. But the treatment usually does reduce
the size of the tumor, relieve symptoms and increase survival time. Chemotherapy is usually given in an outpatient setting at the hospital or doctor’s office. However, some people do have to stay in the hospital while receiving the treatment.

Chemotherapy is a treatment where medications are used to attack and kill cancer cells. These drugs travel in the blood stream throughout the body and kill cancer cells that may have gone beyond the stomach. A combination of medications is calculated by an oncologist based on staging and a patient’s overall health. The chemotherapy is usually administered intravenously and given at specific time intervals, determined by the oncologist, who works with the surgeon on the overall treatment plan for the patient.

Chemotherapy may be used before surgery to shrink the tumor so that it becomes easier to remove surgically. It can also be used after surgery to kill any cancer cells that may have remained in the body.

Radiation treatments are often used in combination with surgery and chemotherapy. When stomach cancer cannot be treated surgically, radiation is often used in combination with
chemotherapy to treat the cancer. It is sometimes used alone to help relieve symptoms in people with advanced stomach cancer, such as swelling and obstruction.

Radiation Therapy

High-energy beams are used to kill cancer cells, shrink them, or damage them and keep them from growing. The radiation comes from a machine that aims radiation beams at the cancer in the abdomen. It affects only those cells in the part of the body that is being treated. Radiation can kill very small areas of cancer that cannot be seen and removed during surgery. It is generally given in a hospital or clinic five days a week, for several weeks.

Radiation may be used before surgery to shrink the tumor so that it becomes easier to remove surgically. It can also be used after surgery to kill any cancer cells that may have remained in the stomach area.

Radiation treatments are often used in combination with surgery and chemotherapy. When combined with chemotherapy after surgery, radiation can often delay or prevent recurrence of the
cancer. It may also help prolong the life of the patient. When stomach cancer cannot be treated surgically, radiation is often used in combination with chemotherapy to treat the cancer. It is used to relieve the pain, bleeding and eating problems by shrinking the tumor.

Targeted Chemotherapy

Medications used to attack specific abnormalities within cancer cells are considered targeted therapy. Trastuzumab (Herceptin®) is a man made version of an immune system protein. It is know as a monoclonal antibody and is used more often to treat breast cancer. Recent studies show that when given with chemotherapy it helped some patients with metastatic stomach cancer live longer compared to cases where chemotherapy was given alone. This drug is only helpful for the stomach cancers that contain a certain type of protein. The FDA has now approved it as part of the treatment for stomach cancer. There are drugs that are used to treat gastrointestinal stomach cancer which is a rare form of cancer. Imatinib (Gleevec)
and sunitinib (Sutent) are two such medications.

Nutrition

Food intake is an essential ingredient in the treatment of stomach cancer. Proper nutrition is fundamental to maintaining strength and healing. Having stomach cancer may make it difficult to eat. With the aid of the medical team and a nutritionist, a diet plan will help meet the needs of the patient. It is important to ingest the necessary amount of vitamins, proteins, calories and minerals the patient. This will help the patient prevent weight loss and discomfort when eating. There are cases where the intake of the required nutrition is assisted with the help of an IV (intravenous). Daily supplements of vitamins and minerals may be necessary after surgery. These include calcium, iron, vitamin D and vitamin D shots.

Clinical Trials

Studies used to test new forms of treatments are called clinical trials. They may include new surgical approaches, new approaches to radiation, testing new chemotherapy drugs, or even new methods such as gene therapy. These studies can lead to new methods becoming part of the standard treatment for the cancer when their results indicate safety and effectiveness.

Clinical trials offer access to treatments that aren’t ordinarily available. While they may produce serious unexpected side effects, they may provide positive results that would not have been received with the normally approved standard treatments. Clinical trials are closely monitored by the federal government to ensure safety for the patients participating in
the trials.

Prevention

While there are no specific known reasons for the cause of stomach cancer, there are known risks for it. The risks can be reduced by some lifestyle changes that include:

Support

The onset of stomach cancer can change a patient’s life and as well of the lives of their family and friends. Needing help after receiving this diagnosis is not uncommon, and there are many sources of support that help patients deal with all of the emotions and concerns that the diagnosis brings. Supportive care is available, before, during and after the treatment begins. Support groups offer support in person, over the telephone, or on the internet. In these groups patients and/or the family members will meet or talk to other patients and their family members who will share their experiences and acquired knowledge about how to deal with the disease and the effects of the treatments.

Doctors, nurses and other members of your health care team are also available to provide support and help deal with the emotions, concerns and physical issues associated with the diagnosis of stomach cancer.

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