Stomach cancer is sometimes called gastric cancer. Worldwide it is one of the most common cancers. Stomach cancer is more common in men than in women and ten/ds to occur mainly in older people. Most people who develop stomach cancer are over the age of 55.
In most cases, stomach cancer begins from a cell which is on the inside lining of the stomach (the mucosa). This type of stomach cancer is called adenocarcinoma of the stomach. As the cancer cells multiply :
- The tumour may invade deeper into the wall of the stomach. In time, it may pass through the wall of the stomach and invade nearby organs such as the pancreas or liver.
- The tumour may spread up or down the stomach into the oesophagus (gullet) or small intestine.
- Some cells may break off into the lymph channels or bloodstream. The cancer may then spread to nearby lymph nodes or spread to other areas of the body (metastasise).
Diagnosis of Stomach Cancer
If you have symptoms that suggest stomach cancer, your doctor will check to see whether they are due to cancer or to some other cause. Your doctor may refer you to a gastroenterologist, a doctor whose specialty is diagnosing and treating digestive problems. Your doctor will ask about your personal and family health history. You may have blood or other lab tests. You also may have :
- Physical exam : oncologist feels the abdomen of the patient for fluid, swelling, or other changes. They also will check for swollen lymph nodes.
- Endoscopy : Surgical Oncologist uses a thin, lighted tube (endoscope) to look into the stomach after numbing the throat with an anesthetic spray. Patient may be given medicine to help him relax. The tube is passed through the mouth and esophagus (food pipe) to the stomach.
- Biopsy : An endoscope has a tool for removing tissues. Surgical Oncologist uses the endoscope to remove tissue from the stomach. A pathologist checks the tissue under a microscope for cancer cells. A biopsy is the only sure way to know if cancer cells are present.
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Surgery
The goal of surgery is to remove all of the stomach cancer and a margin of healthy tissue, when possible. Options include :
- Removing a Portion of the Stomach (Subtotal Gastrectomy). During subtotal Gastrectomy, the surgeon removes only the portion of the stomach affected by cancer. Subtotal gastrectomy can be of two types :
- Distal subtotal gastrectomy is performed if the tumor cells are present in the lower part of the stomach near to the stomach duodenum junction.
- Proximal subtotal gastrectomy is done when the tumor is situated in the upper part of the stomach and also involves the esophagus.
- 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.
Chemotherapy
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs travel throughout your body, killing cancer cells that may have spread beyond the stomach. Chemotherapy can be given before surgery (neoadjuvant chemotherapy) to help shrink a tumor so it can be more easily removed. Chemotherapy is also used after surgery (adjuvant chemotherapy) to kill any cancer cells that might remain in the body.
Radiation therapy
Radiation therapy may be used to kill the cancer cells. Radiation therapy can be administered using a machine outside the body (external radiation therapy) or using needles, seeds, wires, or catheters placed in the body in or near the cancer (internal radiation therapy). External radiation therapy uses a machine outside of the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
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