Stomach cancer occurs there is a build-up of abnormal cells in the lining of the stomach. This can develop into a tumor. Also called Gastric cancer, it progresses slowly, and symptoms are difficult to identify in its early stage. There are two types of Stomach cancers:
- Intestinal stomach cancer – common among older patients and certain high- risk groups like Japanese, Koreans
- Diffuse stomach cancer – more common among women than men and among A type blood group.
Causes of Stomach cancer
Although scientists are not exactly sure what causes cancer cells in the stomach, they do know some factors that raise the risk of this incidence such as:
- Lymphoma – a group of blood cancers
- H. Pylori – a common bacteria causing ulcers
- Gastritis – inflammation in the gut
- Pernicious anemia – a type of long-lasting anemia
- Polyps – growths in the stomach
- Epstein-Barr virus infection – an illness associated with fever, sore throat, swollen lymph nodes in the neck, and enlarged spleen
- Type A blood
- Certain genes
- Certain people group – Japanese, Korean, South American, or Belarusian descent
- Stomach surgery for an ulcer
Other lifestyle factors that can affect Stomach cancer are:
- Smoking and tobacco chewing
- Being overweight or obese
- A diet high in smoked food, pickles, and salt
- Exposure to asbestos
- Working in industries like coal, timber, rubber, and metal
Symptoms of Stomach cancer
- Prolonged indigestion
- Frequent heartburn
- Nausea and vomiting
- Loss of appetite
- Early satiety
- Blood in the stool
- Stomach pain
- Excessive fatigue
Stages of Stomach cancer
Cancer is divided into stages. The higher the stage, the more advanced cancer is and the lower is the survival rate.
- Stage 0 – Cancer cells or very abnormal cells present in the innermost layer of the stomach (mucosa) but has not spread to other layers or nearby lymph nodes.
- Stage IA – Cancer cells have moved to the next layer, the submucosa and not to the lymph nodes.
- Stage IB – Cancer cells have moved to the submucosa and into one or two nearby lymph nodes.
- Stage IIA – Cancer has spread to a deeper layer and has spread to 3 – 6 nearby lymph nodes.
- Stage IIB – Cancer may not have spread as deep as Stage IIA but has spread to up to 15 lymph nodes.
- Stage IIIA – Cancer cells may have spread to a deeper layer and up to 15 lymph nodes or starting to grow through the stomach wall but spread to fewer lymph nodes.
- Stage IIIB – Cancer may not be as deep as Stage IIIA but spreading to over 16 lymph nodes and starting to reach nearby organs and structures.
- Stage IIIC - Cancer has either spread through most layers of the stomach and over 16 lymph nodes or spread to nearby organs and structures and up to 15 lymph nodes.
- Stage IV – Cancer has spread to distant sites like liver, lungs, brains, or peritoneum but it may or may not spread to lymph nodes.
Diagnosis and tests
- Physical examination
- Blood test
- MRI Scan
- CT Scan
- X Rays
Treatments for Stomach cancer
Depending on the overall health of the patient and spread of cancer cells, one of the following or a combination of these will be recommended. Surgery is usually recommended for an early stage while radiotherapy and chemotherapy are used for later stages.
- Radiation therapy – Using X-rays and other high energy rays to kill abnormal cells
- Medications – Using chemotherapy and chemotherapy drugs to kill cancer cells growing rapidly and to reduce the side effect of chemotherapy respectively
- Surgery – Surgical removal of all or part of the stomach called Gastrectomy or Gastroenterostomy, a surgery connecting the small intestine to an opening made in the stomach
- Palliative care – A specialized medical care to provide relief from pain and other illnesses.
- Physical examination of the body
- Familiarize your doctor with your medical history
- Take diagnostic tests
- Your doctor will inform you of the stage you are in and will consider treatment option most suitable to you
- If surgery is recommended, you may be given chemotherapy or radiotherapy priory to surgery depending on your stage to shrink the cancer and make it easier to remove during surgery
- If you are too sick for surgery, chemoradiation, radiation therapy or, chemotherapy will be used for treatment if your body can tolerate it.
- You will be given general anaesthetic and so you will be asleep and feel no pain
- An open surgery with a large incision or small incisions using laparoscopy will be performed
- Surgery can be either partial gastrectomy, which is removal of part of the stomach or total gastrectomy involving removal of the entire stomach
- Depending on the stage, lymph nodes may or may not be removed
- Incisions are closed with sutures after surgery
- If the cancer is Stage IV, a gastric bypass or subtotal gastrectomy may be performed to keep the stomach from being blocked or to control bleeding
- If the stomach is significantly affected causing blockage, a laser beam passed through an endoscope may be directed to destroy the tumor and relief obstruction
- A stent may also be inserted to allow food to pass through if needed.
- Chemo or Chemoradiation may be done for patients who have not had chemo prior to surgery or after surgery, doctors may leave some cancer behind to be treated through chemoradiation 3 – 4 months after surgery
- You will be able to eat only small amounts of food for a while after your operation
- You will be given medications to relieve pain and vitamin injections
- Eating nutritious food is imperative to a good recovery
- You will need to take a break from your normal daily activities
- Please refrain from carrying or lifting heavy objects or doing strenuous activities
- Regular check-ups will be done every three months for the first year
- Physical examinations, blood tests, scans are part of the follow-up to see your response to treatments
- After initial treatment, cancer can recur and will be treated accordingly.
Risks and complications
Some complications that could occur are:
- Internal bleeding
- Blood clots
- Acid reflux
- Leaking from where the stomach was closed
- Wound infection
There are also possible side effects to chemotherapy and radiation therapy such as:
- Nausea and vomiting
- Hair loss
- Nerve damage
- Weight loss
- Skin changes or skin irritation on the affected areas
Factors affecting the cost of Stomach cancer treatment
Factors that influences the price includes:
- Age of the patient
- Stage of the cancer
- Location of hospital
- Surgeon’s fee
- Duration of hospital stay
- Medical care
- Diagnostic tests
- Other services