Stomach Cancer

Cancer that starts in the stomach lining, often leading to digestive issues.

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Stomach Cancer

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Stomach Cancer

Stomach cancer, as the name suggests, an abnormal condition with the growth of tumours that starts in the stomach and can occur in any area of the stomach. The stomach is a muscular sac-like structure that receives food that we eat from the oesophagus.

The food remains in the stomach for 2-3 hrs. During this time, the food starts getting digested and is then passed into the small intestines for further digestion. Stomach cancer is also known as gastric cancer and can affect any part of the stomach.

Symptoms of Stomach Cancer

Difficulty in swallowing
Feeling bloated after eating or feeling full after eating a small portion of food
Heartburn
Indigestion
Nausea
Pain or fullness in the upper abdomen
Vomiting with or without blood in vomitus

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Gastric outlet obstruction

This occurs when the cancerous growth obstructs the passage of food from the stomach into the small intestine. As a result, the food starts accumulating in the stomach, causing distension of the stomach, fullness after meals and vomiting of food particles every few days.

Causes of Stomach Cancer

It’s not clear what causes stomach cancer, but extensive research indicates the following factors increase the risk of developing stomach cancer:

High salt and nitrate consumption
Low dietary intake of Vitamin A & C
Excessive consumption of smoked or cured food
Lack of refrigeration
Consumption of contaminated water eg. well water
Gastro-oesophagal reflux disease
Obesity
Workers in the rubber and coal industries
Cigarette smoking
Infections with Helicobacter pylori or Epstein-Barr virus
Radiation exposure
Prior gastric surgery for benign gastric ulcer disease
Family history of gastric cancer
Genetic Conditions such as the Li-Fraumeni syndrome, Familial Adenomatous Polyposis (FAP), and Lynch syndrome can also predispose individuals to stomach cancer

When to see the Doctor?

Indigestion and heartburns are very common symptoms and may overlap with other gastric problems. The symptoms can appear in diverse forms as mentioned above and hence, if you are experiencing a combination of any of these symptoms, especially over longer periods, you should consult a doctor.

Types of Stomach Cancer

Carcinoma:Cancers stemming from the epithelial cells lining the stomach are called carcinomas and are of multiple types; with adenocarcinoma accounting for nearly 90 to 95% of stomach cancer cases. The other rare types are squamous cell carcinoma small cell carcinoma, adenosquamous carcinoma, etc.
Lymphoma:This is the cancer of the body’s immune cells, usually the T & B lymphocytes. These cells are also present in the walls of the stomach and hence can give rise to gastric lymphomas.
Gastrointestinal stromal tumour (GIST):These cancers originate in the interstitial cells of the stomach cells, called the Cajal cells. Some of these tumours are benign, but in some cases also lead to the formation of malignant tumours.
Gastrointestinal Carcinoid tumour:The stomach also has hormone-producing cells which can become malignant leading to the formation of carcinoid tumours.
Sarcomas:These are relatively rare cancers and include Leiomyosarcomas, Lymphosarcomas, Fibrosarcoma, Myxosarcoma, etc.

Prevention of Stomach Cancer

Exercise regularly and keep your weight under control
Try to incorporate more fruits and vegetables into your diet each day
Reduce the intake of salty and smoked foods
Quit smoking
People with a family history of stomach cancer should undergo periodical testing and screening to detect cancer at the early stages
Do not delay seeking a medical consultant, when you start exhibiting symptoms.

Testing for Stomach cancer includes:

A physical exam: A thorough physical examination will be carried out, after taking a detailed history of your symptoms.
Endoscopy: Usually upper gastrointestinal endoscopy i.e. UGI scopy is performed, wherein an endoscope a thin tube with a camera at its end will be inserted through your mouth into the oesophagus and stomach, to rule out any abnormal growth or ulceration.
Biopsy: A biopsy is performed at the time of UGI scopy to determine the type of stomach cancer.
Blood tests: Routine blood tests will be taken along with special tests to determine tumour marker levels eg. CEA, CA 19.9
CT scan: A CT scan of the chest, abdomen and pelvis is done to determine the stage of disease; which in turn help decide on the best treatment approaches for the patient.
PET CECT scan: A PET CT scan is recommended in advanced or recurrent cases to rule out the spread of cancer to other sites, eg lungs, liver, bone, etc.
Diagnostic laparoscopy and biopsy: In advanced cases, a diagnostic laparoscopy is done to document the spread of the disease, and a biopsy is also executed simultaneously.

Treatment for Stomach Cancer

Endoscopic Mucosal Resection (EMR)or Endoscopic submucosal dissection (ESD) uses an endoscope and special instruments to remove small early tumours present on the mucosal or submucosal layer.
Subtotal gastrectomy: In large-size malignant tumours, a part of the proximal or distal stomach is removed along with adjacent lymph nodes. The rest of the stomach is then anastomosed to the upper part of the small intestine (jejunum) to establish continuity for food passage and digestion.
Total gastrectomy:The whole of the stomach sometimes needs to be removed, depending upon the length of the stomach affected with cancer. In such cases, the oesophagal tube is connected directly to the small intestine (jejunum).
Bypass surgeries:In some advanced cases (stage IV), only bypass procedures are performed, like gastro-jejunostomy, to allow the patient to eat, during treatment.