Stomach Cancer

Stomach cancer is also known as gastric cancer. There are several types of stomach cancer, the most common ones are those malignant (cancer) cells arising from the lining of the stomach. This commonly presents as an ulcer or growth in the stomach. There are also rarer form of stomach cancer arising from deeper muscle tissue known as gastrointestinal stroma tumour (GIST) and helicobacter pylori induced gastric lymphoma known as MALT Lymphoma.

Risk Factors

Having any of the following medical conditions or lifestyle factors could increase one’s risk:

  • Helicobacter pylori (H. pylori) infection of the stomach.
  • Chronic gastritis (inflammation of the stomach).
  • Pernicious anemia.
  • Intestinal metaplasia (a condition in which the normal stomach lining is replaced with the cells that line the intestines).
  • Eating a diet high in salted, smoked foods and low in fruits and vegetables.
  • Eating foods that have not been prepared or stored properly.
  • Being older or male.
  • Smoking cigarettes.
  • A family history of stomach cancer

Symptoms

Most gastric cancers may not have any symptoms. Those presented with symptoms often comes in late stage. It is only diagnosed after a gastroscopy.

Symptoms of the later stages of gastric cancer include:

In more advanced stages of gastric cancer, the following signs and symptoms may occur:

  • Blood in the stool (which will appear black)
  • Vomiting.
  • Weight loss for no known reason.
  • Stomach pain.
  • Trouble swallowing.

Diagnosis

Diagnosis of gastric cancer is based on seeing what is happening within the stomach.

The following tests and procedures may be used:

Upper GI endoscopy or Gastroscopy. This is a procedure to look inside the esophagus, stomach, and duodenum (first part of the small intestine) to check for abnormal areas. An endoscope (a thin, lighted tube) is passed through the mouth and down the throat into the esophagus. Often, a biopsy is performed, where cells are removed so they can be viewed under a microscope to check for signs of cancer. The sample of tissue may also be checked for Helicobacter pylori (H. pylori) infection.

A Barium swallow, where a series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken. However, unlike an endoscopy, no cells can be taken for sampling, and so any suspicious findings on a Barium study have to be followed-on by an endoscopy.

Staging

The doctor would need to find out if cancer has spread past the inner lining of the stomach. The process of doing so is called staging. It may involve gastroscopy, endoscopic ultrasound, CT scan, MRI scan or PET scan.

Treatment

Treatment of stomach cancer depends on the stage of cancer.

Stage 0 cancer or cancer confined to the inner lining of the stomach can be treated endoscopically. The tumor is removed completely using the gastroscope and some special instruments. There is no external scar and the patient recovers immediately after the procedure. This procedure requires special expert to perform to ensure complete removal of the tumour.

More advanced stage of cancer may require surgery to remove part or all of the stomach. Some reconnection of the digestive system may be needed so that you can continue to eat.

Chemotherapy is sometimes needed before or after the surgery.

Radiation can be used to kill cancer cells as well.

Immunotherapy is the medication that works with our body’s immune system to kill cancer cells.

Prevention

Helicobacter pylori infection is an important risk factor for gastric cancer. Eradicating the bacteria would lower the risk of gastric cancer. It is believed that eradicating the infection earlier in life would confer a better protection.