HEALTH - STOMACH CANCER (GASTRIC - CANCER) SYMPTOMS
What is Stomach Cancer?
Stomach cancer is cancer that occurs in the stomach — the muscular sac
located in the upper middle of your abdomen, just below your ribs. Your
stomach is responsible for receiving and holding the food you eat and
then helping to break down and digest it. Stomach cancer, also called gastric cancer,
begins when cells in the stomach become abnormal and grow
uncontrollably. These cells form a growth of tissue, called a tumor.
Cancer can begin in any part of the stomach, and it can spread to nearby lymph nodes and other areas of the body, such as the liver, pancreas, colon, lungs, and a woman’s ovaries. Most stomach cancers are a type called adenocarcinoma, which means that the cancer started in the cells that line the inside of the stomach. Other types of cancerous tumors that form in the stomach include lymphoma, gastric sarcoma, and carcinoid tumor, but these are rare.
Stomach cancer is uncommon in the United States, and the number of people diagnosed with the disease each year is declining. Stomach cancer is much more common in other areas of the world, particularly Japan.
The five-year relative survival rate (percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases) of people with stomach cancer is about 25%. This statistic reflects the fact that most cases of stomach cancer are diagnosed when the cancer has already spread to other parts of the body. If stomach cancer is found before it has spread, the five-year relative survival rate is about 61%.
The stomach is located in the upper abdomen and plays a central role in digesting food. When food is swallowed, it slides down the esophagus, or throat, and enters the stomach. The muscles in the stomach mix the food and release gastric juices that help digest and break down the food. The food then moves into the small intestine for further digestion.
The wall of the stomach has five layers:
- Inner layer or lining (mucosa): Juices made by glands in the inner layer help digest food. Most stomach cancers begin in this layer.
- Submucosa: This is the support tissue for the inner layer.
- Muscle layer: Muscles in this layer create a rippling motion that mixes and mashes food.
- Subserosa: This is the support tissue for the outer layer.
- Outer layer (serosa): The outer layer covers the stomach. It holds the stomach in place.
Food moves from the mouth through the esophagus to reach the stomach. In the stomach, the food becomes liquid. The liquid then moves into the small intestine, where it is digested even more.
Stomach cancer can affect nearby organs and lymph nodes:
- A stomach tumor can grow through the stomach's outer layer into nearby organs, such as the pancreas, esophagus, or intestine.
- Stomach cancer cells can spread through the blood to the liver, lungs, and other organs.
- Cancer cells also can spread through the lymphatic system to lymph nodes all over the body.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original tumor. For example, if stomach cancer spreads to the liver, the cancer cells in the liver are actually stomach cancer cells. The disease is metastatic stomach cancer, not liver cancer. For that reason, it is treated as stomach cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic disease.
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Health: Causes of Stomach Cancer (Gastric - Cancer)
Doctors aren't sure what causes stomach cancer. There is a strong correlation between a diet high in smoked, salted and pickled foods and stomach cancer. As the use of refrigeration for preserving foods has increased around the world, the rates of stomach cancer have declined.
Several different types of cancer can occur
in the stomach. The most common type is called adenocarcinoma, which
starts from one of the common cell types found in the lining of the
stomach. There are several types of adenocarcinoma. Other types
of gastric cancer occur much less frequently.
Adenocarcinoma of the stomach is a common cancer of the digestive tract worldwide, although it is relatively uncommon in the United States. It occurs most frequently in men over 40 years old. This form of gastric cancer is extremely common in Japan, Chile, and Iceland. The rate of most types of gastric adenocarcinoma in the United States has declined over the years. Experts think the decrease may be related to reduced intake of salted, cured, and smoked foods.
Types of stomach cancer
The cells that form the tumor determine the type of stomach cancer. The
type of cells in your stomach cancer helps determine your treatment
options. Types of stomach cancer include:
- Cancer that begins in the glandular cells (adenocarcinoma). The glandular cells that line the inside of the stomach secrete a protective layer of mucus to shield the lining of the stomach from the acidic digestive juices. Adenocarcinoma accounts for more than 90 percent of all gastric cancers.
- Cancer that begins in immune system cells (lymphoma). The walls of the stomach contain a small number of immune system cells that can develop cancer. Lymphoma in the stomach is rare.
- Cancer that begins in hormone-producing cells (carcinoid cancer). Hormone-producing cells can develop carcinoid cancer. Carcinoid cancer is rare.
- Cancer that begins in nervous system tissues. A gastrointestinal stromal tumor (GIST) begins in specific nervous system cells found in your stomach. GIST is a very rare form of cancer.
Because the other types of stomach cancer are rare, when people use the term "stomach cancer" they generally are referring to adenocarcinoma.
Health: Risk Factors of Stomach Cancer (Gastric - Cancer)
A risk factor is anything that
increases a person’s chance of developing cancer, or any other disease. Some risk factors can
be controlled, such as smoking, and some cannot be controlled, such as
age and family history. Although risk factors can influence the
development of cancer, most do not directly cause cancer.
Some people
with several risk factors never develop cancer, while others with no
known risk factors do. However, knowing your risk factors and
communicating them to your doctor may help you make more informed
lifestyle and health-care choices. Research has shown that people with certain risk factors are more likely than
others to develop stomach cancer.
Studies have found the following risk factors for stomach cancer:
Age. Most cases of stomach cancer occur in people over age 55.
Gender. Men have twice the risk of developing stomach cancer as women.
Family history. People who have a first-degree relative (a parent, child, or sibling) who has had stomach cancer are at increased risk for stomach cancer.
Race. Stomach cancer is more common in Asian, Pacific Islander, Hispanic, and African Americans than in non-Hispanic white Americans.
Diet. Eating foods preserved by drying, smoking, salting, or
pickling may increase the risk of stomach cancer. Eating fresh fruits
and vegetables may help lower the health risk of gastric cancer.
Bacteria. A common bacterium called Helicobacter pylori, which causes stomach inflammation and ulcers, may increase the risk of stomach cancer. However, most people who are infected with this bacterium never develop stomach cancer.
Previous surgery or health conditions. People who have had stomach surgery or have pernicious anemia (severe decrease in red blood cells) or achlorhydria (absence of hydrochloric acid in the gastric juices, which help digest food) have an increased health risk of stomach cancer.
Occupational exposure. Exposure to certain dusts and fumes may increase the risk of developing stomach cancer.
Tobacco and alcohol. Tobacco use and excessive alcohol consumption may increase the risk of developing stomach cancer.
Genetic mutations. Certain inherited genetic disorders, such as hereditary diffuse gastric cancer, hereditary non-polyposis colorectal cancer (HNPCC or Lynch syndrome) and familial adenomatous polyposis (FAP) may increase the risk of stomach cancer.
Obesity. Excess body weight increases a man’s risk of developing stomach cancer. It is not clear whether obesity increases a woman’s risk of stomach cancer.
Most
people who have known risk factors do not develop stomach cancer. For example,
many people have H. pylori in their stomach but never develop cancer. On the
other hand, people who do develop the disease sometimes have no known risk
factors.
Risk factors for gastric cancer are a family history of gastric cancer, Helicobacter pylori infection, blood type A, smoking, a history of pernicious anemia, a history of chronic atrophic gastritis, an health condition of decreased gastric acid, and a prior history of an adenomatous gastric polyp.
If you think you may be at risk, you should talk with your doctor or health care provider. Your doctor may be able to suggest ways to reduce your health risk and can plan a schedule for checkups.
Health: Symptoms of Stomach Cancer (Gastric - Cancer)
People with stomach cancer may
experience the following symptoms. Sometimes, people with stomach
cancer do not show any of these symptoms. Or, these symptoms may be
caused by a health condition that is not cancer. If you are concerned
about a symptom on this list, please talk with your doctor or health care provider. Stomach cancer is usually not found at an early stage because it
often does not cause specific symptoms. When symptoms do occur, they
may be vague and can include:
Symptoms of advanced stomach cancer may include: Most often, these symptoms are not due to
cancer. Other health problems, such as an ulcer or infection, can cause the same
symptoms. Anyone with these symptoms should tell the doctor so that problems can
be found and treated as early as possible. People
with the symptoms listed above should talk with their doctor or health care provider.
Doctors use many tests to diagnose cancer and determine if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:
- Age and medical condition
- The type of cancer suspected
- Severity of symptoms
- Previous test results
In addition to a physical examination, the following tests may be used to diagnose stomach cancer:
Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed from the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease).
Endoscopy. This test allows the doctor to see the inside of the body. The person may be sedated, and the doctor inserts a thin, lighted, flexible tube called a gastroscope or endoscope through the mouth, down the esophagus, and into the stomach. The doctor can remove a sample of tissue during an endoscopy and check it for evidence of cancer.
Endoscopic ultrasound. This test is similar to an endoscopy, but the gastroscope has a small ultrasound probe on the end that produces an image of the stomach. An ultrasound uses sound waves to create a picture of the internal organs. The ultrasound image helps doctors determine how far the cancer has spread into the stomach and nearby tissue.
X-ray. An x-ray is a picture of the inside of the body. For instance, a chest x-ray can help doctors determine if the cancer has spread to the lungs.
Barium swallow. In a barium swallow, a person swallows a liquid containing barium and a series of x-rays are taken. Barium coats the lining of the esophagus, stomach, and intestines, so tumors or other abnormalities are easier to see on the x-ray.
Computed tomography (CT or CAT) scan. A CT scancreates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.
Magnetic resonance imaging (MRI).An MRIuses magnetic fields, not x-rays, to produce detailed images of the body. A contrast medium may be injected into a patient’s vein to create a clearer picture.
Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into a patient’s body and absorbed by the organs or tissues being studied. This substance gives off energy that is detected by a scanner, which produces the images. This technique is increasingly used to predict the effectiveness of chemotherapy in treating this type of cancer.
Health: Staging of Stomach Cancer (Gastric - Cancer)
Staging
is a way of describing a cancer, such as where it is located, if or
where it has spread, and if it is affecting the functions of other
organs in the body. Doctors use diagnostic tests to determine the
cancer's stage, so staging may not be complete until all of the tests
are finished. Knowing the stage helps the doctor to decide what kind of
treatment is best and can help predict a patient's prognosis (chance of
recovery).
The stages of adenocarcinoma stomach cancer include:
- Stage I. At this stage, the tumor is limited to the layer of tissue that lines the inside of the stomach. Cancer cells may also have spread to nearby lymph nodes.
- Stage II. The cancer at this stage has spread deeper, growing into the muscle layer of the stomach wall. Cancer may also have spread to the lymph nodes.
- Stage III. At this stage, the cancer may have grown through all the layers of the stomach. Or it may be a smaller cancer that has spread more extensively to the lymph nodes.
- Stage IV. This stage of cancer extends beyond the stomach, growing into nearby structures. Or it is a smaller cancer that has spread to distant areas of the body.
Recurrent cancer. Recurrent cancer is cancer that comes back after treatment. It may be a localized recurrence (comes back in the place where it started), or it may be a distant metastasis (comes back in another part of the body).
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Natural Alternative Treatment Option: NATURAL CANCER TREATMENT
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Health: Conventional Treatment for Stomach Cancer (Gastric - Cancer)
The treatment of stomach cancer depends on the size and location of the tumor, whether the cancer has spread, and the patient’s overall health. In many cases, a team of doctors, including a gastroenterologist (a doctor who specializes in the function and disorders of the gastrointestinal tract, including the stomach, intestines, and associated organs), surgeon, medical oncologist, and radiation oncologist, will work with the patient to determine the best treatment plan.
This section outlines treatments that are the standard of care (the best treatments available) for this specific type of cancer. Patients are also encouraged to consider clinical trials when making treatment plan decisions. A clinical trial is a research study to test a new treatment to prove it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options.
Stomach cancer may be treated with surgery, radiation therapy, or chemotherapy. Often, a combination of these treatments is used. It can be difficult to cure stomach cancer because it is often not detected until it is at an advanced stage.
Surgery
The goal of surgery is to remove all of the stomach cancer and a margin of healthy tissue, when possible. Options include:
- Removing early-stage tumors from the stomach lining. Very small cancers limited to the inside lining of the stomach may be removed using endoscopy. The endoscope is a lighted tube with a camera that's passed down your throat into your stomach. The doctor uses special tools to remove the cancer and a margin of healthy tissue.
- Removing a portion of the stomach (subtotal gastrectomy). During subtotal gastrectomy, the surgeon removes only the portion of the stomach affected by cancer.
- 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.
- Surgery to relieve signs and symptoms. Removing part of the stomach may relieve symptoms of a growing tumor in people with advanced stomach cancer. In this case, surgery can't cure stomach cancer, but it can make you more comfortable.
Surgery carries a risk of bleeding and infection. If all or part of your stomach is removed, you may experience digestive problems, such as diarrhea, vomiting and dumping syndrome, which occurs when the small intestine fills too quickly with undigested food.
Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. Patients with stomach cancer usually receive external-beam radiation therapy, which is radiation given from a machine outside the body. Radiation therapy may be used before surgery to shrink the size of the tumor or after surgery to destroy any remaining cancer cells.
Side effects from radiation therapy include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. Systemic
chemotherapy is delivered through the bloodstream, targeting cancer
cells throughout the body. Chemotherapy can be given by mouth or
injection. The goal of chemotherapy can be to destroy cancer remaining
after surgery, slow the tumor’s growth, or to reduce cancer-related
symptoms.It also may be combined with radiation therapy. Currently,
there is no standard chemotherapy treatment plan that is accepted
worldwide. Fluorouracil (5-FU, Adrucil) and cisplatin (Platinol) are
commonly used drugs in treating stomach cancer.
The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.
The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications.
Advanced stomach cancer
Advanced stomach cancer has spread to other areas of the body and is
generally treated the same way as earlier stages of the disease, with
surgery, chemotherapy, or radiation therapy. Doctors may also use
surgery to relieve symptoms and prevent intestinal or stomach
blockages. Chemotherapy or radiation therapy can also help relieve
symptoms.
Health: Prevention of Stomach Cancer (Gastric - Cancer)
Although it may not be possible to prevent stomach cancer, the following steps can help reduce your risk:
- Emphasize fruits and vegetables. A diet rich in fresh fruits and vegetables, especially those high in vitamin C and beta carotene, has been shown to help protect against stomach cancer. Look for deep green and dark yellow or orange fruits and vegetables, such as Swiss chard, bok choy, spinach, cantaloupe, mango, acorn or butternut squash, and sweet potatoes. Also try to eat vegetables from the cabbage family, including broccoli, brussels sprouts and cauliflower. Lycopene, a nutrient found in tomatoes and other red fruits and vegetables such as strawberries and red bell peppers, may be a particularly powerful anti-cancer chemical.
- Avoid nitrites and nitrates. These nitrogen compounds are known to contribute to stomach cancer. They're found primarily in processed meats — bologna, salami and corned beef, for instance — and in cured meats such as ham and bacon.
- Limit smoked, pickled and heavily salted foods. These have been linked to an increased risk of stomach cancer. Countries where the consumption of smoked, pickled and salted food is high have correspondingly high stomach cancer rates. Experiment with herbs and other ways of flavoring foods that don't add sodium.
- Don't smoke. Tobacco use greatly increases your risk of stomach cancer, especially cancer that occurs at the junction of the esophagus and stomach.
- Limit alcohol consumption. Alcohol may cause changes in cells that can lead to cancer.
- Limit red meat. Eating large amounts of red meat — particularly when it's barbecued or well-done — increases your risk of stomach cancer. Instead, choose fish or poultry.
- See your doctor if you have symptoms of an ulcer. Some medical conditions increase your risk of stomach cancer, such as anemia, gastritis and stomach polyps. If you've been diagnosed with one of these health conditions, ask your doctor how this affects your stomach cancer risk. Infection with H. pylori, the bacterium that causes most cases of gastric ulcers, is one of the leading causes of stomach cancer. Don't ignore symptoms of ulcers, such as a gnawing pain in your abdomen or chest that's worse when your stomach is empty or at night. Other, more severe signs and symptoms of ulcers include nausea, vomiting, bleeding and unintended weight loss. There are no guidelines to determine who should undergo screening for stomach cancer in the United States. But in some cases, you and your doctor may decide your risk is high enough that the benefits of screening outweigh the potential health risks.
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Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services_______________________________________________________________________________________________________
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