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Stomach Cancer Treatment

Stomach cancer is also known as gastric cancer. The stomach is a muscular sac that is located in the upper and middle part of the abdomen, just below the ribs.  Although stomach cancer can affect any part of the stomach, it mostly forms in the stomach body, which is the main part of the body. Treatment mainly includes surgery for the removal of stomach cancer. Other forms of treatment may be recommended before or after surgery.


Types:
According to the type of cells that cancer begins in, stomach cancer can be classified as follows:
1. Adenocarcinomas: These types of cancers are seen in the glandular lining of the stomach. It is the most common type of stomach cancer.
2. Sarcomas: Stomach cancers affecting the connective tissue, that is, the fat, muscles, or blood vessels.
3. Lymphomas: Stomach cancers develop from the lymphocytes, which are a type of blood cells that are involved in the body’s immune or disease-fighting system.
4. Other types of cancers: Squamous cell carcinoma, small cell carcinoma, and carcinoids are the other types of stomach cancers.
5. Metastatic cancers: The cancers that begin in other parts of the body, like melanoma (a type of skin cancer) and breast cancer, and later spread to the stomach are known as metastatic cancers.

Causes:
The exact cause of stomach cancer is not clearly known. Stomach cancer starts due to the changes (mutations) in the DNA of the cells. These changes cause the cells to grow and multiply rapidly. The abnormal cells accumulate to form a tumor. This tumor can invade and destroy healthy tissue. The cancer cells can spread (metastasize) to the other parts of the body.

Risk factors:
The factors which may increase the risk of developing stomach cancer may include:

  • Smoking
  • Obesity
  • Gastroesophageal reflux disease (the stomach acid persistently flows back into the food pipe causing a burning sensation in the chest)
  • A high intake of salty and smoked foods
  • A diet having less of fruits and vegetables
  • Family history of stomach cancer
  • Gastritis (chronic or long-term inflammation of the stomach)
  • Stomach polyps (masses of cells that are formed on the lining inside the stomach) 
  • Helicobacter pylori infection (a bacterial infection that 
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Symptoms

The symptoms of stomach cancer include:

  • Difficulty in swallowing
  • Heartburn (burning sensation in the chest)
  • Nausea
  • Indigestion
  • Stomach pain
  • Feeling full after eating a small quantity of food
  • Feeling bloated after eating
  • Vomiting
  • Unintended weight loss
  • Complications:
  • Stomach cancer can cause the following complications:
  • Bleeding in the esophagus, stomach, or small intestine
  • Spread of stomach cancer to other parts of the body like lungs, liver, bones, or lymph nodes
  • Obstruction of the small intestine
  • Gastric perforation (hole formation in the stomach, large intestine, or small intestine.

Diagnosis

1. Physical examination: The patient is checked physically by the doctor. The symptoms, medical history, and family history of the patient are noted.
2. Upper endoscopy: An endoscope is a thin tube with a camera on one end. It is passed through the mouth and throat into the stomach by the surgeon to check for any signs of cancer.
3. Imaging tests: CT scans, MRI scans, PET scans, and a special type of x-ray called barium swallow are imaging tests done to obtain clear images of the internal structures of the body.
4. Biopsy: The surgeon excises (removes) a small sample of the suspected tissue growth during an upper endoscopy using special medical tools. This sample is sent to the laboratory to check for the presence of cancer cells.
5. Blood tests: This test can be used for measuring organ function, to check which organs in the body are affected by cancer.
6. Endoscopic ultrasound: An endoscope is passed down the throat into the stomach by the surgeon, and a special ultrasound tool is used for creating images of the stomach in this test.
7. Exploratory surgery: This procedure is done by laparoscopy. The surgeon makes small incisions in the abdomen and inserts a tube with a special camera, known as a laparoscope, in the abdomen to transmit the images to a monitor. This test helps in checking if cancer has spread beyond the stomach.
 

Treatment

The type of treatment done depends on the severity of cancer, location of cancer, and the overall health of the patient. Treatment options include:

1. Surgery: It is the most common form of treatment for stomach cancer. The different types of surgeries include:
a) Endoscopic mucosal resection and endoscopic submucosal resection: It is a surgical procedure to remove small cancers by passing special medical tools through an endoscope. Removal of the superficial tumors is known as endoscopic mucosal resection, and the deeper tumors is known as endoscopic submucosal resection.
b) Subtotal gastrectomy: This procedure involves the removal of that part of the stomach which is affected by cancer, along with some healthy tissue surrounding it.
c) Total gastrectomy: This is the surgical removal of the entire stomach and some surrounding tissue.
Lymph nodes removal: The lymph nodes in the abdomen are removed by the surgeon to test them for the presence of cancer.

2. Chemotherapy: This therapy involves the use of certain drugs to kill cancer cells.

3. Radiation therapy: This therapy involves the use of high-powered energy beams like x-rays and protons to kill cancer cells.

4. Targeted drug therapy: Some drugs attack specific characteristics of the cancer cells, ultimately causing the death of the cancer cells. This is known as targeted drug therapy.

5. Immunotherapy: This form of treatment involves the use of certain drugs to boost the body’s immune or disease-fighting system to kill the cancer cells.

Risks

The various risks associated with the different types of treatments done for stomach cancer include:
1. Surgery:

  • Dizziness 
  • Bleeding 
  • Infection
  • Nausea
  • Diarrhea

2. Radiation therapy:

  • Skin reactions
  • Weakness
  • Upset stomach
  • Loose bowel movements

3. Chemotherapy and targeted drug therapy:

  • Tiredness
  • Nausea
  • Vomiting
  • Diarrhea
  • Loss of appetite
  • Hair loss

4. Immunotherapy:

  • Skin reactions
  • Changes in weight
  • Flu-like symptoms
  • Diarrhea

After Procedure

  • In case of a surgical procedure like gastrectomy, you will probably be in the hospital for 3 to 10 days after the procedure.
  • Some pain and discomfort are normally seen after a surgical procedure. The doctor may advise some pain medications to get relief from the same.
  • You will be asked to gradually move from a liquid diet to a semi-solid and solid diet after surgery.
  • A feeding tube may be placed in the small intestine through an incision in the abdomen. This tube is generally removed after 3 to 4 weeks.
  • You may be asked to wear compression stockings for a few weeks after the surgery to help with blood circulation in the legs and prevent blood clot formation.
  • The doctor may advise you to avoid driving, heavy lifting, and strenuous activities for a couple of weeks after the surgery.
  • A physiotherapist may help you with breathing and coughing exercises to help in keeping the lungs clear and reducing the chances of chest infection.
  • Palliative or supportive treatment is generally recommended along with other forms of treatment like chemotherapy, radiation therapy, targeted drug therapy, and immunotherapy. This therapy helps in the management of the symptoms of the disease and improves the quality of life of the patient.
  • Regular follow-up appointments with the doctor are a must after treatment. The doctor will check for any recurrence of cancer and the overall health and well-being of the patient.

 

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