Stomach Cancer

Stomach Cancer

Overview of the Stomach

The stomach is located in the upper part of the abdomen. When food is swallowed, it travels down the esophagus to the stomach, where it mixes with gastric juices to aid digestion.

What is Stomach Cancer?

Stomach cancer begins when healthy cells in the lining of the stomach grow uncontrollably, forming a mass or tumor. Tumors can be benign (non-cancerous) or malignant (cancerous). Stomach cancer can develop anywhere in the stomach.

The most common type of stomach cancer is Adenocarcinoma, which originates from the glandular cells in the lining of the stomach.

Statistics

• India: 66,222 new cases of stomach cancer are diagnosed annually.

• Rank: Stomach cancer ranks 6th among all cancers in incidence and mortality in India.

• Deaths: Around 53,253 people die from stomach cancer each year in India.

Survival Rate

• In the United States, the 5-year survival rate is 33%.

• Early detection is crucial—when diagnosed at the early stages, the survival rate increases to 72%.

• However, 62% of stomach cancers are diagnosed at an advanced stage, reducing treatment effectiveness.

Risk Factors

Several factors can increase the likelihood of developing stomach cancer:

1. Age:

• People over 55 years are at higher risk.

2. Gender:

• Stomach cancer is twice as common in men compared to women.

3. Bacteria (H. pylori):

• Helicobacter pylori infection is a major risk factor, causing ulcers and chronic inflammation in the stomach lining.

4. Family History:

• Having close relatives with stomach cancer increases the risk.

5. Diet:

• Diets rich in salty, pickled foods increase the risk.

• A diet high in fruits and vegetables reduces the risk.

6. Previous Medical Conditions:

• Individuals with prior stomach surgeries, pernicious anemia, or achlorhydria have a higher risk.

7. Tobacco and Alcohol Use:

• Smoking and heavy alcohol consumption raise the risk significantly.

8. Obesity:

• Research shows that obesity increases the risk of stomach cancer in men.

9. Occupational Exposure:

• Prolonged exposure to certain chemicals may increase cancer risk.

Symptoms of Stomach Cancer

Early symptoms may be subtle, but as cancer progresses, the following signs may appear:

Early Symptoms:

• Heartburn or indigestion

• Stomach pain or discomfort

• Nausea and vomiting (vomiting soon after eating)

• Diarrhea or constipation

• Bloating after eating

• Loss of appetite

• Feeling of food obstruction in the chest

Advanced Symptoms:

• Vomiting blood

• Unexplained weight loss

• Fatigue or weakness

Diagnosis

• Biopsy: A tissue sample is examined under a microscope to confirm cancer.

• Biomarker Testing: Identifies genetic mutations in the cancer cells.

• Endoscopy: A thin, flexible tube with a camera is used to examine the stomach lining. Biopsies may be taken during this procedure.

• Barium Swallow: X-ray imaging after swallowing a barium-based liquid helps identify abnormalities.

• CT Scan / MRI / PET-CT: Used to assess the extent of the tumor.

• Laparoscopy: A small incision is made to insert a camera and examine the abdominal cavity.

Treatment Options for Stomach Cancer

1. Surgery

Surgery aims to remove the tumor along with some healthy tissue around it (margin):

• Endoscopic Surgery: Used for very early-stage cancers.

• Subtotal / Partial Gastrectomy: Removes part of the stomach if the cancer has not spread beyond the stomach.

• Total Gastrectomy: The entire stomach is removed, and the esophagus is connected to the small intestine to maintain digestion.

• Lymph Node Removal: Nearby lymph nodes are also removed during surgery to prevent further spread.

2. Radiation Therapy

• External Beam Radiation Therapy (EBRT) delivers high-energy radiation to destroy cancer cells.

• Radiation is used before surgery (to shrink the tumor) or after surgery (to eliminate remaining cancer cells).

• Palliative Radiation may relieve symptoms in advanced stages.

Side effects:

• Fatigue

• Nausea and vomiting

• Skin redness and itching

3. Chemotherapy

Chemotherapy uses anti-cancer drugs to kill cancer cells:

• Neoadjuvant Chemotherapy: Given before surgery to shrink tumors.

• Adjuvant Chemotherapy: Given after surgery to destroy any remaining cancer cells.

Common drugs used include:

• Cisplatin

• Oxaliplatin

• Fluorouracil

• Capecitabine

• Docetaxel

• Irinotecan

• Paclitaxel

Side effects:

• Fatigue

• Hair loss

• Nausea and vomiting

• Loss of appetite

• Infections

4. Targeted Therapy

This treatment targets specific genes and proteins in cancer cells:

• Trastuzumab

• Trastuzumab Deruxtecan

5. Immunotherapy

Immunotherapy boosts the body’s immune system to fight cancer cells:

• Nivolumab

• Pembrolizumab

• Dostarlimab

Follow-Up Care

• Regular follow-ups are necessary to monitor for recurrence and manage side effects.

• Follow-up care includes:

• Physical exams

• Blood tests

• Imaging tests like CT scans or PET-CT.

Stomach cancer can be challenging to treat, especially if diagnosed at an advanced stage. Early detection, combined with a multidisciplinary treatment approach, significantly improves outcomes. Regular follow-up is essential for maintaining health and managing long-term effects.

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