STOMACH CANCER

 

Stomach cancer, also known as gastric cancer, usually starts in the inner lining of the stomach. As the cancer develops, cancer cells dig deeper into the stomach walls. While it is common worldwide, it is considered rare in the US. It is important to note that the common symptoms of stomach cancer, such as unexplained weight loss and stomach pain, are often not evident in the early stages of the disease.

There are different types of stomach cancer, classified according to the type of cell where the cancer originates. Some examples:

1. Adenocarcinoma: Adenocarcinoma stomach cancer originates in the cells that produce mucus. This type of cancer is the most common among cases of stomach cancer, comprising almost all cases of this type of cancer.
2. Stromal tumors (GIST): GIST tumors develop from special nerve cells present in the wall of the stomach and other organs of the digestive system. GISTs are classified as a type of soft tissue sarcoma.
3. Carcinoid tumors: Carcinoid tumors originate from neuroendocrine cells , which are found in different parts of the body. These cells perform functions similar to nerve cells and are also involved in hormone production. Carcinoid tumors are classified as a type of neuroendocrine tumor .
4. Lymphoma: Lymphoma is a cancer that originates in the cells of the immune system, responsible for fighting infections . Lymphoma can start in the stomach when the body sends immune cells to the stomach, usually in response to an infection . Most lymphomas that develop in the stomach are classified as non- Hodgkin lymphomas .

SYMPTOMS

In its early stages, stomach cancer often has no noticeable symptoms . Even the most prevalent early signs, such as unexplained weight loss and stomach pain, often only appear when the disease is at a more advanced stage.

Symptoms of stomach cancer can include:

• Loss of appetite.

• Difficulty swallowing.

• Feeling of fatigue or weakness.

• Nausea and vomiting.

• Unexplained weight loss.

• Heartburn and indigestion.

• Black stools (melena) or bloody vomit.

• Feeling bloated or gassy after meals.

• Stomach pain, often above the navel.

• Feeling full, even after a small meal or snack.

Importantly, many of these symptoms can also be associated with other conditions. It is essential to see a doctor to assess whether these symptoms are indicative of stomach cancer or another disease.

CAUSES

Stomach cancer results from genetic mutations in the DNA of stomach cells. However, there are several factors that seem to increase the likelihood of developing this condition. Some of these factors include:

1. Family History of Stomach Cancer: Having close relatives who have had stomach cancer can increase your risk of developing the disease.
2. Helicobacter infection _ pylori (H. pylori ): This bacteria is known to cause inflammation in the lining of the stomach, increasing the risk of developing gastric cancer.
3. Gastroesophageal Reflux Disease (GERD): GERD, also known as acid reflux, occurs when stomach acid returns to the esophagus frequently and may contribute to the development of stomach cancer.
4. Gastritis: Inflammation of the stomach lining, known as gastritis, can increase the likelihood of developing gastric cancer.
5. Epstein-Barr Virus Infection: This viral infection is associated with certain types of cancer, including stomach cancer.
6. History of stomach ulcers or stomach polyps: People who have had stomach ulcers or stomach polyps are at a higher risk of developing gastric cancer.
7. Inadequate diet: A diet rich in fatty, salty, smoked or preserved foods, and low in fruits and vegetables, can contribute to an increased risk of stomach cancer.
8. Exposure to toxic substances: Frequent exposure to substances such as coal, metal and rubber can increase the risk of gastric cancer.
9. Smoking: Smoking, vaping or chewing tobacco is associated with a higher risk of developing stomach cancer.
10. Excessive alcohol consumption: Excessive alcohol consumption can also increase the likelihood of developing gastric cancer.
11. Obesity: Obesity is linked to an increased risk of several types of cancer, including stomach cancer.
12. Autoimmune Atrophic Gastritis: This condition is characterized by chronic inflammation of the stomach lining, which can lead to the development of gastric cancer.

It is important to note that the presence of these risk factors does not guarantee the development of stomach cancer, but being aware of them and adopting a healthy lifestyle can help reduce your risk.

DIAGNOSIS

Diagnosing stomach cancer involves different approaches to confirm whether symptoms are related to a tumor or other causes. The doctor will perform a series of steps, including a medical and family history, as well as a physical exam. Laboratory tests, x-rays, or other procedures may be ordered to determine the source of the symptoms.

The following tests are used to detect the cause of symptoms:

• Fecal occult blood test (FOBT): Stomach cancer sometimes causes internal bleeding that is not visible. Through the fecal occult blood test, small amounts of blood can be detected . If blood is detected in this analysis, additional tests will be needed to identify the source of the bleeding. It is important to note that other benign conditions, such as hemorrhoids, can also cause blood in the stool.

• Contrast-enhanced X-ray of the esophagus and stomach (upper gastrointestinal tract) - esophageal-gastro-duodenal transit: This X-ray examination is performed after ingestion of a barium solution, a thick, white liquid (mupe). Barium allows the doctor to visualize the stomach on X-ray, making it easier to identify tumors or abnormal areas. During the exam, the doctor may introduce air into the stomach to make small tumors more visible.

• Endoscopy: This is an examination of the stomach and esophagus done with a thin, lighted tube called a gastroscope, inserted through the mouth into the stomach. The doctor applies a local anesthetic to the patient's throat to reduce discomfort and gag reflexes. In some cases, relaxing medications are also given. The gastroscope allows the doctor to directly view the inside of the stomach. If abnormal areas are found, the doctor may remove tissue through the gastroscope. A pathologist will then examine the tissue under a microscope to look for cancer cells. This procedure of removing and microscopically examining tissue is called a biopsy and is the only reliable method of confirming the presence of cancer cells.

TREATMENT

The treatment of stomach cancer involves several approaches, which can be combined depending on the stage of the disease and the individual characteristics of the patient. The main treatment options include:

1. SURGERY: Surgery is the most common treatment for stomach cancer and is known as a gastrectomy. During this procedure, the surgeon partially (partial or sub-total gastrectomy ) or completely (total gastrectomy) removes the stomach, along with the surrounding tissue. After a partial gastrectomy, the doctor connects the remaining part of the stomach to the esophagus or small intestine. After a total gastrectomy, the esophagus is connected directly to the small intestine.
2. CHEMOTHERAPY: Chemotherapy is an approach that uses drugs to fight cancer cells. It can be done with a single drug or a combination of them. Medications can be given by mouth, in the form of pills, or through an intravenous (IV) injection directly into a vein. In both cases, the drugs enter the bloodstream and circulate throughout the body, acting systemically.
3. RADIOTHERAPY: Radiation therapy is a localized treatment that only affects the cancer cells in the treated area. Using high-energy rays, it aims to destroy malignant cells. Radiation therapy is sometimes given after surgery to eliminate possible remaining cancer cells in the tumor area. In addition, the feasibility of intraoperative radiotherapy, performed during surgery, is being studied. Radiotherapy can also be used as a palliative treatment, aiming at pain relief.
4. IMMUNOTHERAPY - BIOLOGICAL THERAPY: Biological therapy, also known as immunotherapy, is a form of treatment that helps the immune system recognize and destroy cancer cells. In addition, it helps the body to recover from some side effects of the treatment.

PREVENTION

There are several measures that can be taken to help prevent stomach cancer. Five ways to prevent stomach cancer:

1. Healthy eating: Opt for a balanced diet rich in fruits, vegetables and whole foods. Reduce consumption of processed, fatty and salty foods. Avoid excessive consumption of red meats and sausages, such as sausage and bacon, which are associated with a higher risk of stomach cancer.
2. H. pylori : Treat Helicobacter bacteria infection pylori , if diagnosed. This bacterial infection is linked to a higher risk of developing stomach cancer. Consult a doctor to make the diagnosis and follow the appropriate treatment, if necessary.
3. Don't smoke: Smoking is a known risk factor for many types of cancer, including stomach cancer. Quitting smoking or avoiding passive smoking can significantly reduce your risk of developing this disease.
4. Moderation in alcohol consumption: Excessive alcohol consumption is associated with a higher risk of stomach cancer. It is advisable to limit alcohol consumption and adopt a moderate lifestyle in this regard.
5. Beware of preservatives and smoked foods: Some smoked, pickled or processed foods may contain carcinogenic substances such as nitrates and nitrites. Try to limit the consumption of these foods and, when possible, opt for fresh and natural options.

Remember that prevention is key, but it does not guarantee complete elimination of the risk of stomach cancer. It is also important to have routine checkups and regular medical visits for early detection of the disease, especially if you have additional risk factors or a family history of gastric cancer.