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Stomach Cancer

  Home   |   Stomach Cancer

What is stomach cancer?

Stomach is a digestive organ which connects the food pipe otherwise known as esophagus to the small intestine. Cancers usually happen in the inner lining of the stomach. Stomach cancer is knownas gastric cancer. These cancers are not uncommon in India especially in the south

What are the symptoms of stomach cancer?

Symptoms of stomach cancer include:
  • frequent heartburn
  • Vomiting
  • indigestion and burping frequently
  • feeling full after eating less food only
  • persistent abdominal pain.

It should be remembered that these symptoms may be present in many patients who do not have stomach cancer.

Similarly, it is possible that patients with cancer stomach may not have any of these symptoms Quite often patients present with anemia and weight loss without any gastric symptoms and are detected to have stomach cancer.

Who is at risk of getting stomach cancer?

Anyone can get stomach cancer, but some factors may increase your risk.

These factors include

  • Smoking
  • Male sex
  • Chronic infection with a bacteria known as H. pylori
  • Previous surgeries like gastrojejunostomy
  • Heredity plays a role in a small number of patients

    • How is stomach cancer diagnosed?

    When stomach cancer is suspected the main test would be an upper GI endoscopy. In this test a lighted tube connected to a camera is passed through the mouth and the stomach is visualized. If any suspicious lesion is found then biopsy is done at the same time

    The pathologist will check the tissue under a microscope and confirm if there is a cancer or not If confirmed to be cancer then further tests like CT scan or PET scan will be required to see how much it has spread.

    How is stomach cancer treated?

    Once diagnosed with stomach cancer it is preferable to meet an oncologist.

    Treatment will depend on the stage of the cancer.

    Basically, there are four stages in stomach cancer. Stage 1 which is confined to the mucosa of the stomach and stage 4 which has spread to other organs.

    The usual treatments which are used are

    • Surgery
    • Chemotherapy
    • Radiation therapy
    • Immunotherapy

    In early cases the main treatment will be surgery

    Intermediate stages are likely to require combination treatments. In most cases of stage 3 stomach cancer most likely chemotherapy will be given first followed by surgery. In certain situations, surgery may be followed by chemotherapy. Here coordination between different departments is important.

    Radiation has a limited role in stomach cancer and is usually used when there is active bleeding from the cancer.

    What is the surgery done for stomach cancer?

    Depending on the location and extent of the disease either part or whole of the stomach is removed along with the surrounding tissue. This procedure is known as radical gastrectomy

    If only the lower portion of the stomach is to be removed then the procedure is known as distal radical gastrectomy.

    If the entire stomach has to be removed then the procedure is known as Radical total gastrectomy.

    Following removal of the stomach the small intestine is brought up, made into a pouch and joined to the lower end of the esophagus.

    It is important to remove the draining lymph nodes around the stomach at the time of the surgery.

    Depending on the extent of lymph node removal the surgery is classified as D1 and D2 nodal dissection. Various trials have shown better survival with D2 nodal dissection.

    Can stomach cancer surgery be done laproscopically and robotically?

    Most certainly yes. However, the decision must be individualized as certain situations may not be good for this method. When performed by these methods the hospital stay is shorter and the pain patients must suffer is lesser. Overall outcomes regarding survival remain the same as open surgery.

    When is chemotherapy used in stomach cancer?

    Chemotherapy may be used in 3 situations

    1. Prior to surgery in intermediate stage stomach cancer. This is termed neo adjuvant chemotherapy and has shown better outcomes.

    2. Post surgery in intermediate stage stomach cancer – This is known as adjuvant chemotherapy.

    3. In stage 4 stomach cancer where the intent is not to cure but to prolong survival and reduce complications. This is known as palliative chemotherapy.

    Can stomach cancer be prevented?

    Stomach cancer cannot be prevented. However, you can reduce your risk of developing all cancers by:

    • Maintaining a healthy weight
    • Eating a balanced diet
    • Limiting your alcohol intake
    • Avoid smoking
    • Exercising regularly