Stomach Cancer Treatment in Mumbai, India

Stomach cancer, also known as gastric cancer, is the uncontrolled growth of the stomach cells. It develops in the stomach's inner lining, and the abnormal cells formed might develop into tumours. It is common in people over the 60s through 80s. It develops over some time and can go undetected for a long time. As cancer progresses, it might spread to distant organs through the lymphatic system or blood.

This cancer occurs in the abdominal region, either at the proximal or distal end of the stomach. The proximal part of the stomach includes cardio (first part), fundus (next to cardia), and body(corpus). The distal part of the stomach consists of the lower two parts, the antrum and pylorus. This might affect any part of the stomach.

Almost all cancer (about 95%) begins in the glandular tissue that forms the stomach lining.

Alternate Name

Gastric cancer, abdominal cancer.

Stomach Cancer Symptoms

Stomach cancer initially does not cause any marked symptoms, but when it shows symptoms, they are

• Difficulty in swallowing
• Feeling full even after consuming small quantities of food.
• Bloating of the stomach after eating
• Indigestion
• Stomach pain
• Nausea
• Unexplained weight loss
• vomiting
• Stomach pain.

Stomach Cancer Causes

The exact cause of stomach cancer is unknown, but it is known that it starts when in the stomach cells, there is a sudden change in DNA which is called mutations. This mutation makes the cells divide uncontrollably and finally results in a tumour. This tumour finally becomes cancerous.

Stomach Cancer Stages

Stomach cancers have five stages

Stage 0

Stage 1- Stage 1 and stage IB

Stage 2- Stage 2A and stage 2B

Stage 3- Stage 3A ,Stage 3B and stage 4B

Stage 4- Metastasis stomach cancer

Stomach Cancer Treatment

Treatment of cancer is a combined effort of doctors from different specialisations who chart out treatment plans for stomach cancer treatment depending on several factors such as stage and type of cancer, patient’s preferences, possible side effects and overall patient health. Combination therapy is employed usually to treat cancer.

The type of treatment employed for stomach cancer are

• Surgery of cancerous tissue; If stomach cancer has not spread to other parts of the body, then surgery is the best option. Parts of my stomach and some lymph nodes are removed.
• Chemotherapy Anticancer drugs are either given through veins or orally before surgery (Neoadjuvant treatment), or it is given along with radiation therapy (chemoradiation).
• Targeted drug therapy for the stomach. Drugs that target HER2 protein(increased during cancer) such as trastuzumab
• Immunotherapy uses the body's own immune system to treat cancer.
• In radiation therapy; high-energy radiation is used to kill cancer cells.

Stomach Cancer Risk Factors

However, the chances of getting stomach cancer are

• Obesity- Obesity might cause the body to produce more leptin and insulin, stimulating cell division and promoting cancer cell growth.
• Smoking increases the risk of stomach cancer, especially in the upper part of the stomach, which is closer to the oesophagus. The incidence of stomach cancer is double in people who smoke.
• Family history predisposes one to cancer. There are two to three higher rates of developing cancer when somebody in the family has it.
• Helicobacter pylori infections. This bacteria is one of the major reasons for developing stomach cancer.
• Chronic stomach inflammation and gastritis erode the epithelial layer, making it prone to developing cancer.
• Gastroesophageal reflux disease. This disease results in acid reflux, and this acid might erode the upper part of the stomach closer to the oesophagus.
• Diet rich in salt; studies have shown that the stomach lining is damaged by salt and may cause lesions, and together with stomach cancer-causing bacteria, Helicobacter pylori may increase the incidence of stomach cancer.

Stomach Cancer Possible Complications

Gastric cancer can escalate to conditions such as

• Gastrointestinal bleeding
• Ascites
• Metastasis to other distant organs
• Loss of weight
• Weight loss

Tests For Stomach Cancer

Other than physical examination, the tests normally employed for detection are

• Biopsy; Examining a small amount of cancerous tissue under a microscope
• Molecular testing of the tumour; done to identify a specific gene, proteins
• Endoscopy. The doctor examines the stomach by using an endoscope
• Endoscopic ultrasound; is similar to endoscopy but has an ultrasound at the end of the probe
• X-ray.
• Barium swallow; liquid containing barium is swallowed, followed by an X-ray.
• Computed tomography (CT or CAT) scan; Detailed 3-dimensional image using X-rays.

Stomach Cancer Prevention

Primary Prevention

The primary prevention includes

• Chemoprevention
• Screening for early detection
• Healthy diet
• Anti-H pylori therapies
• Food habits and dietary factors have a major role development of stomach cancer

Secondary Prevention

Secondary prevention of cancer emphasises on

• Early detection of cancer and minimally invasive treatment methods.
• Periodic endoscopic examination of patients who had pylori infections helps to detect cancer early.

Gastrointestinal stromal tumours(GISTs)

This is an uncommon type of tumour that begins in the stomach wall called interstitial cells of Cajal as a very mild form. This GIST normally spreads to other parts of the body.

Differential Diagnosis for Stomach Cancer

Gastric cancer manifests with no specific symptoms, so as a result, there are multiple differential diagnoses. Important among them are GERD, gallstone disease, pancreatic cancer and peptic ulcer disease.

Epidemiology

• Less prevalence of gastric cancer is found in India compared to other developed countries.
• In India, gastric cancer is the fifth most common type of cancer in males and the seventh most common cancer among females.

Prognosis

Expected Prognosis

The expected prognosis with stomach cancer is that 31.5% of people suffering from this cancer survive five years or longer.

Natural progression

Normally stomach cancer develops at the age of 60 and above and begins as a loss of appetite and weight. It then progresses to dysphagia, abdominal pain and vomiting. If left untreated, 63% of patients progress to advanced stages in the other five years. In 80-90%, metastasis occurs.

Pathophysiology

There are two pathological types of gastric cancer: diffuse and intestinal. The intestinal type occurs as a final result of inflammatory process progression as it moves from chronic gastritis to atrophic gastritis and ultimately to intestinal metaplasia and dysplasia.

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