The stomach is an important organ in the digestive system. Located on the left side of the body in the upper abdominal region, the stomach secretes acids and enzymes required to digest food. Food moves from the mouth into a narrow ‘food pipe’ or oesophagus from where it reaches a muscular, bag-like structure, which is the stomach. The oesophageal sphincter, at the upper end of the stomach, acts as a valve and allows the food into the stomach. A muscular tissue called Rugae line the inside of the stomach. The Rugae contract periodically to churn the food. Subsequently, the food enters the small intestine through a valve, at the lower end of the stomach, called as Pyloric sphincter.
There are various ailments that can affect this vital organ and one of them is stomach cancer. Stomach cancer is the sixth most common type of cancer and affects people of all ages and socio-economic groups. It is good to know more about this ailment so that preventive action or timely medical help can be taken.
Types of Stomach cancers
- Adenocarcinoma – Cancer of the cells in the inner-most lining of the stomach. This is the most common type and accounts for about 93% of all cases, worldwide.
- Lymphoma: Lymphoma is a generic cancer of the immune systemwhich develops wherever lymphatic tissues are found, including the stomach. Lymphoma of the stomach is quite rare and accounts for about 4% of all stomach cancers.
- Carcinoid tumors: These develop in the hormone-producing cells of the stomach. The best part about this type of stomach cancer is that it does not spread to other organs of the body. This accounts for about 3% of stomach cancer incidences.
Causes and Risk Factors for Stomach Cancer
Cancer in general is a condition in which an abnormal mutation occurs in the cells’ DNA. The mutation causes the cell to grow, divide rapidly and continue living at the expense of normal cells which may die. In the process, a tumour is created and it starts spreading within the body. Cancerous cells can break off from the tumour and spread far and wide within the body. When the above process is localized to the stomach, we have the above 3 types of cancers. However, it’s not clear what causes such behaviour or why stomach cancers develop.
There are certain risk factors which can act as triggers for the cancer formation.
Lifestyle related Causes:
- Alcohol use and abuse
- Tobacco use and abuse
- Sedentary lifestyle and lack of exercise
- Diet rich in smoked, salted and pickled food
- Diet rich in meat
- Diet low in fresh fruits and vegetables
- Not storing or cooking food properly
- Environmental exposure to dust and fumes
- Working in industries that process coal, metal, timber, rubber, lead orasbestos
- Family history of stomach cancer
- Li-Fraumeni syndrome
- Familial adenomatous polyposis (FAP)
- Lynch syndrome
- Various genetic mutations.
Other ailments and conditions which might cause Stomach Cancer
- Chronic atrophic gastritis, or long term stomach inflammation that makes the stomach lining thinner
- History of stomach polyps or stomach lymphoma
- Helicobacter pylori (H. pylori) bacterial infection
- Megaloblastic (pernicious) anaemiawhich might develop due to a deficiency of vitamin B12
- Ménétrier’s Disease
- Cancers in other parts of the digestive system
- Epstein-Barr virus infection
- Intestinalmetaplasia, in which cells usually line the intestine line the stomach lining undergo abnormal changes
- Stomach ulcers
Other Risk factors
- Age 50 and above
- Gender: Men are more at risk than women
- Type A blood group
- Stomach surgery for an ulcer
Symptoms of Stomach Cancer
Symptoms of stomach cancer may mimic other conditions such as Gastroesophageal Reflux Disease (GERD), gastritis or peptic ulcer which may delay detecting the condition earlier. If you or any of your near and dear suffer from the following symptoms repeatedly, or for longer durations of time, consult a doctor and ask for stomach cancer screening.
Stomach cancer develops over different stages and the patient may suffer one or more of the following symptoms.
- Severe, persistent heartburn
- Severe indigestion that is always present
- Unexplained, persistent nausea
- Difficulty in swallowing
- Abdominal pain or vague discomfort in the abdomen, usually above the navel
- Nausea, vomiting and a bloated feeling after meals
- Vomiting blood or blood in the stools
- Diarrhoea or constipation
- Loss of appetite
- Unexplained weight loss
- Weakness and fatigue
- Sense of fullness after eating small amounts of food (or early satiety)
- Jaundice, yellowish eyes or skin
- Excessive fatigue
- Stomach pain, which may be worse after meals
- Frequent burping
- Pain in the breastbone
- Trapped wind
- Abuild-up of fluid in the stomach, which may cause the stomach to feel lumpy to the touch
- Upper endoscopy: A thin tube containing a tiny camera is passed down the throat and into stomach of the person. If any suspicious tissues are found, a piece of such tissue is collected for analysis, a procedure called as Biopsy.
Also Read: What is endoscopy? What are the different types of endoscopy?
- Imaging tests:Computerized tomography (CT), positron emission tomography (PET) and MRI (magnetic resonance imaging) scans are used to look for stomach cancer.
- Exploratory surgery:The doctor may recommend surgery to look for signs that the cancer has spread beyond theoesophagus or stomach, within the chest or abdomen. The procedure is usually laparoscopic. That is, the surgeon makes several small incisions in the abdomen and inserts a special camera that transmits images to a monitor in the operating room.
- Barium swallow:Also called asupper GI series test. The person must consume a drink containing barium. The fluid coats the stomach which makes it easy to show up very clearly in X-rays.
- Stool tests: Also called faecal occult blood test, this is used to detect the presence of blood in the stoolswhich might not be visible to the naked eye.
Also Read: Tests to diagnose stomach problems
Treating stomach cancer has two purposes: one is to destroy the cancerous tissue completely and secondly, to prevent its spread to lungs, lymph nodes, bones and liver. Depending on which stage the cancer is at currently, treatment options include:
- Surgery: Depending on which part of the stomach is affected and how wide is the spread, there are various options such as endoscopic mucosal resection, subtotal gastrectomy and total gastrectomy.
- Chemotherapy: In this, chemicals are injected into the body to either shrink the tumour before surgery, destroy any cancerous cells left behind after the surgery, or to destroy cancerous cells that might have spread to the rest of the body.
- Radiation therapy: In this method, X-rays and proton streams are irradiated on the target area to destroy the cancerous cells.
- Immunotherapy: In this method, certain drugs are given to attack specific abnormalities in cancer cells or vaccines are given to increase the person’s immunity level. Depending on which type of stomach cancer and what stage it is in, these drugs include Herceptin, Cyramza, Gleevec, Sutent, Stivarga, etc.
Stomach cancer can be successfully treated when detected in the early stages. Watch out for any of the symptoms and do not take them lightly. Consult your family physician and discuss these symptoms with him/her. Needless to say, he/she will refer you to the right doctors or institution, for a successful treatment and rehabilitation.
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