Stomach cancer

About

Stomach cancer, also known as gastric cancer, is a type of cancer that begins in the lining of the stomach. It is a relatively common cancer and is the fourth leading cause of cancer-related deaths worldwide. Symptoms of stomach cancer can include abdominal pain, loss of appetite, weight loss, frequent indigestion, feeling of fullness in the stomach, vomiting, and fatigue. Treatment for stomach cancer depend on the stage of the cancer and may include surgery, radiation, and chemotherapy.

Symptoms

The most common symptom of stomach cancer is constant stomach pain, sometimes accompanied by nausea and/or vomiting. Other symptoms of stomach cancer can include indigestion, heartburn, difficulty swallowing, bloating, loss of appetite, unexplained weight loss, exhaustion, blood in the stool, and swelling of the abdomen.

Causes

The exact cause of stomach cancer is unknown, however certain risk factors have been identified that may increase a person’s risk. These include:

  • Age – stomach cancer is more common in people over the age of 50
  • Gender – stomach cancer is more common in men
  • Diet – a diet high in salted, smoked, and pickled foods, as well as a diet low in vegetables and fruits may increase risk
  • Smoking – smokers who use tobacco are more likely to develop stomach cancer
  • Helicobacter pylori (H. pylori) infection – this bacterium is found in the stomach of infected individuals and causes inflammation and irritation, leading to an increased risk of stomach cancer
  • Family history – having one or more family members with stomach cancer increases your risk
  • Gastric polyps – growths in the stomach that can become cancerous
  • Gastrectomy – having part of the stomach surgically removed can increase the risk of stomach cancer
  • Medical conditions – certain medical conditions such as Babesiosis, chronic atrophic gastritis, and pernicious anemia can increase the risk of stomach cancer.

Risk factors

The risk factors for stomach cancer include:

  • Smoking
  • Age (60 and older)
  • Poor diet, including a diet high in smoked or salted foods or foods with nitrates and nitrite
  • Certain infections such as Helicobacter pylori (H. pylori)
  • Having had stomach surgery
  • Eating a diet low in fresh fruits and vegetables
  • Being overweight or obese
  • Alcohol use
  • Exposure to certain chemicals such as asbestos
  • Excessive intake of processed or smoked meats
  • Gastric polyps (small growths in the stomach)
  • Family history of stomach cancer
  • Ethnicity (greater risk among Asians, African Americans and Latinos)

Diagnosis

Stomach cancer is typically diagnosed using a combination of tests, such as physical examination, lab tests, imaging scans, and biopsy. During a physical exam, your doctor may check your abdomen for any signs of swelling or discomfort. Lab tests may be used to check your blood for any abnormalities, while imaging scans may be used to look for any suspicious lumps or masses. A biopsy may also be used to check a sample of the abnormal tissue to examine it for cancer cells.

Sub-types

There are four main subtypes of stomach cancer, including adenocarcinoma, gastrointestinal stromal tumors (GISTs), squamous cell carcinoma and lymphoma.

Adenocarcinoma is the most common type of stomach cancer, making up 85-90% of all cases. It starts in the cells that make mucus and other fluids to help digest food.

Gastrointestinal stromal tumors (GISTs) are the second most common type of stomach cancer, representing about 1% of all stomach cancer cases. They tend to begin in the cells found in the wall of the stomach and can be benign or malignant.

Squamous cell carcinoma is another type of stomach cancer and is formed from squamous cells located in the lining of the stomach. It is rare and accounts for about 1-5% of cases.

Lymphoma is the rarest type of stomach cancer, making up 4-5% of cases. It is a type of cancer that affects the lymphatic system and causes large numbers of cancerous cells to build up in the tissues of the stomach.

Treatments

The treatment options for stomach cancer vary depending on the stage and type of stomach cancer a person has. Generally, treatments include surgery, chemotherapy, radiation therapy, and targeted therapy.

Surgery: Surgery is the most common treatment for stomach cancer and can involve removing the tumor and a portion of the stomach and/or lymph nodes. Surgery may also involve reconstructing the stomach or removing the whole stomach.

Chemotherapy: Chemotherapy involves the use of drugs to destroy cancer cells and may be used in combination with surgery.

Radiation Therapy: Radiation therapy involves using high-energy beams to destroy cancer cells. It can be used in combination with surgery or chemotherapy and may be used after surgery to reduce the risk of the cancer coming back.

Targeted Therapy: Targeted therapies are drugs that target specific molecules involved in cancer growth, helping to stop or slow it down. Examples include drugs that target the VEGF (vascular endothelial growth factor) pathway and drugs that target the HER2 (human epidermal growth factor receptor 2) pathway.

Prevention

  1. Quit smoking and reduce alcohol consumption.
  2. Eat a healthy diet with a variety of fruits, vegetables, whole grains and lean proteins.
  3. Maintain a healthy weight.
  4. Avoid processed and pickled foods.
  5. Exercise regularly.
  6. Get vaccinated against Helicobacter pylori bacteria, a common cause of stomach ulcers.
  7. Participate in regular checkups and screening tests.
  8. Avoid food that has been contaminated with pesticides, fertilizers, and other chemicals.
  9. Reduce your stress levels and practice relaxation techniques.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of stomach cancer. Generally, stomach cancer is more common in men than women, and men tend to develop the condition at a younger age. Additionally, certain risk factors for stomach cancer, such as smoking and Helicobacter pylori infection, are more common in men. Women tend to have better survival rates when compared to men, likely due to their earlier detection and diagnosis of the condition. Research has indicated that the rate of recurrence and progression to metastatic disease is higher in men than women. Additionally, research suggests that women may be more likely to receive aggressive treatment, such as surgery as a first line of treatment, while men are more likely to receive less aggressive approaches on average. Therefore, gender-based differences in the presentation and management of stomach cancer should be taken into consideration.

Nutrition

Nutrition plays an essential role in the management of stomach cancer, as it helps to support the health and wellness of the body while undergoing treatment. Eating a well-rounded, nutrient-dense diet can help to improve energy levels, reduce nausea and vomiting, speed up recovery time, support the immune system, and help to reduce the risk of infection. Additionally, it can help to manage the side effects of chemotherapy and radiation, such as constipation, diarrhea, and mouth sores. Eating adequate amounts of protein, vitamins, and minerals can also help to maintain muscle mass and improve overall quality of life. Proper nutrition can also help to reduce inflammation, which is important in preventing cancer cells from spreading. Lastly, a diet low in salt and saturated fats can help to reduce the risk of stomach cancer recurrence.

Physical Activity

Physical activity has been shown to be associated with a decreased risk of stomach cancer. Regular physical activity can reduce inflammation in the gut and help to reduce harmful compounds that can increase the risk of cancer. Additionally, physical activity is also associated with a healthy BMI, which can aid in reducing the risk of cancer. Finally, physical activity can enhance the immune system and reduce the risk of developing stomach cancer.

Further Reading

  1. https://bestpractice.bmj.com/topics/en-us/264/references
  2. https://www.mayoclinic.org/diseases-conditions/stomach-cancer/symptoms-causes/syc-20352438
  3. https://www.cancer.org/cancer/stomach-cancer/about/what-is-stomach-cancer.html
  4. https://www.ncbi.nlm.nih.gov/books/NBK459142/
  5. https://seer.cancer.gov/statfacts/html/stomach.html

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