In the last few decades, medical experts have witnessed a worldwide decline in stomach cancer cases. However, it’s still listed as the seventh major cause of cancer-related deaths in the United States. This could be because gastric cancer is a disease that does not show symptoms until later stages. The American Cancer Society estimated over 26,000 new stomach cancer cases in 2022, out of which 11,000 deaths were registered.
New research and clinical expertise are intriguing patients with gastric cancer and other gastrointestinal tract malignancies. However, each individual’s risk is affected by various factors such as ethnicity, infection with bacteria or virus (such as the Epstein-Barr virus), smoking, obesity, and so on.
Types Of Stomach Cancer
Apart from poor lifestyle habits and hereditary causes, stomach cancer is also widely known to be caused by the side effects of some prescription drugs. For instance, in 2019, a random quality test by a Connecticut-based laboratory found Zantac to contain traces of a well-known carcinogen named NDMA.
Zantac is the brand name under which GlaxoSmithKline sells ranitidine, a drug consumed for relief from gastroenteric problems. The results of these tests suggested that ranitidine causes stomach cancer along with several other types of cancers.
Here are a few other factors that heavily influence the casualties of stomach cancer.
- Regular consumption of processed foods and smoking
- Medical history of stomach surgery,
- Pernicious anemia
- Hypertrophic gastropathy
Gastric cancer may also be inherited through familial syndromes such as hereditary nonpolyposis colorectal cancer. It’s also known as the Lynch syndrome, that’s caused by defects in the body’s ability to repair damaged DNA.
Another one is called hereditary diffuse gastric cancer. There are rare cases where certain people inherit an inactive copy of the CDH1 gene that can later cause stomach cancer. So if there’s a chain of gastric cancer cases in your family, it would be wise to get yourself checked for CDH1 in your system.
Symptoms Of Gastric Cancer
The symptoms of gastric cancer include epigastric pain and bleeding from the tumor. The bleeding may lead someone to vomit blood or have dark, tarry stools. Persistent blood loss can lead to iron deficiency anemia which may cause dizziness and lightheadedness. The tumor can also obstruct the stomach causing weight loss, nausea, vomiting, feeling full fast, or bloating.
Gastric Cancer Treatment Procedures
Gastric cancer is a complex disease case that requires the expertise of a multidisciplinary team with experience in providing complex and updated treatments to patients.
Testing & Diagnosis
Patients are typically diagnosed with gastric cancer during an upper endoscopy. The endoscopic findings may reveal a mass or an ulcer in the stomach which is then biopsied. A pathologist reviews the biopsy material and confirms the diagnosis.
Sometimes patients undergo an additional procedure called staging. Typically, this is performed by an endoscopic ultrasound procedure known as the T stage. It tells the treating physician the depth of the tumor growth within the stomach wall. Endoscopists also visualize the nearby lymph nodes and based on these imaging characteristics, they determine if the lymph nodes are cancerous.
Metastasis Check-Up
Furthermore, during the M stage, additional staging information is obtained by CT or PET scan to see if cancer has spread to other organs. Patients are treated with systemic chemotherapy and immunotherapy if metastasis to other organs is identified during imaging. Surgery or endoscopic stenting can help relieve obstructive symptoms caused by the tumor.
Patients without distant metastasis on imaging should undergo a final test such as diagnostic laparoscopy. This is a minimally invasive procedure performed under general anesthesia to evaluate the abdominal cavity or perineum for any evidence of metastasis. These metastases are often too small to be detected on CT or PET scans. Peritoneal metastases are identified in 20% of patients with gastric cancer.
Other Preparations & Procedures
At the same time, patients should also have their abdomen washed with saline and evaluated by a pathologist from microscopic circulating tumor cells. This fluid can be positive for cancer cells in another 14% of patients with gastric cancer. This procedure is done as an outpatient and can be combined with the placement of a port for subsequent systemic chemotherapy and a feeding tube if needed for nutrition.
To Conclude
As opposed to the decrease in frequency we mentioned earlier, medical records suggest an alarming rise in the diagnosis of gastric cancer in young patients. Fortunately, new advances in systemic chemotherapy, sequencing of treatment, and improved surgical techniques allow patients to live longer than before with gastric cancer.