Name: Tumor of the stomach
Approximately 90–95% of stomach tumors are malignant, and of all malignant tumors, more than 95% is cancer. Stomach cancer ranks second in terms of morbidity and mortality after lung cancer.
In men, stomach cancer occurs 2 times more often than in women. Most often, people over 40-45 years old get sick, although not so often stomach cancer occurs in people 30-35 years of age and even younger ones.
The cause of the disease, like the root cause of all other malignant tumors, is not completely known. However, the main reasons that increase the risk of stomach cancer can be identified:
- hereditary factor (it is noted that the risk of the disease is approximately 20% higher in relatives of persons suffering from malignant lesions of the stomach);
- exposure to carcinogens (preservatives, nitrosamines, excessively rough, smoked, fatty, overcooked or spicy foods);
- an important role is played by precancerous conditions – chronic atrophic gastritis, gastric ulcer, pernicious anemia, condition after gastric resection (especially after 10–20 years after resection according to Billroth-II), gastric polyps (malignancy rate up to 40% with polyps more than 2 cm in diameter), immunodeficiency states;
- alcohol abuse.
Clinical symptoms of gastric cancer in the initial stages of the disease are scarce and uncertain. Not only the patients themselves, but also doctors do not often regard them as a manifestation of gastritis and, without conducting a full gastrological examination, they confine themselves to prescribing various medications. However, after carefully testing the complaints, you can catch a number of symptoms that are alarming about the presence of a malignant disease:
- a change in general well-being, expressed in the appearance of weakness, a decrease in the likelihood of work, fatigue, unmotivated rises in temperature;
- a persistent decrease in appetite or a complete loss of it up to an aversion to food without any objective reason;
- progressive weight loss, accompanied, along with the first two signs, by pallor of the skin, not explained by other diseases;
- change in mental status – loss of joy in life, interest in the environment, in work, apathy, alienation.
Simultaneously with the general signs of a malignant disease, symptoms may occur that indicate damage to the stomach:
- phenomena of “gastric discomfort” – constant or food-related discomfort, a feeling of heaviness, fullness in the upper abdomen;
- a feeling of fullness in the stomach, even after a small amount of food;
- sometimes soreness in the epigastric region, occasionally nausea and vomiting.
The described symptoms can be detected either against the background of complete health, or against the background of an already existing gastric disease (gastritis, gastric ulcer, duodenal ulcer). In these cases, attention is paid to the change in the old, well-known sensations to the patient and the addition of new symptoms to them.
If complications arise, such as gastric bleeding, obstruction (blocking of the exit from the stomach by the tumor, as a result of which food from the stomach cannot enter the intestine), perforation of the tumor, the clinical picture changes.
With gastric bleeding (which can occur from an ulcerated tumor), there is a sharp weakness, up to loss of consciousness, nausea, vomiting like “coffee grounds” or dark blood with clots, black (“tarry”) stools. This situation is of an emergency nature, often we are talking about hours or even minutes, therefore, if the above signs appear, you should immediately call an ambulance.
With perforation (breakthrough) of the tumor and the exit of the contents of the stomach into the abdominal cavity, peritonitis develops (sharp severe pain in the abdomen, tension in the muscles of the abdominal wall, weakness, fever).
With obstruction (stenosis of the outlet of the stomach), heaviness in the epigastric region, constant nausea, vomiting of food eaten a few days ago, gastric contents with a greenish tint, are disturbing. This situation, as a rule, does not occur overnight, like bleeding, but it is also serious and requires immediate medical attention.
All of the described complications require immediate medical attention!
With a far advanced process, the appearance of constant pain radiating to the back, weight loss, up to cachexia (exhaustion), the skin becomes earthy, and a sharp weakness appears.
The presence of the previously presented symptoms may prompt you or your doctor to conduct the necessary investigations. Diagnosis of stomach cancer consists of a number of instrumental and laboratory research methods.
The main and generally available instrumental methods of examination include EGDS (esophagogastroduodenoscopy, gastroscopy) and radiography of the stomach (X-ray of the stomach).
With a combination of endoscopy and biopsy, the probability of making a correct and timely diagnosis, even at an early stage of gastric cancer, is within 95%.
X-ray of the stomach is an addition to gastroscopy, but often it is also an independent research method. With radiography, it is likely to reveal a tumor of the stomach, even if it is improbable to determine it during gastroscopy.
In difficult cases, also to determine the prevalence of the process, CT (X-ray computed tomography), MRI (magnetic resonance imaging, nuclear magnetic resonance imaging) are used.
To exclude metastasis of gastric cancer to other organs, along with CT and MRI, ultrasound and chest X-ray are used, in which it is likely to detect the presence of metastases, and subsequently change the treatment tactics accordingly.
A blood test does not give clear indicators of the presence of cancer, however, a decrease in hemoglobin and an increase in ESR cannot be ignored.
Determination of the level of oncomarkers (special blood indicators that increase in the presence of a malignant tumor in the body) is important, but is an addition to the main diagnostic methods and is used more often to control the treatment process.
It should be remembered that the detection of any, even a malignant disease at an early stage improves the prognosis of the upcoming treatment.
In the treatment of stomach cancer, the main role belongs to the surgical method. The volume of surgical treatment of gastric cancer depends on the extent of the tumor in the stomach, the degree of involvement of regional lymph nodes and the presence of distant metastases. The type and extent of the operation will be determined by the surgeon depending on the lesion.
With common forms of stomach cancer, combined operations are likely to be performed with the removal of not only the stomach, but also those involved in the process of the pancreas, part of the colon, spleen, part of the liver, which, according to world data, increases the duration and quality of life of such patients. The removed tumor is sent for histological examination, after which further treatment tactics are determined – chemotherapy is likely to be required.
Gastric cancer metastasizes (gives screenings) to the lymph nodes, liver, ovaries, and peritoneum. Sometimes metastases are detected at the first visit of the patient to the doctor. The presence of metastases (that is, the 4th stage of the oncological process) is not a reason for refusing to treat a patient (as unfortunately happens in many medical institutions). It is almost impossible to achieve a complete cure, but many patients manage to prolong life.
Prevention of stomach cancer consists in the timely treatment of precancerous conditions – gastric polyposis, chronic ulcers and gastritis, as well as in maintaining a normal diet, reducing alcohol consumption.