Stomach cancer is a malignant tumor growing from the mucous membrane – the innermost layer of the wall of the stomach. This layer is in contact with food and gastric juice.
Like any other malignant tumor, it is characterized by a gradual but inexorable growth. Upon reaching a certain phase of its development, it can produce metastases – secondary tumor nodes in other organs (liver, lungs, bones, lymph nodes, ovaries, etc.).
Stomach cancer is dangerous. In the process of its growth, it depletes the strength of the human body (this is a feature of all malignant tumors). It also leads to severe and life-threatening complications, even being in a treatable stage.
Most often this disease causes the following complications:
- tumor bleeding;
- tumor perforation (i.e. its rupture with the formation of a through-hole in the abdominal cavity);
- stenosis of the pylorus with the development of complicated eating disorders.
Among all types of stomach tumors, cancer is most common. About 90-95% of all tumors of the stomach are malignant.
Thus, any tumor-like lesion of the stomach wall is a very severe suspicion of gastric cancer, requiring a thorough, timely and complete examination.
Stomach cancer is one of the most common types of tumor damage to human organs. This disease occupies the 6th place in the list of malignant diseases in the world.
Over 780 000 people in the world die every year from stomach cancer. Speaking of world statistics on mortality due to malignant tumors, only cancer of the lung and colon is ahead of cancerous tumors of the stomach.
Degrees of stomach cancer
The degree of organ damage by cancer cells is most often determined after surgery. To assess the stage of the disease, several factors are considered:
- the depth of the gastric wall lesion;
- whether lymph nodes located directly near the stomach are affected by metastases;
- whether there are metastases in distant lymph nodes and/or other organs.
- Stage 0 – pathology in the cells is detected in the superficial layer of the gastric mucosa.
- Stage 1 – the tumor penetrates into single lymph nodes, as well as into the muscle layer of the stomach wall.
- Stage 2 – cancer cells infect the outer layer of the gastric wall and a larger number of lymph nodes. At this stage, there are no distant metastases.
- Stage 3 – the spread of a malignant tumor to the most external – the serous layer of the stomach wall. Cancer cells infect nearby internal organs of the abdominal cavity and also infect the lymph nodes.
- Stage 4 – the last – is diagnosed if the patient has metastases in distant lymph nodes and/or other organs.
The first signs of disease are invisible. The patient may be disturbed by periodic pain and slight discomfort in the stomach, nausea, loss of appetite, vomiting, weakness, heartburn.
At a later stage in the development of oncology, bleeding, belching, changes in stool and its color (with chronic leakage of blood from the stomach, feces become black), weight loss, feeling of stomach fullness, constant nausea, yellowness of the skin and eyes.
The effectiveness of treatment for stomach cancer depends on the timely detection of a developing tumor. Diagnosis of gastric cancer includes two types:
The primary diagnostic methods for stomach cancer include (primary diagnosis allows you to determine the presence of a tumor) is esophagogastroduodenoscopy (endoscopy) with targeted biopsy (taking pieces of tissue for subsequent histological examination). It allows you to confirm or disprove the diagnosis, determine the type of cancer cells, see changes in the mucosa.
After confirming the presence of a stomach tumor, a precision diagnosis is prescribed, which allows you to determine the prevalence of the existing tumor. It may include such examination methods as:
- computed tomography of the organs of the abdominal and thoracic cavities, the pelvic cavity with intravenous contrasting of vessels, if necessary. This method allows you to evaluate the nature of the tumor spread, the involvement of adjacent organs, large vessels, etc .;
- positron emission tomography of the whole body is a method that includes computed tomography and the simultaneous introduction of a radioactive drug into the vascular bed, by which it is more reliable to determine the nature of tumor spread (this method has a number of restrictions on stomach cancer since this type of tumor refers to tumors that do not accumulate a radioactive drug (fluorodeoxyglucose);
- ultrasound examination of the organs of the abdominal cavity and retroperitoneal space is used to detect the tumor boundaries, its germination in nearby lymph nodes and organs, the spread of metastases, the presence of ascitic (metastatic) fluid in the abdominal cavity, etc .;
- endoscopic ultrasonography of the stomach combines two methods: endoscopy and ultrasound. It allows a doctor to evaluate the growth of the tumor into the depths of the gastric wall from the inside of the stomach cavity. The method is especially relevant in cases of early stomach cancer. It is possible to carry out the removal of the tumor immediately during endoscopy without extensive surgical interventions.
- X-ray of the digestive tract with barium. A contrast agent helps to see the boundaries of the neoplasm in the stomach, to determine the degree of stomach narrowing by a tumor, the presence of intestinal obstruction with metastatic damage to the intestinal walls, etc .;
- laparoscopy under anesthesia through punctures helps determine the disease’s stage. It is also possible to detect the location of metastases that are not visible with CT and ultrasound.
This diagnostic option is carried out after a clarifying diagnosis and sets the task to determine whether it is possible to carry out the planned antitumor treatment in a particular patient. The range of examinations varies for each individual patient, but usually includes:
- blood tests;
- assessment of respiratory reserves;
- echocardiography (heart ultrasound);
- daily monitoring of ECG;
- ultrasound of the vessels of the neck and lower extremities, and many others.
The main methods of treating stomach cancer include surgical, medicinal and radiation.
The most common radical treatment is the surgical removal of stomach cancer. Such operations are carried out on a regular basis. This method is used at different stages of cancer treatment.
In the initial stage of the disease development, it is possible to use endoscopic treatment, that is, removal of the tumor by means of an endoscope during endoscopy, or removal of only a small portion of the gastric wall with the tumor during surgery while maintaining the organ.
At later stages of the disease development, the amount of intervention will be different: either a part of the stomach (resection) or the entire organ (gastrectomy) is removed. In addition to the removal of the organ itself with the tumor, the lymph nodes surrounding the stomach must also be removed.
At the 4th stage of the disease, the possibilities of surgical treatment are intended for decreasing the patient’s suffering. Operations are performed to set up feeding tubes (for feeding), to eliminate the obstruction, only with an immediate threat to the patient’s life. Operations are performed to remove the stomach with the tumor.
Chemotherapy (drug therapy)
Such treatment is prescribed after surgery on the stomach in order to consolidate the results of surgical treatment and to delay the possible relapse of the disease. Such therapy is carried out in courses (usually two or three) sometimes in combination with radiation therapy.
During treatment, several drugs can be used simultaneously. They are administered intravenously. Different drugs affect cancer cells in different ways, preventing them from dividing and destroying. The cost of chemotherapy for stomach cancer largely depends on the number of prescribed drugs.
Perfusion thermo-chemotherapy, which is carried out immediately after surgery, after the tumor removal in the operating room, deserves special attention in the case of advanced gastric cancer. For a few hours, a heated solution of chemotherapy is injected into the abdominal cavity. Such treatment can significantly reduce the likelihood of disease relapse in the abdominal cavity. If you feel seek after chemotherapy, you may take Zofran.
The essence of the method is that the patient is exposed to ionizing radiation. This allows you to slow down the tumor growth and kill its cells. Radiation therapy for gastric cancer is carried out according to indications after surgery in combination with chemotherapy.
Specialists use two types of radiation therapy:
In the first case, using special equipment, the beam acts on the tumor, passing through healthy organs and tissues. Then, a catheter, needle, string or grain with radioactive substances is inserted into a malignant neoplasm.
The success of treatment depends largely on the early diagnosis of the disease and the selection of appropriate treatment methods.
The general state of human health is also important because there are factors leading to disease development: alcohol abuse, unhealthy lifestyle, heredity.
The treatment success also depends on the identified stage of oncology. In the initial phase, the survival rate reaches 70-80%, in the second – 50-60%. In the third and fourth stages, the rate survival rate is even lower.