Signs Of Stomach Cancer, Stages Of Gastric Cancer, Diagnosis and Treatment

Signs Of Stomach Cancer, Stages Of Gastric Cancer, Diagnosis and Treatment .

Stomach or gastric cancer usually affects age group of 55-65 years. It is seen more in males. There is a hereditary tendency and an increased incidence of stomach cancer in those with blood group A.

Factors associated with increased risk for stomach cancer are-

• High salt intake.
• Exposure to alpha-toxins, nickel refining and rubber processing.
• Living in areas with high nitrate content in the soil.
• Chronic gastritis usually type-A.

Stages of Gastric CancerNearly 95% of stomach cancers are adenocarcinomas.

The remaining includes lymphoma, leiomyosarcoma, carcinoid tumor, metastatic cancer and others.

Morphological type’s are

Polypoid.

Ulcerating.

Ulcerating and infiltrating.

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Infiltrating.

Three most important prognostic variables are the depth of the tumor invasion and presence of metastasis.

By the TNM (tumor, node, and metastasis) classification 5 year survival rates vary from 70% fro stage I, 30% for stage II, 9% for stage III and 0.5% and 2% for stage IV.

Clinical Features of Stomach CancerPatient may present with the following symptoms

• Epigastric discomfort, fullness or burning after heavy meal or belching.
• Disturbance of appetite and nausea.
• Decrease in appetite.
• Recurrent bouts of nausea and vomiting.
• Post-prandial distress simulating peptic ulcer.
• Haematemesis (vomiting of blood) or malena (blood in stools) may be the first presenting symptom in some cases.
  
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• Slight dysphagia (difficulty in eating) after solid foods, cough induced by swallowing and regurgitation may occur if lesion is in lower esophagus.
• Colonic symptoms include diarrhea due to rapid stomach emptying or even constipation and lower abdominal discomfort.
• Patient may approach medical help with compliant of lump in abdomen.
• Loss of weight and strength.
• Anemia and pallor.
• Symptoms due to metastasis- like ascites, jaundice, and pathological fractures.
• Acute abdomen- rarely perforation of gastric carcinoma may be the first manifestation.

Signs of Stomach CancerEpigastric mass, jaundice, a left supra-clavicular node or ascites may be seen.

Physical signs almost invariably signify an incurable disease, with the exception of pyloric stenosis which may be caused by a relatively early cancer.

Diagnosis of Gastric Cancer

Radiology: Double contrast studies are done to detect mucosal abnormalities due to neoplastic invasion/infiltration.

Endoscopy: If barium meal results are equivocal, then brush cytology combined with biopsy with help of endoscopy helps confirming the diagnosis.

CT-scan is often useful in staging of stomach cancer particularly for detecting hepatic and lymph node metastasis.

Treatment for Stomach Cancer

• Radiotherapy is not frequently used as gastric adenocarcinoma is a relatively radio-resistant tumor. Therefore, radiation can help only in palliation of pain.
• Chemotherapy has been used, however results are not encouraging. It has been used to down-stage locally advanced cancer prior to surgery.
• Surgery remains the main treatment modality for cure and palliation.
• In early cases, local gastric resection and in more advanced cases sub-total or total gastrectomy is the treatment of choice.