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Stomach Cancer

Overview

Stomach or gastric cancer occurs when the stomach cells grow abnormally. The most common site of cancer in the stomach is the main body of the stomach. Initially, the cancer cells are seen near the lining of the stomach, after which they eventually invade deeper into the walls.

The exact cause is not yet known. However, some common causes of stomach cancer include:

  • Genetics: Cancer occurs due to mutation in the DNA in the cells of the stomach
  • Infections: Helicobacter pylori and Epstein-Barr virus
  • Obesity and diet: High-fat diet, high salt diet - including pickles, and less consumption of fruits and vegetables
  • Alcohol and tobacco
  • Gastritis and gastrointestinal reflux disease

  • Bloated feeling
  • Loss of appetite
  • Unexplained weight loss
  • Blood in stools or vomit
  • Nausea
  • Feeling full after a snack

  • Endoscopy
  • CT scan
  • Biopsy
  • Barium swallow test
  • Biomarker tests

Treatment for stomach cancer depends on the stage of cancer.

Surgery is performed to remove the cancer, which includes removing stomach parts affected by cancer, along with the lymph nodes. Diet changes such as eating smaller and frequent meals will be necessary. Doctors may prescribe vitamin supplements to compensate the actions of stomach, some of which can only be injected. Stomach cancer surgery involves different types:

  • Total gastrectomy: This operation involves the complete removal of stomach along with the lymph nodes and omentum, sometimes including parts of intestines, pancreas, spleen, and oesophagus. The remaining parts are attached (usually the end of oesophagus to the remaining small intestine). This is performed when the cancer is in the upper part of stomach.
  • Subtotal (partial) gastrectomy: This operation involves removal of only a part of the stomach. It is often recommended when the cancer is in the lower part only or upper part of the stomach.
  • Palliative surgery: Surgery is preferred even in cases of advanced cancer and unresectable stomach cancer to prevent the blockage of stomach by the tumour and to prevent bleeding or relieve symptoms or complications. This includes subtotal gastrectomy as well. The goal is not to cure cancer but to relieve symptoms.
  • Endoscopic resection: Endoscopic mucosal and submucosal resections are used in early stage cancers, when the chances of cancer spreading to the lymph nodes is minimal. This procedure involves an endoscope to remove the tumour and surrounding parts of the stomach.
  • Endoscopic tumour ablation: An endoscope is used to guide laser beam to eliminate the parts of tumour in people in whom surgery cannot be done. This is performed to relieve blockage and stop bleeding without any surgery.
  • Gastric bypass (gastrojejunostomy): Sometimes, the tumours are large enough to block the food from leaving the lower part of the stomach. An option to help prevent or treat this blockage of food passage is to bypass the lower part of stomach. A part of the jejunum is attached to the upper part of the stomach, so that food passes without any obstruction.
  • Stent placement: A stent is placed using an endoscope to prevent the blockage at the opening or end of stomach. So that the food passes freely through it.
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