Gastric cancer

Gastric cancer or stomach cancer is a disease in which the cells forming the stomach begin to grow uncontrollably, forming a mass called a tumor.

Later, these cells often spreads (metastasizes) to adjoining organs such as the esophagus or the small intestine and finally they can reach the lymph nodes spreading the cancer to any part of the body.

The exact cause for stomach cancer is still unknown, but several potential factors may increase the risk:

• Helicobacter pylori infection
• Atrophic gastritis
• Menetrier disease
• Pernicious anemia
• Polyps in the large intestine

Diet may be also an important risk factor. Eating foods with high quantities of salt and nitrites increases the risk of gastric cancer. The formation of nitrosamines from nitrite is dangerous because nitrosamines are considered to be strong carcinogens. The presence of nitrites is high in frozen and smoked fish, cured meat, sausages or coconut oil.

Smokers are also more prone to suffer the disease.

Most cases of gastric cancer are diagnosed in people over 50 years old.

The incidence rate is about 7 or 8 cases per 100,000 individuals each year.

Gastric cancer in the early stages is usually asymptomatic. The most common symptoms are:

• Stomach discomfort
• Bloated feeling after eating
• Nausea
• Heartburn
• Loss of appetite
• Bad breath

Patients with advanced cancer may present:

• Blood in the stool
• Vomiting
• Weight loss
• Stomach pain

The two main methods to diagnose gastric cancer are:

• X-ray of the upper gastrointestinal tract: The patient is given a contrast solution of barium sulfate to drink and multiple x-rays are then taken to identify any abnormalities in the lining of the stomach.
• Gastrointestinal endoscopy: A thin, flexible, lighted tube (endoscope) is passed down the patient's throat and into the stomach. The advantages of endoscopy are that biopsies can be taken and small lesions may be evaluated.

The usual treatment for gastric cancer is surgical resection of involved gastric tissue and adjacent lymph nodes. In a surgical procedure known as total gastrectomy, the entire stomach may be removed. The surgeon will connect the esophagus directly to the small intestine. However, doctors prefer to leave at least part of the stomach if possible. Patients who have been given a partial gastrectomy should change their diet afterward based on medical recommendations.

Radiotherapy or chemotherapy can be applied later to increase the chances of cure.

Prognosis for patients with gastric cancer is poor (5-year survival rate is 15–20%).