Gastric Cancer

Stomach cancer or gastric cancer is characterized by the disordered growth of the cells that make up the wall of the organ.

Most gastric tumors occur somewhere in the inner lining layer of the stomach and appear as a raised, irregular lesion, millimeters in diameter, often ulcerated, resembling a wart with a small crater at its highest point.

Ulceration is the result of uncontrolled cell multiplication, characteristic of cancer or so-called malignant tumors. These abnormal cells replace normal tissue and can invade other layers of the stomach and thus reach neighboring organs.

Symptoms

Some symptoms include: weight loss, anorexia, fatigue, vomiting, nausea and persistent abdominal discomfort, characterizing a benign tumor or even stomach cancer. Vomiting blood is a common symptom and occurs in approximately 13% of cases of malignant tumors.

The most common symptoms are: feeling of bloating in the stomach after meals or early feeling of satisfaction during meals, abdominal discomfort, ulcer-like abdominal pain and severe heartburn, nausea and vomiting, loss of appetite, indigestion or periodic burning, diarrhea, weakness and fatigue, unintentional weight loss, bloody vomiting, evacuation of dark, pasty stools with a very strong odor. In more advanced stages, there may be severe weight loss, jaundice (yellow eyes) and pale skin.

Diagnosis

The diagnosis takes into account the exam called upper digestive endoscopy, which in addition to visualizing the characteristics and dimensions of the tumor, allows a biopsy to be performed for analysis, contributing to surgical planning.

If the diagnosis of cancer is confirmed, the degree of local extension of the disease and dissemination (distant metastases) is defined based on computed tomography of the abdomen and chest. Other tests, such as magnetic resonance imaging and echo-endoscopy, are requested in cases where the characterization of the extent of the disease is not well defined by endoscopy and tomography.

Treatment

Cancer treatment is divided into two modalities:

Dressing: its main element is surgery to remove the tumor. Surgery can range from removing the tumor endoscopically to partial or complete removal of the stomach (partial or total gastrectomy). The removal of lymph nodes (organs that consist of various types of cells and are part of the lymphatic system) is part of stomach removal surgery, the objective of which is to determine whether there are malignant cells in these lymph nodes, as it implies modifications in the treatment, and its consequent removal if they are compromised.

Radiotherapy and/or chemotherapy are included together with surgery, thus forming therapy with curative intent, depending mainly on the stage of the tumor. Cure rates of 60% to 70% are obtained in patients with localized disease using the aforementioned therapy measures.

Palliative: is performed on patients in some situations, such as: with tumors that cannot be removed, with clinical conditions that prevent curative surgery, with metastatic disease. Palliative therapy consists of chemotherapy and radiotherapy, indicated according to the presentation of the disease.

Risk factors

The biggest risk factors for the development of gastric cancer are: infection with Helicobacter Pylori – a bacterium present in the gastric mucosa of more than half of the world's population that causes inflammation resulting in pre-malignant lesions – and the presence of a family history of stomach cancer (This can increase the risk of cancer by up to five times). Other factors are: obesity, diet low in fruits and vegetables, smoking and previous gastric surgery.

How to prevent

For prevention, a balanced diet consisting of raw vegetables, citrus fruits and foods rich in fiber is recommended. It is important to combat smoking and reduce alcohol intake.

If you experience digestive symptoms such as stomach pain, early satiety or vomiting, including hemorrhagic vomiting, you should immediately seek medical help.

In more advanced stages, the treatment is compromised and so is the cure, reducing the chances in older people as well. Therefore, people who belong to any of these risk groups described above should consult a doctor and undergo follow-up to assess risks and request preventive tests.

Although the incidence of gastric tumors has shown a significant reduction in recent decades, they represent the second most common malignant tumor worldwide. The number of people who develop stomach cancer is very high in Japan, Chile, Eastern Europe, South America and Central America, being the main cause of death from cancer in many of these countries.