Medical & Legal information on Stomach Cancer: Causes & Treatment Options
• Stomach Cancer Overview
• Who Is Affected?
• Stomach Cancer Causes
• Common Stomach Cancer Symptoms
• Diagnosing Stomach Cancer
• Developing a Treatment Plan
• Surgical, Radiation and Chemotherapy Treatment Options
Stomach Cancer Overview
Stomach Cancer (gastric cancer) is a serious disease where cancerous cells form in the stomach’s lining. Nearly every gastric cancer is adenocarcinoma, where malignant cancers develop and release mucus and other fluids. Other forms of stomach cancer develop as gastrointestinal stromal tumors, gastrointestinal carcinoid tumors, or lymphomas. H. Pylori bacterial infection is the most common cause of stomach cancer.
Most cases of stomach cancer are diagnosed after the disease has reached an advanced stage because there are usually no early warning signs or associated symptoms in earlier stages. Often, the symptoms do appear early on because they tend to be subtle or vague.
Who Is Affected?
Statistics maintained and released by the National Cancer Institute reveal that approximately 26,000 new cases of stomach cancer were diagnosed in 2016, representing 1.6 percent of all new cancer cases. In addition, there were likely more than 10,700 deaths that same year caused by the disease. Approximately 60 percent of all individuals diagnosed with stomach cancer every year have already reached their 65th year.
Approximately 7.4 of every 1000 men and women are diagnosed with cancer every year. The lifetime risk of developing the disease is approximately one percent of women and men based on data between 2011 and 2013. As of 2013, approximately 80,000 individuals were living with stomach cancer in America. The five-year survival rate for the disease after the initial diagnosis is 30.4 percent. The five-year survival rate where the stomach cancer has metastasized (spread) to other areas of the body are significantly lower (five percent).
Stomach Cancer Causes
Scientists, researchers, and doctors have yet to determine exactly why cancer cells begin growing in the lining of the stomach. However, there are specific risk factors that likely increased the potential for developing the disease.
Studies indicate that common bacteria (H. Pylori) infections cause ulcers in the stomach. In addition, gastritis, (a gut inflammation) and long-lasting anemia more than likely play key roles in the development of the disease. Other potential causes of stomach cancer include:
- Smoking cigarettes, cigars, and other tobacco products
- Having type A blood
- Previous history of stomach surgeries to treat ulcers
- Obesity and being overweight
- Exposure to asbestos and other harmful substances
- Environmental exposure in rubber, timber, metal and coal industries
- Mutated genes
- Epstein-Barr virus infection
- Diets that are high in salty, pickled or smoked foods
Common Stomach Cancer Symptoms
Often, the warning signs and symptoms involved with stomach cancer go unnoticed or are thought to be related to some other type of condition. The most common stomach cancer-related symptoms include:
- Loss of appetite
- Minimal nausea
- A bloated feeling after consuming a meal
The sensation of heartburn and indigestion after eating a meal is not necessarily an indicator of stomach cancer. However, if the symptoms continue, it is essential to speak with a primary health care provider.
Usually, advancing stomach cancer leads to tumors in the stomach and the development of serious symptoms that include:
- Extreme heartburn
- Ongoing diarrhea or constipation
- Stomach swelling
- Jaundice – The yellowing of skin and eyes
- Difficulty in swallowing
- Unexpected weight loss
- Stool with blood
- Stomach pain
Diagnosing Stomach Cancer
The physician or diagnostician will perform a comprehensive physical examination and obtain a complete medical history of the patient to determine if any risk factors associated with stomach cancer exists, or if there is an ancestral history of other members of the family having stomach cancer in the past. The doctor will likely conduct a variety of tests that include:
- Comprehensive Blood Tests – These test results can provide early or advanced indicators of stomach cancer
- Upper Endoscopy – The doctor will insert a small camera on a flexible thin tube down the patient’s throat to look at the interior of the stomach.
- Upward Gastrointestinal Series Test – The patient will drink a barium-laced chalky liquid that will clearly reveal components and abnormalities of the stomach and stomach lining during an x-ray.
- Biopsy – The doctor will remove a small sample of tissue from the lining of the stomach to be observed under a microscope by using an endoscopic device to look for indicators of cancer cells.
- Computerized tomography (CT) Scan – Using a powerful x-ray machine, the doctor will capture detailed images of the interior of the patient’s body.
Developing a Treatment Plan
The doctor will likely recommend one or more effective treatments for solutions for treating stomach cancer. The treatment plan will usually combine one or more available options and be developed by a multidisciplinary team of doctors and specialists that could involve:
- Medical Oncologist – This specialist has extensive training in treating stomach cancer using medication.
- Gastroenterologist – This specialist has extensive training in the gastrointestinal tract including the intestines and stomach.
- Radiation Oncologist – This specialist has extensive training in using radiation therapy as an effective treatment to kill cancer cells.
- Surgical Oncologist – The surgeon specializes in treating stomach cancer using surgical options.
Surgical, Radiation and Chemotherapy Treatment Options
The multidisciplinary team might recommend tumor removal surgery to ensure that the tumor and surrounding healthy tissue is excised during a surgical procedure. This option is available during different stages of the disease’s progression.
- Early Stage Stomach Cancer – During the early stage of the progression of the disease, doctors will often recommend an endoscopic mucosal resection. This surgical treatment removes the tumor using an endoscope.
During this early stage, the doctor might also recommend removal of a portion of the stomach affected by cancer and any associated lymph nodes. This partial or subtotal gastronomy procedure allows the surgeon to connect the remaining portion of the stomach to the small intestine or esophagus.
- Advancing Stage Stomach Cancer – If the disease progresses and metastasized (spreads) to other areas of the stomach including the outer wall before spreading to lymph nodes, surgery used concomitantly with chemotherapy or chemotherapy in conjunction with radiation might be the best option. In these procedures, the doctor will likely perform a total or subtotal gastronomy where the entire stomach is removed and the small intestine is attached directly to the esophagus. At Stage IV – the most advanced stage – surgery is usually not an option.
Even a partial gastronomy is still considered major surgery and usually produces serious side effects including dizziness after eating, diarrhea, nausea, and cramps. After the surgery is completed, the patient will lack the capacity to eat large amounts of food in one sitting. In addition, if the entire stomach has been removed, the patient will likely require vitamin B12 injections because they no longer have the capacity to absorb the necessary vitamin to the lining of the stomach.
A radiologist or radiation oncologist will use high energy x-ray beams (radiation therapy) to target and kill cancer cells. This procedure is often used prior to surgery to shrink the tumor size or used after surgery as a way to kill any cancer cells that remain.
Aggressive drugs have been designed to kill cancer cells and strip away their ability to continuously grow and reproduce. This multi-visit procedure is conducted by a medical oncologist.