Stomach cancer is common throughout the world and affects all
races, it is more common in men than women, and has its peak age range
between 40 and 60 years old. Mortality is higher in Japan and Chile,
presumably because of the different diets in those countries where they
are less dependent on red meat.
Over the last 25 years the
incidence of this type of cancer in the western world has decreased by
50% and the resulting death rate is less than a third of what it used to
be but in less developed countries it is still a major cause of death,
probably because in these countries by the time the disease is diagnosed
(usually by means of a Barium meal) the stomach cancer is at a very
advanced stage.
TYPES OF STOMACH CANCER
There are several
different types of stomach cancer, some of which are very rare. The most
common types start in the glandular cells of the stomach lining
(adenocarcinomas), this is where stomach acid and digestive enzymes are
made, and where most cancers start. When the tumor becomes more
advanced, it can travel through the bloodstream and spread to organs
such as the liver, lungs, and bones. Cancers that start in the lymphatic
tissue (lymphoma), in the stomach's muscular tissue (sarcoma) or in the
tissues that support the organs of the digestive system
(gastrointestinal stromal tumors) are less common and are treated in
different ways.
SIGNS AND SYMPTOMS
Early clues to stomach cancer are chronic dyspepsia and epigastric
discomfort, followed in later stages by weight loss, anorexia, a feeling
of fullness after eating, anemia and fatigue. Blood in the stools may
also be present and if the Cancer is in the Cardia (top) vomiting may
occur.
CAUSATION
The exact cause is unknown although the presence of the Helicopter
pylori bacterium seems to be a major factor. Predisposing factors
include environmental influences such as smoking and high alcohol
intake. Because stomach cancer is more common amongst those with a
family history and with people with type A blood, genetic factors are
also implicated. Dietary factors, particularly methods of food
preservation such as pickling, smoking or salting also have an influence
on the prevalence.
DIAGNOSIS
Stomach cancer is diagnosed through an examination that may include
an upper gastrointestinal (GI) series; endoscopy or gastroscopy where a
thin flexible tube is passed down the throat so the doctor can see into
the stomach, esophagus and upper part of the bowel Barium meals and
Barium swallows. Because the cancer can spread to the liver, the
pancreas, and other organs near the stomach as well as to the lungs, the
doctor may order a CT scan, a PET scan, an endoscopic ultrasound exam,
or other tests to check these areas.
The cancer can spread
(metastasize) to the esophagus or the small intestine, and can extend
through the stomach wall to nearby lymph nodes and organs. Metastasis
occurs in 80-90% of individuals with stomach tumors, with a five year
survival rate of 75% in those diagnosed in early stages and less than
30% of those diagnosed in late stages.
TREATMENT
Although the cancer may be treated with surgery, radiation therapy,
or chemotherapy, in many cases surgery is the treatment of choice. Even
in patients whose disease is not considered surgically curable,
resection offers a palliative effect and improves potential benefits
from chemotherapy.
The nature and extent of the cancer determines
what kind of surgery is most appropriate. Common surgical procedures
include, partial and total removal of the stomach.
Antiemetics can control nausea, which increases as the cancer
advances. In the more advanced stages, sedatives and tranquilizers may
be necessary to control anxiety. Narcotics are commonly necessary to
control sever and unremitting pain.
In some cases of advanced stomach cancer, a laser beam directed
through an endoscope can vaporize most of the tumor and relieve
obstruction without an operation.
PROGNOSIS
Stomach cancer is curable if detected early, but most people don't
seek medical help until the disease is quite advanced, possibly because
symptoms occur late and are often vague and non-specific. Eating fresh
fruits and vegetables that contain antioxidant vitamins (such as A and
C) appears to lower the risk of stomach cancer. The rate of cancer is
about doubled in smokers so the cessation of smoking is essential.
In
the United States and most of the Western world, the 5-year survival
rate ranges from 5-15%. In Japan, where stomach cancer often is
diagnosed early, the 5 year survival rate is about 50%. Five year
survival rates for more advanced stomach cancers range from, around 20%
for those with regional disease to almost nil for those with distant
metastases.
Treatment for metastatic stomach cancer can relieve
symptoms and sometimes prolong survival, but long remissions are not
common. The survival of inoperable stomach cancer is usually only a few
months if untreated. With chemotherapy the average survival is about 12
months. If cancer is found before it has spread, the five-year relative
survival rate is about 61%.
Stomach cancer is common throughout the world and affects all
races, it is more common in men than women, and has its peak age range
between 40 and 60 years old. Mortality is higher in Japan and Chile,
presumably because of the different diets in those countries where they
are less dependent on red meat.
Over the last 25 years the
incidence of this type of cancer in the western world has decreased by
50% and the resulting death rate is less than a third of what it used to
be but in less developed countries it is still a major cause of death,
probably because in these countries by the time the disease is diagnosed
(usually by means of a Barium meal) the stomach cancer is at a very
advanced stage.
TYPES OF STOMACH CANCER
There are several
different types of stomach cancer, some of which are very rare. The most
common types start in the glandular cells of the stomach lining
(adenocarcinomas), this is where stomach acid and digestive enzymes are
made, and where most cancers start. When the tumor becomes more
advanced, it can travel through the bloodstream and spread to organs
such as the liver, lungs, and bones. Cancers that start in the lymphatic
tissue (lymphoma), in the stomach's muscular tissue (sarcoma) or in the
tissues that support the organs of the digestive system
(gastrointestinal stromal tumors) are less common and are treated in
different ways.
SIGNS AND SYMPTOMS
Early clues to stomach cancer are chronic dyspepsia and epigastric
discomfort, followed in later stages by weight loss, anorexia, a feeling
of fullness after eating, anemia and fatigue. Blood in the stools may
also be present and if the Cancer is in the Cardia (top) vomiting may
occur.
CAUSATION
The exact cause is unknown although the presence of the Helicopter
pylori bacterium seems to be a major factor. Predisposing factors
include environmental influences such as smoking and high alcohol
intake. Because stomach cancer is more common amongst those with a
family history and with people with type A blood, genetic factors are
also implicated. Dietary factors, particularly methods of food
preservation such as pickling, smoking or salting also have an influence
on the prevalence.
DIAGNOSIS
Stomach cancer is diagnosed through an examination that may include
an upper gastrointestinal (GI) series; endoscopy or gastroscopy where a
thin flexible tube is passed down the throat so the doctor can see into
the stomach, esophagus and upper part of the bowel Barium meals and
Barium swallows. Because the cancer can spread to the liver, the
pancreas, and other organs near the stomach as well as to the lungs, the
doctor may order a CT scan, a PET scan, an endoscopic ultrasound exam,
or other tests to check these areas.
The cancer can spread
(metastasize) to the esophagus or the small intestine, and can extend
through the stomach wall to nearby lymph nodes and organs. Metastasis
occurs in 80-90% of individuals with stomach tumors, with a five year
survival rate of 75% in those diagnosed in early stages and less than
30% of those diagnosed in late stages.
TREATMENT
Although the cancer may be treated with surgery, radiation therapy,
or chemotherapy, in many cases surgery is the treatment of choice. Even
in patients whose disease is not considered surgically curable,
resection offers a palliative effect and improves potential benefits
from chemotherapy.
The nature and extent of the cancer determines
what kind of surgery is most appropriate. Common surgical procedures
include, partial and total removal of the stomach.
Antiemetics can control nausea, which increases as the cancer
advances. In the more advanced stages, sedatives and tranquilizers may
be necessary to control anxiety. Narcotics are commonly necessary to
control sever and unremitting pain.
In some cases of advanced stomach cancer, a laser beam directed
through an endoscope can vaporize most of the tumor and relieve
obstruction without an operation.
PROGNOSIS
Stomach cancer is curable if detected early, but most people don't
seek medical help until the disease is quite advanced, possibly because
symptoms occur late and are often vague and non-specific. Eating fresh
fruits and vegetables that contain antioxidant vitamins (such as A and
C) appears to lower the risk of stomach cancer. The rate of cancer is
about doubled in smokers so the cessation of smoking is essential.
In
the United States and most of the Western world, the 5-year survival
rate ranges from 5-15%. In Japan, where stomach cancer often is
diagnosed early, the 5 year survival rate is about 50%. Five year
survival rates for more advanced stomach cancers range from, around 20%
for those with regional disease to almost nil for those with distant
metastases.
Treatment for metastatic stomach cancer can relieve
symptoms and sometimes prolong survival, but long remissions are not
common. The survival of inoperable stomach cancer is usually only a few
months if untreated. With chemotherapy the average survival is about 12
months. If cancer is found before it has spread, the five-year relative
survival rate is about 61%.
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