STOMACH CANCER SYMPTOMS AND TREATMENT

It is the abnormal enlargement of cells of stomach that may spread throughout the stomach and metastasize (spread) to other organs especially the oesophagus, lungs, lymph nodes and liver. It is the fourth leading cancer globally. Metastasis occurs in 80-90% of people with stomach cancer.

Risk factors
It depends on
Age: 72 years or older are most common   
Sex: Men are more prone than women to develop it
Diet: Smoked foods, salted or pickled food consumers may be at high risk
Bacteria: Helicobacter pylori infection increases risk
Smoking: People consuming more cigarettes develop stomach cancer
Certain health problems: Stomach surgery, chronic gastritis, APD by H. Pylori etc

Note:
Most people who have known risk factors do not develop stomach cancer. For example, people have H. Pylori in their stomach but never develop cancer.
Sometimes people developing cancers do not have known risk factors.
Symptoms:
Asymptomatic, only nonspecific symptoms in its early stages
Early symptoms:

• Indigestion or burning sensation
• Loss of appetite

Late symptoms:

• Abdominal pain or discomfort in the upper abdomen
• Nausea and vomiting
• Diarrhoea or constipation abdominal area, the patient feels a full and tight abdomen, which may cause abdominal pain)
• Decrease in weight, weakness and fatigue
• Bleeding
• Dysphagia ( difficulty in swallowing)

Diagnosis:
Physical examination: checks abdomen for fluid collection, swelling, or other changes and also palpate for swollen lymph nodes.
Upper GI series: Using contrast medium i.e drinking a barium solution and taking x-rays of the oesophagus and stomach that gives clear image of stomach.
Endoscopy: visualisation of oesophagus and stomach
Biopsy: To identify if cancer cells are present.
Blood tests: Complete blood count to check for anemia.
Chest x-ray: To confirm the spread of cancer to lungs.
CT scan: To confirm whether the tumors is present in liver, pancreas, or elsewhere in the body.

Staging:
Stage 0: limited to inner lining of the stomach.

Stage 1: penetration to the second or third layers of the stomach (stage 1A) or to the second layer and nearby lymph nodes ( stage 1B). Stage 1A is treated by surgery, stage 1B may be treated  with chemotherapy ( 5 fluorouracil) and radiation therapy.

Stage 2: penetration to the second layer and more distant lymph nodes, or the third layer and only nearby lymph nodes, or all four layers but not the lymph nodes.

Stage 3: penetration to the third layer and more distant lymph nodes, or penetration to the fourth layer and either nearby tissues or nearby or more distant lymph nodes.

Stage 4: metastasis to nearby tissues and more distant lymph nodes, or has metastasized to other organs. Cure is rare at this stage.

Treatment:
It depends upon the size place of tumour stage of disease and individual general health status.
It can be treated either by local therapy or systemic therapy.
Local therapy: surgery and radiation
Systemic therapy: chemotherapy
Radiation therapy: radiation therapy has side effects  that depends mainly on the dose of radiation and the part of the body that is treated. Abdominal radiation therapy may cause
Pain in the stomach or the intestine
Nausea and diarrhoea
Skin in the treated area may becone red, dry, and tend

Surgery: stomach cancer can be treated by two main surgery

Partial (subtotal) gastrectomy: removal of the part of the stomach with cancer. It also include removal of the part of the esophagus or part of the small intestine. Nearby lymph nodes and other tissues may be removed.

Total gastrectomy: removal of the entire stomach, nearby lymph nodes, parts of the esophagus and small intestine, and other tissues near the tumor. The spleen also may be removed. The surgeon then connects the esophagus directly to the small intestine.

Chemotherapy: Radiation therapy may be given along with chemotherapy. Anticancer drugs for stomach cancer are injected through blood vessel. But some of the drugs may be given by mouth. Some people may need to stay in hospital during treatment.