Gastric Cancer

Gastric cancer is a cancer in the stomach. Stomach cancer is 4th most common cancer and 2nd leading cause of cancer death. It is a very aggressive tumor and causes about 800,000 deaths worldwide per year. Eastern Asia, such as China and Japan, has the highest incidence.

Types of stomach cancer:

Different types of gastric cancer have different properties to respond to the current treatments and different prognosis.

  • Adenocarcinoma. Adenocarcinoma of the stomach is a cancer arises from the glandular cells. This is the majority of all stomach cancers and accounts about 95% of gastric cancer. Generally, it has a poor prognosis. Picture above is the endoscopic view of a gastric adenocarcinoma at the distal part of the stomach.
  • Lymphoma. Lymphoma of the stomach is a tumor that origins from the cells of the immune system. This type of cancer in the stomach is rare and generally has better prognosis than adenocarcinoma.
  • GIST. GIST means gastrointestinal stromal tumor. It arises from mesenchymal connective tissue cells, which are the mother cells of bone, cartilage, vascular cells, etc. It is a type of sarcoma with variable malignant potentials. Most of GISTs can be cured if they are small, found early, and completely removed.
  • Carcinoid cancer. This type of cancer begins from hormone-producing cells. There are three subtypes of this kind of tumor with different etiologies and prognosis.

Risk factors:

The common risk factors of gastric cancer are:

  • Living in certain geographic area, such as China, Japan, etc.
  • Salty, pickled, or smoked foods.
  • Smoking.
  • Aflatoxin from fungus.
  • Family history of stomach cancer.
  • Familial adenomatous polyposis (FAP).
  • Helicobacter pylori.
  • Chronic atrophic gastritis.
  • Pernicious anemia.
  • Stomach polyps such as adenomatous polyp, etc.

Symptoms of gastric cancer

At early stage, patient may not have symptoms at all. The most common symptoms of gastric cancer are not specific, such as: fatigue, nausea, vomiting, epigastric discomfort or pain, bloating, fullness quickly after eating, belching, burping, decreased appetite, loss of weight, etc. Some patients may have dark stools, black stools, or positive occult blood test. Blood test may show anemia and/or low iron.

Diagnosis and Treatment

Diagnosis of gastric cancer usually needs one or more of the following tests:

  • Blood works
  • Stool studies
  • X-ray
  • CT scan
  • Endoscopy
  • EUS
  • PET scan

Treatment is depending on the findings from the above tests and the patient’s medical conditions. It may be involved with one or more of the following modalities:

For advanced learning about gastric cancer, click here.

References:

  1. PubMed Health.
  2. Wikipedia.
  3. Mayo clinic online health information.
  4. Sleisenger and Fordtran's Gastrointestinal and Liver Disease- by Mark Feldman MD, et al.
  5. The Little Black Book of Gastroenterology-by David W. Hay.
  6. Principles of Clinical Gastroenterology by Tadataka Yamada, et al.


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