Stomach Cancer
Stomach is storage organ of food where initial digestion process starts.
Types
Adenocarcinoma of the stomach - Between 90% and 95% of all stomach cancers are of this type.
Lymphoma of the stomach - Accounts for 4% of stomach cancers.
Gastrointestinal stromal tumor (GIST) - Rare tumors.
Neuroendocrine tumors - carcinoid tumor.
Other types of very rare cancer of the stomach include, Squamous cell carcinoma, leiomyosarcoma, and small cell carcinoma.
Causes
Old age
Obesity
Smoking
Tobacco
Alcohol
A diet high in smoked, pickled, salty foods like smoked fish
H.pylori infection
GERD Reflux esophagitis
Reduced immunity like HIV are some of risk factors
People working in rubber, chemical industry
People with blood group A are high risk for developing stomach cancer
Symptoms
Anaemia
Weakness
Severe and persistent heartburn | Nausea | Vomitting
Feeling bloated after eating
Unintentional weight loss | decreased appetite
abdominal pain | lump in abdomen
Black stools | Blood in vomit
Distal stomach cancer cause obstructive symptoms leading to abdominal fullness, vomiting, pain in abdomen.
Diagnosis / Tests Required
Upper GI scopy followed by Biopsy of lesion.
Ct scan abdomen pelvis to assess spread.
Pet scan done to see distant metastasis.
Diagnostic laparoscopy is must prior to any treatment to rule out microspread.
Treatment
Surgery can be done by Open/ Laparoscopy
- Total gastrectomy performed for lesions in the upper third (proximal) stomach.
- Distal subtotal gastrectomy performed for tumors in the lower two third (distal) part of the stomach.
- Radical gastrectomy – removal of stomach + distal part of esophagus + proximal part of duodenum + reater and lesser omentum + lymphnodes.
- Oesophagojejunostomy with Roux-En-Y.
- Bypass surgery – In advanced stage done first for feeding .Then chemotherapy started.
Basic principal of Surgery is removal of cancer with good margin with lymph nodes (D2 lymphadenectomy), both ends should be free from cancer. Then intestine joined to proximal part for maintaining bowel continuity.
