GASTRIC Cancer

Several different types of cancer can occur in the stomach. The most common type is called adenocarcinoma, which starts from one of the common cell types found in the lining of the stomach.

 

Causes and risk factors

Scientists have found several risk factors that make a person more likely to get stomach cancer. Some of these can be controlled (eg smoking)  but others cannot (eg. age, family history)

Gender - Stomach cancer is more common in men than in women - up to three males are affected for every female (estrogen may protect women against the development of this cancer form.)

Age - There is a sharp increase in stomach cancer rates in people over the age of 50. Most people diagnosed with stomach cancer are between their late 60s and 80s.

Ethnicity - Globally, stomach cancer is more common in Japan, China, Southern and Eastern Europe, and South and Central America. This disease is less common in Northern and Western Africa, South Central Asia and North America.

Helicobacter pylori infection - People with stomach cancer have a higher rate of H pylori infection than people without this cancer. Even so, most people who carry this germ in their stomach never develop cancer.

Diet - An increased risk of stomach cancer is seen in people with diets that have large amounts of smoked foods, salted fish and meat, and pickled vegetables. Nitrates and nitrites are substances commonly found in cured meats. They can be converted by certain bacteria, such as H pylori, into compounds that have been shown to cause stomach cancer in lab animals. On the other hand, eating lots of fresh fruits and vegetables appears to lower the risk of stomach cancer.

Smoking -Smoking increases stomach cancer risk, particularly for cancers of the upper portion of the stomach near the esophagus. The rate of stomach cancer is about doubled in smokers.

Obesity - Being overweight or obese is a possible cause of cancers of the upper part of the stomach nearest the esophagus. In recent times, the number is rising for the deadly gastric cancer associated with high-fat diets amongst the young population who are fond of junk foods. It is so aggressive that only 2 out of 10 can survive after 5 years as compared to 6 in 10 for the common gastric cancer. Smoking and drinking complicate the problem. Obese people can develop heartburn that worsens the condition.

Existing growth - Have a polyp larger than 2 cm in your stomach or inflammation and swelling of the stomach for a long time.

Previous stomach surgery - Stomach cancers are more likely to develop in people who have had part of their stomach removed to treat non-cancerous diseases such as ulcers. This might be because the stomach makes less acid, which allows more nitrite-producing bacteria to be present. Reflux (backup) of bile from the small intestine into the stomach after surgery might also add to the increased risk. These cancers typically develop many years after the surgery.

Pernicious anemia - Certain cells in the stomach lining normally make a substance called intrinsic factor (IF) that we need to absorb vitamin B12 from foods. People without enough IF may end up with a vitamin B12 deficiency, which affects the body’s ability to make new red blood cells and can cause other problems as well. Along with anemia (too few red blood cells), people with this disease have an increased risk of stomach cancer.

Blood type A - It has been consistently observed that blood type A is associated with an increased risk for stomach cancer and poorer survival. On the contrary, Blood type O appears to exert a protective effect by preventing the growth and spread of the tumor and being associated with longer survival times.

Inheritance - Have a family history of gastric cancer (in 10% of cases reported)

Symptoms

Stage 1 (Early) – Limited to the inner lining of the stomach

• Indigestion or a burning sensation (heartburn)
• Loss of appetite, especially for meat
• Abdominal discomfort or irritation

Stage 2 (Middle) - Penetration to the second and/or third layers of the stomach and nearby lymph nodes

• Weakness and fatigue
• Bloating of the stomach, even after small meals

Stage 3 (Late) – Penetration to the third and/or fourth layer and more distant lymph nodes or has metastasized to other organs

• Abdominal pain in the upper abdomen
• Nausea and occasional vomiting
• Diarrhea or constipation
• Weight loss
• Bleeding (vomiting blood or having blood in the stool) which is blackish, leading to anemia.
• Tumor in the extension of the gastric tumor in to the esophagus.

Note that these can be symptoms of other problems such as a stomach virus, gastric ulcer or tropical sprue.

Signs and tests

+ Not everyone has warning signs such as stomach pain and loss of appetite.

+ Symptoms may not occur in the early stages of the disease or patients may self-treat symptoms that gastric cancer has in common with other, less serious gastrointestinal disorders (bloating, gas, heartburn and a sense of fullness). This causes a delay in diagnosis and treatment.

The following tests can help diagnose gastric cancer:

• Complete blood count (CBC) to check for anemia
• Endoscopy to examine the stomach tissue
• Stool test to check for blood in the stools

Gastric 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.

Treatment

+ At an advanced stage, is recommended to perform chemotherapy and surgery to remove the entire stomach as well as the surrounding lymph nodes, with the basic purpose of removing all cancer and a margin of normal tissue. Depending on the extent of invasion and the location of the tumor, surgery may also include removal of part of the intestine or pancreas. For aggressive cancer, the relapse rate is higher than for common stomach cancer.

+ For patients who cannot have surgery, chemotherapy or radiation therapy can improve symptoms and may prolong survival, but will likely not cure the cancer. Both treatments are better applied after surgery to improve the chance of a recovery.
 

Chance of recovery

Tumors in the lower stomach are cured more often than those in the higher stomach around the gastro-esophageal junction. How far the tumor invades the stomach wall and whether lymph nodes are involved when the patient is diagnosed affect the chances of a cure.

When the tumor has spread outside the stomach, a cure is not possible and the goal of treatment is to improve symptoms.
 

Prevention

Mass screening programs have been successful at detecting disease in the early stages in Japan, Korea and Taiwan where raw foods are commonly consumed.

The following may help reduce your risk of gastric cancer:

• Avoid smoking
• Eat a healthy, balanced diet rich in fruits and vegetables
• Take a medication to treat stomach disorders

Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001270/

VIVA corner

With the stomach malfunctioning, the digestive system has to work even harder to produce more stomach juices to digest those foods critical for the break down of proteins, carbohydrates and fats into the molecules of nutrients your body can assimilate.

VIVA Nutrazyme helps to reduce this burden to prevent further depletion of the enzyme stores.