Benign tumor in the stomach and duodenum is uncommon and accounts for only 5-10% of all stomach cancers and 10-20% of all duodenal tumors.
Although this mass is benign, in certain cases, it can become malignant.

Most cases occur in the elderly and in people over 55 years.
If stomach cancer is diagnosed at an early stage, there is a good chance of cure.

Generally, if the cancer is in the third or fourth stage (it has grown and spread) the treatment is less likely to resolve the cancer.
However, treatment can slow the progress of cancer.

Incidence and mortality from stomach cancer have been reduced over the past 50 years by about 1% per year.

 

Types of Stomach Cancer

There are different types of stomach cancer, including:

  • Stomach adenocarcinoma – 90/95% of all gastric cancers are of this type. Cancer develops from cells that form the mucosa, the innermost wall of the stomach.
  • Lymphoma in the stomachaccounts for 4% of stomach cancers. Cancer cells formed in lymphatic tissue) are sometimes found in the wall of the stomach. Lymphatic tissue drains fluid and helps fight infection .
  • Gastrointestinal stromal tumor (GIST) – rare tumors that occur in the muscle or connective tissue of the stomach wall (interstitial cells of Cajal). Some of these tumors may be benign (noncancerous). GISTs can also be found in other parts of the digestive tract.
  • Neuroendocrine Tumors  – Cancer cells meet and form tumors in hormone-producing cells, usually in the digestive tract (including the stomach). This type of stomach cancer is rare; the most frequent is the cancerous tumor.
  • Other types of very rare stomach cancer are squamous cell carcinoma, small cell carcinoma and leiomyosarcoma.

 

How does this occur? Symptoms of stomach cancer

There are several symptoms of stomach cancer.
However, these are similar to other less serious diseases such as a peptic ulcer, stomach cancer can sometimes be difficult to recognize.

For this reason, cancer is often diagnosed when it is already at an advanced stage.

Among the initial symptoms of stomach cancer are:

 

Symptoms of stomach cancer that are alarming

It is important to check for any possible symptom of stomach cancer as soon as possible.
The health department has identified a number of symptoms and warning signs in some people who have an increased risk of stomach cancer.
It is necessary to walk the doctor as soon as possible if the following symptoms occur:

  • Difficulty swallowing
  • Digestion problems in combination with weight loss , malaise or anemia (a decrease in red blood cells that can make you feel tired and out of breath).
  • Those over 55 years old always find it difficult to digest
  • You have indigestion and one of the following elements in the medical history:

1. A family history of stomach cancer
2. Previous surgical intervention for stomach ulcers
3. Barrett’s esophagus – a condition in which abnormal cells grow on the inner wall of the esophagus,
4. Pernicious anemia – a disease in which the stomach is not able to absorb vitamin B12 from food,
5. Dysplasia – is an abnormal formation of cells that are not cancerous, but could actually become cancerous in the future,
6. Gastritis – inflammation of the inner wall of the stomach,
7. Jaundice – eyes and skin become yellow,
8. A swollen mass develops in the upper abdomen.

 

Advanced stomach cancer

The symptoms of advanced stage stomach cancer are:

 

Causes of stomach cancer

Risk Factors
When your doctor diagnoses stomach cancer, it is natural to ask what might have caused the disease. But the exact causes of stomach cancer are unknown. Doctors rarely know why one person develops stomach cancer and another does not.
There are certain risk factors that increase the chances of developing stomach cancer.
Studies have found the following risk factors for stomach cancer:

Helicobacter pylori
The Helicobacter pylori is a bacterium that infects the lining (mucosa) of stomach. Helicobacter pylori infection can cause inflammation of the stomach and gastric ulcers.
It also increases the risk of stomach cancer, but only a small number of infected people get sick.
In this case, it can also occur in young people or in pregnancy .

Inflammation of the Chronic Stomach
People who have inflammation of the stomach for a long period (such as pernicious anemia or chronic gastritis ) have an increased risk of stomach cancer.
In addition, people who have removed part of the stomach have an increased risk of stomach cancer many years after surgery.

Smoking
Smokers are more likely than nonsmokers to develop stomach cancer. Who smokes a lot is more at risk.

Family history
Relatives (parents, siblings, sisters or children) of a person with stomach cancer are more likely to develop the disease.
If close relatives have a history of stomach cancer, the risk is even greater.

Lousy diet, lack of physical activity, or obesity. 
Studies suggest that people who eat a diet rich in smoked, salted or brine foods have an increased risk of stomach cancer. On the other hand, people who eat a diet rich in fresh fruits and vegetables may have a lower risk of illness.
Lack of physical activity can increase the risk of stomach cancer.
Also, obese people may have higher risk of cancer in the upper stomach.

Most people with these risk factors do not develop stomach cancer. For example, many people with helicobacter pylori infection never develop cancer.
On the other hand, people who develop the disease sometimes have no known risk factors.

 

Diagnosis of stomach cancer

Eraxion – bigstockphoto.com

Cancer of the stomach is usually diagnosed through a series of tests, including:

  • Gastroscopy – The doctor passes a thin flexible tube through the throat to see the stomach, esophagus and upper part of the intestine.
  • Biopsy – The doctor removes a small piece of tissue from the stomach during an endoscopy to examine under a microscope.
  • Radiography with Barium – The liquid barium seen on the screen making an X-ray of the stomach is the digestive tract. This may reveal abnormalities in the stomach.
  • Ultrasound – A device that uses sound waves to create an image of the stomach.
  • Blood tests – These tests include carcinoembryonic antigen (CEA) tests. CEA is produced in large quantities by some cancer cells.
    This occurs in about half of patients with stomach cancer.

In case of diagnosis of stomach cancer, other tests may be necessary to see if the cancer has spread. These include:

  • Computed tomography (CT) – a special x-ray examination observed from different points of view to construct a three-dimensional image of the body. It is possible to inject a dye to highlight internal organs
  • Magnetic resonance imaging (MRI) – similar to CT, uses a powerful magnet and the magnetic field instead of x-rays to create three-dimensional images of the body.
  • Positron Emission Tomography (PET) – A doctor makes an injection with a glucose solution containing a small amount of radioactive material. The scanner can ‘See’ the radioactive substance. Cancer cells are displayed as hot spots (areas where glucose is taken).

Staging
Patients with gastric cancer should undergo a thorough preoperative preparation to decide the most appropriate management.
The spread may be local, lymphatic, through the blood or may travel through the peritoneal cavity, for example, may go to the ovaries (Krukenberg’s tumor).

Metastasis most often forms in the liver , lung , bone and less frequently to the brain.
The initial evaluation and staging should include computed tomography of the chest and abdomen to determine the presence or absence of metastasis.
In the absence of metastasis, the operability evaluation is preferably done with endoscopic ultrasound.
Possible exams for staging are chest X-rays, transabdominal ultrasound, magnetic resonance imaging, bronchoscopy, and laparoscopy.

Tumor, nodule and metastasis staging (TNM)
TX, NX or MX indicates ‘not evaluated’.
T0-no evidence of primary tumor.
TIS-carcinoma in situ (intraepithelial neoplasia).
T1-invades the lamina propria and submucosa.
T2-invades the muscular or subserous mucosa.
T3-penetrates the visceral peritoneum but not adjacent structures.
T4-invades adjacent structures (spleen, colon, etc.).

N0 – no LN metastasis.
N1 – 1-6
N2 – 7 positive lymph nodes to 15 lymph nodes.
N3 – more than 15 lymph nodes.

M0-no distant metastasis.
M1-distant metastasis, we more distant mesenteric or retroperitoneal lymph nodes.

 

What are the treatment options for stomach cancer?

Treatment options include surgery, chemotherapy, and radiation therapy.
The recommended treatment for each case depends on several factors such as the stage of cancer (size or dispersion) and overall health.

It is important to eat a lot and need to see a nutritionist to follow the best diet possible.

It is important to speak with a specialist who knows the case.
Your doctor can explain the pros and cons, the likelihood of success, possible side effects and other details about the possible treatment options for this type of cancer.

You also need to talk to the specialist about treatment goals, for example:
Certain types of stomach cancer can have a remission, especially if they are treated in the early stages of the disease.

 

The goal of treatment may be to block the growth of cancer and relieve symptoms. If cure is not possible, treatment may limit the growth or spread of cancer then progresses more rapidly.
This may make the symptoms regress for a moment.
If it is not possible to make a cure, treatment can be done to reduce the size of the cancer.
This can relieve symptoms like pain.
If a tumor is advanced, treatments with nutritional supplements, analgesics, other techniques for pain or other symptoms can be done.

 

When to operate? The surgery

Removal of the tumor can be determinant if the cancer is in early stage.
The most common operation is to cut the affected part of the stomach.
Sometimes the whole stomach is removed. This surgery can be done by laparoscopy.
Even if the cancer is advanced and a cure is not possible, some surgical techniques may be helpful in relieving symptoms. For example, a block can be relieved by removing part of the stomach, using laser surgery or bypassing.

Chemotherapy
Chemotherapy is a cancer treatment that is performed with anti-cancer drugs that kill cancer cells or prevent them from multiplying even if it causes many side effects, including diarrhea, reduced red blood cell count, white blood cell count and plateletloss of hair and fatigue .
When chemotherapy is combined with surgery, it is called adjuvant chemotherapy.
For example, as a result of the surgery, a cycle of chemotherapy is required.
The goal is to kill all cancer cells that can spread from the primary tumor. Sometimes, adjuvant chemotherapy is done before surgery to shrink a large tumor so the operation is simpler.
The surgeon may recommend this therapy if the tumor is not operable.

Radiation
therapy Radiation therapy is a treatment that fires high-energy radiation beams at the focus of cancerous tissue only at this point. This kills cancer cells or blocks the multiplication of cancer cells.
Radiation therapy is not often done to treat stomach cancer.
It is sometimes used to reduce the size of a part of the cancer that is causing the symptoms.
Chemoradiation
In some cases, a combination of chemotherapy and abbreviated radiotherapy like chemoradiotherapy – is performed in conjunction with surgery.

 

What is the prognosis and survival rate and life expectancy?

Without treatment, the stomach cancer can grow and spread to other parts of the body.
If it is diagnosed and treated early (before it grows beyond the wall of the stomach or has spread to lymph nodes and other parts of the body), there is a good chance of regression with surgery.
Unfortunately, most cases are not diagnosed at an early stage.

If the cancer is diagnosed when it develops through the wall of the stomach or spreads to other parts of the body, it is less likely to be cured (terminal phase).
However, the treatment can often delay the progression of cancer using chemotherapy drugs.

If the tumor is limited to submucosa of the stomach and did not metastasize, the survival of 5 years is 90%.
In the case of advanced stage gastric cancer, 5-year survival falls by about 25%.

 

Can stomach cancer be prevented?

The answer may be yes and no.

The “no”

Experts do not know exactly what causes stomach cancer, there is no vaccine to protect themselves, so there is no way to stop it.

The Yes”

Among the alternative treatments to reduce the risk of developing the disease are the diet for cancer and a healthy diet.
Fruits and Vegetables – People who eat lots of fruits and vegetables are less likely to develop stomach cancer than others.
Savory and smoked foods – avoid salty and smoked foods as much as possible.
Smoke – if you do not smoke the chances of developing stomach cancer decrease.

Check with your doctor – ask your doctor if an illness can increase your risk of developing stomach cancer. It is best to consider periodic screening.

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