The stomachThe stomach is part of the digestive system. It is a hollow organ in the upper abdomen, under the ribs.
The wall of the stomach has five layers : -
- Inner layer or lining (mucosa): - Juices made by glands in the inner layer help digest food. Most stomach cancers begin in this layer.
- Submucosa: - This is the support tissue for the inner layer.
- Muscle layer: - Muscles in this layer create a rippling motion that mixes and mashes food.
- Subserosa: - This is the support tissue for the outer layer.
- Outer layer (serosa): - The outer layer covers the stomach. It holds the stomach in place.
Understanding cancerCancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.
Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.
Tumors can be benign or malignant: -
- Benign tumors are not cancer: -
- Benign tumors are rarely life-threatening.
- Most benign tumors can be removed. They usually do not grow back.
- Cells from benign tumors do not invade the tissues around them.
- Cells from benign tumors do not spread to other parts of the body.
- Malignant tumors are cancer: -
- Malignant tumors are generally more serious than benign tumors. They may be life- threatening.
- Malignant tumors often can be removed. But sometimes they grow back.
- Cells from malignant tumors can invade and damage nearby tissues and organs.
- Cells from malignant tumors can spread (metastasize) to other parts of the body. Cancer cells spread by breaking away from the original tumor and entering the bloodstream or the lymphatic system. The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis.
- A stomach tumor can grow through the stomach's outer layer into nearby organs, such as the pancreas, esophagus, or intestine.
- Stomach cancer cells can spread through the blood to the liver, lungs, and other organs.
- Cancer cells also can spread through the lymphatic system to lymph nodes all over the body.
Significance of stomach cancerOver most of the century, the frequency of gastric cancer has been decreasing. Over the past several years, the number of new cases of gastric cancer in the United States seems to be steady, while the number of deaths has greatly decreased. There has continued to be a decrease in cancer arising in the part of the stomach that is closest to the duodenum (the first part of the small intestine). However, cancer at the junction between the esophagus and stomach is on the increase.
Stomach cancer (gastric) preventionGastric cancer can sometimes be associated with known risk factors for the disease. Many risk factors are modifiable though not all can be avoided.
- Diet and Lifestyle : - Excessive salt intake has been identified as a possible risk factor for gastric cancer. Having a high intake of fresh fruits and vegetables may be associated with a decreased risk of gastric cancer. Studies have suggested that eating foods that contain beta-carotene and vitamin C may decrease the risk of gastric cancer, especially if intake of micronutrients is inadequate.
- Pre-existing Conditions: - Infection with a certain bacteria, Helicobacter pylori, is associated with an increased risk of gastric cancer. Long-standing reflux of gastric contents and the development of an abnormal cellular lining is also associated with an increased risk of cancer at the junction of the stomach and esophagus.
SymptomsEarly stomach cancer often does not cause clear symptoms. As the cancer grows, the most common symptoms are: -
- Discomfort in the stomach area
- Feeling full or bloated after a small meal
- Nausea and vomiting
- Weight loss
DiagnosisIf you have a symptom that suggests stomach cancer, your doctor must find out whether it is really due to cancer or to some other cause. Your doctor may refer you to a gastroenterologist, a doctor whose specialty is diagnosing and treating digestive problems.
The doctor asks about your personal and family health history. You may have blood or other lab tests. You also may have: -
- Physical exam : - The doctor checks your abdomen for fluid, swelling, or other changes. The doctor also feels for swollen lymph nodes. Your skin and eyes are checked to see if they seem yellow.
- Upper GI series : - The doctor orders x-rays of your esophagus and stomach. The x-rays are taken after you drink a barium solution. The solution makes your stomach show up more clearly on the x-rays.
- Endoscopy : - The doctor uses a thin, lighted tube (endoscope) to look into your stomach. The doctor first numbs your throat with an anesthetic spray. You also may receive medicine to help you relax. The tube is passed through your mouth and esophagus to the stomach.
- Biopsy : - The doctor uses an endoscope to remove tissue from the stomach. A pathologist checks the tissue under a microscope for cancer cells. A biopsy is the only sure way to know if cancer cells are present.
Stomach Cancer TreatmentThe treatment of stomach cancer depends on the results of tests and your overall health.
- People with advanced heart and lung disease may not tolerate aggressive therapy.
- In many cases, the stomach cancer may have advanced too far for any available treatment to work.
- You will require surgery to be cured. Your stomach is removed entirely, and your esophagus is attached to your small intestine.
- Surgery may relieve symptoms of obstruction. The upper end of your stomach is connected to your small bowel, bypassing the area of obstruction.
- Companion treatment with either chemotherapy or radiation may improve your survival following surgery.
- After your stomach has been removed, your doctor will monitor your disease with repeat CT scans of your abdomen and gastrointestinal endoscopy to make sure the cancer does not return.
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