The stomach is a J shaped hollow organ in the upper abdomen that receives food as it passes from the oesophagus (gullet). The most common form of stomach cancer is adenocarcinoma. Less common malignant tumours of the stomach are lymphomas and gastro-intestinal stromal tumours (GIST).
Gastric cancer is the second most common malignancy world wide.It is more common with increasing age and effects men twice as common as women.
The best understood risk factor for gastric cancer is infection with the Helicobacter pylori bacterium which can chronically inflame the inside of the stomach lining, leading potentially to cancerous changes.Stomach cancer is also associated with previous stomach surgery such as the removal of stomach tissue for peptic ulcer disease, benishis anaemia, stomach polyps and a strong family history of stomach cancer.
Symptoms
The symptoms of gastric cancer are very vague and hence the majority of patients present with quite advanced disease. Symptoms may include indigestion, upper abdominal pain, a bloated feeling after eating and a sensation of getting full quickly, nausea, loss of appetite and heartburn. More advanced stages can be associated with vomiting and blood in the vomit, unexplained weight loss and paradoxically distension of the abdomen. These symptoms may be associated with a large number of benign ulcers. However if they are present for any length of time one should consult a Doctor.
Treatment
The choice of treatment for stomach cancer depends on the stage of the disease. Specifically that relates to the size of the tumour in the stomach and how deeply it is spread through the wall of the stomach, whether it is spread to involve lymph nodes and whether it has spread to other parts of the body. The main stay of any curative treatment for a patient with stomach cancer involves complete removal of the tumour and the associated lymph nodes. This is performed if the staging studies indicate that surgery is likely to help and the tumour has not spread beyond the stomach and the lymph nodes. The operation to remove the tumour involves removing either some (approximately three quarters) of the stomach called a subtotal gastectomy or all of the stomach known as a total gastrectomy. In a total gastrectomy this involves removal of the entire stomach and the small intestine is joined directly to the oesophagus. During the surgery the surgeon will also remove lymph nodes to examine them for cancer cells. At times it may also be necessary to remove the spleen and also part of the pancreas.