Gastric cancer: symptoms, causes and treatment

Definition

What is gastric cancer?

The definition of stomach cancer or stomach cancer is the appearance of cells around the lining of the stomach or stomach that grow uncontrollably.

Cancer cells can attack the layers in the stomach, starting from the innermost layer (mucosa), the supporting layer (submucosa), the muscle layer (muscularis propia), and the outer lining of the stomach covering (subserosa and serosa).

This type of cancer tends to develop quite slowly or take years. Usually starting from the innermost cell and spreading to the outer cell. Changes from normal cells to cancer cells rarely cause symptoms so they often go undetected.

It is called stomach cancer, when it attacks the stomach and the lining of the stomach. If cancer attacks the colon, small intestine, liver, or pancreas, doctors will diagnose it with other types of cancer, even if the organ is around the stomach.

The reason is that the cancer that attacks these organs causes different symptoms and the treatment is also different.

Some of the most common types of stomach (stomach) cancer are:

• Adenocarcinoma: The most common type of cancer, accounting for 90-95% of cases. Cancer cells originate from the mucosal lining of the stomach.
• Lymphoma: Cancer that generally appears in the tissues of the immune system, which sometimes also appears on the abdominal wall.
• Gastrointestinal stromal tumor (GIST): Rare tumors that originate from abnormal cells in the abdominal wall, namely the Cajal interstitial cells. Some of these tumors are benign and malignant (cancerous tumors).
• Carcinoid tumor: These tumors start in hormone-making cells in the stomach, which are less likely to become cancerous and spread to other organs.

How common is this disease?

Compared to breast cancer or cervical cancer, cancer that attacks the stomach or stomach lining is less common.

However, according to data from the World Health Organization (WHO), gastric (stomach) cancer is included in the list of cancer types that most often cause death in the world. In Indonesia, the 2018 Globocan data recorded 3014 cases with a death rate of 2521 people.

Signs & symptoms

What are the signs and symptoms of stomach (stomach) cancer?

Cancer generally rarely causes symptoms early in the disease. Even so, it is possible that some patients will experience some symptoms of cancer at an early stage.

The following are symptoms of stomach (stomach) cancer which can appear at stage 1, 2, or 3:

• Abdominal pain in the upper abdominal area.
• Often experience heartburn, nausea, and vomiting.
• Decreased appetite followed by a decrease in body size.
• The body feels very weak and gets tired easily.
• Experiencing vomiting blood or bloody stools.
• The stomach is full quickly, even though it eats a little.

If cancer cells have spread and invaded surrounding organs, such as the intestines or liver, this is a sign that stomach (stomach) cancer has entered stage 4 or late. Symptoms include:

• Swelling of the upper abdomen.
• The skin and whites of the eyes turn yellowish (jaundice).
• There is a buildup of fluid in the abdominal cavity (ascites).

Everyone can experience different symptoms. Some may also experience symptoms not listed above.

When to see a doctor?

The symptoms above are very common and are often caused by digestive problems other than cancer. However, if your symptoms do not improve within a few weeks, do not delay the doctor's examination. These symptoms could be a sign of cancer that has attacked the stomach or stomach lining.

Cause

What causes stomach (stomach) cancer?

The cause of stomach (stomach) cancer is not known with certainty. However, health experts argue that this disease is no different from the cause of cancer in general, namely DNA mutations.

DNA contains a command system for cells to work normally. If a mutation occurs, the command system can break down and become chaotic. As a result, the work of the cells is not abnormal. Cells will continue to divide without control and damaged cells that are programmed to die will remain alive.

Gradually, there will be a buildup of cells that will form a tumor in the cancerous lining or stomach lining.

Risk factors

What increases the risk of developing stomach (stomach) cancer?

Although the exact cause of stomach (stomach) cancer is not known with certainty, health professionals have found a variety of factors that can increase the risk, such as:

• Age over 50 years because most cases of cancer are detected at the age of 60 to 80 years.
• Men are more vulnerable than women.
• H.pylori bacterial infection that causes open sores in the lining of the stomach or stomach.
• Smoker or often inhales cigarette smoke.
• Have had surgery to remove abscesses in the stomach and are overweight.
• There are certain health problems, such as pernicious anemia or hypertrophic gastropathy
• Family cancer syndrome, which has mutations in the CDH1, MLH1 / MSH2, BRCA1 / BRCA2, and TP53 genes in the body. These genes make a person's risk of stomach cancer, colon cancer, and breast cancer even higher.

Complications

What are the complications of stomach (stomach) cancer?

Cancer can cause complications if it is not treated properly or is treated late. Based on reports in the journal Molecular and clinical oncology,Complications of stomach (stomach) cancer that generally occur are:

• Ascites: There is a buildup of fluid in the abdominal cavity, to be precise between the organs in the stomach and the inner wall of the stomach.
• Abdominal obstruction: Stomach blockage that prevents food or fluids from passing through the small intestine or large intestine. This condition occurs because of a large tumor in the stomach.
• Jaundice: The condition of yellowing of the whites of the eyes and skin due to cancer cells that attack the liver.
• Thrombosis: Blood clots occur in blood vessels that can block blood flow throughout the body.
• Hydronephrosis: Swelling of the kidneys due to a buildup of urine in the kidneys due to a blockage.

Diagnosis & treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the tests for stomach (stomach) cancer?

Diagnosing stomach cancer is not just by looking at the symptoms you are experiencing. The doctor needs to confirm the presence of cancer cells in the area with several medical tests, such as:

• Imaging test

These tests include CT scans and x-rays which are done to look for cancer cells and tumors.

• Endoscopy

This test is done to look at the inside of the stomach with a thin tube equipped with a small camera through the throat. If there is suspicious tissue, the doctor will cut some of the tissue for a biopsy.

• Biopsy

A medical procedure by taking certain body tissue as a sample. Then, the sample will be taken to a laboratory and viewed under a microscope.

To determine the stage of stomach cancer, the oncologist will ask you to perform further medical tests, such as:

• Additional imaging tests, in the form of a PET scan (positron emission tomography).
• Exploratory surgery to see the cancer and how far it has spread. Sometimes this operation is performed by laparoscopy, which is to make a small incision in the abdomen and insert a special camera to see the condition of the stomach.

What are the stages of stomach (stomach) cancer?

After the above tests are done, the doctor will determine the stage of cancer you have, such as:

• Gastric (stomach) cancer stage 1 / early: There is a small tumor in the lining or tissue that lines the stomach and stomach. At this stage, the cancer cells may also have spread to the lymph nodes.
• Stage 2 stomach (stomach) cancer: Cancer has spread to the outer and inner areas, growing to reach the muscle layer and several lymph nodes.
• Stage 3 stomach (stomach) cancer: The cancer may have spread throughout the lining of the stomach and spread to nearby tissues or organs.
• Cancer of the stomach (stomach) stage 4 / late: Cancer may have spread to tissues or organs that are located far away from the area where the cancer started.

What are the ways to treat stomach cancer?

After the diagnosis is made and the stage of the cancer is determined, the doctor will recommend treatment for stomach cancer, in the form of:

• Operation

Cancer cells that have not spread require surgical removal of the tumor. The goal is to remove cancer cells and save healthy tissue from cancer cells.

The procedures range from endoscopic mucosal resection (endoscopic removal of the inner lining of the stomach), subtotal gastrectomy (removing the cancerous part of the stomach), and total gastrectomy (removal of the entire stomach and some of the surrounding tissue). The affected lymph nodes also need to be removed.

• Chemotherapy

Chemotherapy is a cancer treatment using drug therapy. The goal is to kill cancer cells. It is usually done before surgery to reduce the size of the tumor or after surgery to kill any remaining cancer cells.

• Radiotherapy

Apart from chemotherapy, radiotherapy can also be an option. This cancer treatment uses X-ray energy or protons to kill cancer cells.

Radiotherapy is performed before surgery to reduce the size of the tumor. It could also be along with chemotherapy after cancer surgery to kill any remaining cancer cells.

Home remedies

What are the home remedies and lifestyle changes that can be done to treat stomach (stomach) cancer?

Apart from doctor's medication, home care is also needed by cancer patients. You do this by changing the lifestyle that is suitable for cancer patients, such as:

• Going on a cancer diet to get adequate dietary nutrition.
• Avoid dietary restrictions, such as preservative, high-sugar, or high-fat foods.
• Doing regular exercise to control weight.
• Follow the cancer treatment recommended by the doctor until it is complete and routine. Consult your doctor if you want to take herbal stomach cancer drugs.
• Quit smoking and drinking alcohol.

Prevention

How to prevent stomach cancer?

There is no sure way to prevent cancer that attacks the digestive tract. However, health experts recommend several approaches that can reduce the risk of developing stomach cancer or stomach cancer.

Several ways to prevent stomach cancer that you can do, include:

• Increase consumption of vegetables, fruit, nuts and seeds. Reduce the consumption of processed foods, preservative foods, foods high in sugar, and foods that are high in fat and foods that are burnt.
• Make sure you are active every day, such as routine exercise.
• Quit smoking and reduce your alcohol consumption.
• Treat any infections caused by the H. pylori bacteria completely.
• Be careful using pain relievers, such as aspirin. Consult a doctor if you wish to use this drug.
• If you have a family member with a history of cancer, get genetic testing. This is done to see if there is a family cancer syndrome that puts a person at risk for cancer.