Stomach cancer or gastric cancer

Essential information about this disease

Stomach cancer or gastric cancer is a serious disease that can unfortunately manifest itself at any age. Usually, in the early stages, there are no specific symptoms. The origin of this condition is found in the gastric mucosa, which evolves over time from precancerous lesions to solid formations, the actual tumours.

According to statistics, the people most at risk of this disease are men aged 50-70 years, but as mentioned earlier, the disease can occur in any person, regardless of age . Gastric cancer can be promoted by a number of factors, such as poor diet, nutritional deficiencies, infections and certain types of medication.

Treatment involves surgical removal of the tumour, chemotherapy and/or radiotherapy. Doctors also recommend changing your lifestyle and eating a healthy diet rich in fruit and vegetables.

Gastric cancer can be caused by certain unhealthy habits such as eating smoked foods, smoking and drinking alcohol. People who suffer from helicobacter pylori infection, have gastric ulcers or have had stomach surgery are at higher risk of stomach (gastric) cancer. There are several symptoms that may indicate gastric cancer, including heartburn. Although this symptom is also common in other conditions, such as gastro-oesophageal reflux disease, other symptoms in the detection of stomach cancer can be early satiety, weight loss and persistent pain in the abdominal area.

Investigations and tests to help detect gastric cancer (stomach cancer)

Gastric cancer can be a hidden condition in its early stages, making regular screening very important. However, there are certain symptoms that may be indicative of the presence of gastric cancer, including early satiety, weight loss, nausea, difficulty swallowing and disturbed bowel movements.

In advanced stages of gastric cancer, symptoms become more severe, such as fluid accumulation in the abdomen, jaundice, bloody vomiting and black, shiny stools with a specific tarry smell. Anyone can be affected by this condition, but it is more common in people over 50 and it is essential to get checked regularly to prevent it.

When stomach (gastric) cancer is suspected, the patient may be referred to a surgeon for a consultation. It will carry out a clinical examination and recommend a series of tests and investigations to confirm the diagnosis or stage of the disease. These include taking blood tests, which may indicate anemia (a sign of blood loss from the gastric tumor) and elevated tumor markers such as CA 19-9 and carcinoembryonic antigen. Abdominal ultrasound may show ascites fluid or liver metastases in advanced stages of the disease. Upper gastrointestinal endoscopy is essential by highlighting the gastric tumour formation and biopsying it. The sample collected will be analysed histopathologically and will determine the type of cancer.

The above investigations and tests are routinely used to correctly diagnose and stage gastric cancer.

How can gastric cancer (stomach cancer) be treated?

Gastric cancer can be successfully treated with surgery and chemotherapy. In less advanced stages, surgery can even lead to a cure, the technique involving the removal of the stomach (partially or completely), together with the associated lymphatic territory (neoplastic invaded lymph nodes). In place of the removed stomach, an intestinal loop (jejunum) will be brought from the lower abdominal floor and sutured to the esophagus, forming a “Y” anastomosis on the intestinal loop.

Chemotherapy will complement the surgical treatment, destroying possible tumour cells remaining after surgery and thus preventing recurrence. In cases where gastric cancer is in advanced stages, such as liver metastases, peritoneal metastases or ascites, chemotherapy is applied before surgical treatment, trying to convert the patient to an operable stage. For peritoneal metastases, hyperthermic intraperitoneal chemotherapy (HIPEC) may be a therapeutic option in selected cases.

Surgical intervention for advanced cases, where healing may not be possible, becomes necessary in cases where bleeding does not stop, digestive strictures occur and the patient cannot feed when jaundice sets in. These symptoms, if left untreated, can lead to early death. Surgery is palliative in these cases, relieving symptoms and allowing the patient to continue cancer treatment.

Why should patients with gastric cancer (stomach cancer) pay special attention to postoperative follow-up?

Once discharged, the stomach (gastric) cancer patient will have to follow a diet prescribed by the surgeon and nutritionist. Post-operative control involves regular specific investigations (blood tests, with monitoring of the carcinoembryonic antigen value; upper digestive endoscopy; CT (computer tomography) examination to detect any possible recurrence. These investigations should be carried out regularly, as recommended by the attending physician, with the intention of preventing any further complications.