Stomach cancer- An overview

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Information about Stomach cancer- An overview

Published on August 17, 2008

Author: drneelesh


Stomach cancer  ☼ An Overview : Stomach cancer   ☼ An Overview Distributed under Creative Commons license ☼ Introduction: ☼ Introduction leading cause of cancer related morbidity Second most common cause of cancer related deaths after Lung cancer (10.4% of all cancer related deaths).   60% cases occur in the developing world linked to dietary habits and unhealthy food preservation practices ☼Causes-: ☼ Causes- A/S/L- Elderly Male Asians and East Europeans. Diet - Food preserved by drying, smoking, salting and pickling Dietary nitrites converted to carcinogenic N- nitroso compounds by bacteria in the stomach. Helicobacter Pylori infection -People with H. Pylori bacteria infection of the stomach have greater risk. Causes- contd: Causes- contd Prior stomach surgery -People with a history of stomach surgery face a greater risk due to alteration in normal ph of the stomach. Stomach Disorders - Pernicious anemia, achlorhydria and atrophic gastritis 6 times more prone. Smoking Hereditary- underlying genetic factors are poorly understood ( KRAS mutation, c-met amplification) Rarely, some gastric ulcers may turn into cancer. ☼ Types: ☼ Types 90% arise from the glandular cells of the stomach wall and are called Adenocarcinomas. Others – Gastric Lymphomas (cancer of gastric lymphatic tissue) Soft tissue sarcomas (e.g. Leiomyosarcomas) Carcinoids ☼Clinical features : ☼ Clinical features Early stages asymptomatic. non-specific symptoms like indigestion, nausea, vomiting and sometimes Pain. bloated feeling after eating, loss of appetite, dark colored stools (due to presence of blood) and feeling of tiredness (due to anemia). Late features- peritoneal and pleural effusions, Jaundice and cachexia. Hepatomegaly usually occurs and presence of an enlarged left supraclavicular lymphnode (Virchow's sign) is a typical finding. ☼Treatment: ☼ Treatment Surgical intervention Partial/subtotal gastrectomy , Total gastrectomy + making of a new stomach from S.I Radiation therapy- external beam radiation (5 days/week*6 to 8 weeks). Tomotherapy HI-ART (Tomotherapy highly integrated adaptive radiotherapy) for specific reduced doses. Chemotherapy – 5 fluorouracil, Cisplatin, Doxorubicin. Immunotherapy ☼ Prognosis: ☼ Prognosis Indicators - Stage - Tumor Size - Histological Type - Degree of cytological atypia - Lymphatic/vascular invasion Generally, five year survival is a poor 30%. Younger patients have more aggressive disease. Dr. Neelesh Bhandari MBBS(A.F.M.C), MD (Path.) PGP Human Rights. Dr. Neelesh Bhandari MBBS(A.F.M.C), MD (Path.) PGP Human Rights.

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