What is Gastric Cancer?

When the stomach cells start to grow abnormally and in an uncontrolled manner, it results in stomach or gastric cancer. The stomach is an integral part of the digestive system and is made up of three parts- the fundus (the top part), the body (the middle part), and the pylorus (the bottom part). The stomach wall is made up of several layers:

• The outer lining
• Middle muscular layer
• Supportive tissue layer
• The inner lining

Gastric cancer can begin in any of these layers in the stomach wall. Most gastric cancers start in the glands of the stomach’s inner lining and are called adenocarcinomas. Other types of gastric cancers are:

• Gastrointestinal stromal tumours (GIST)
• Non-Hodgkin lymphoma
• Neuroendocrine tumours (NETs)

Gastric cancer is more common in older people; it is also more common in men than women.

Signs and Symptoms of Gastric Cancer

Stomach cancer does not cause any signs or symptoms in its early stages. As the tumour grows, you may experience one or more of the following:

• Severe pain in the abdomen
• Unexplained weight loss
• Nausea
• Vomiting
• Dark stools or the presence of blood in the stool
• Painful or difficulty in swallowing
• Loss of appetite

Screening For Gastric Cancer

Screening for gastric cancer is common in some parts of Asia and the Eastern part of Europe, where this cancer is more common.

Screening for gastric cancer is recommended in high-risk individuals. These include:

• Elderly individuals with chronic gastric atrophy or pernicious anaemia
• People who have undergone partial gastrectomy
• People with a family history of stomach cancer
• Individuals with certain genetic syndrome

A gastroscopy or an upper endoscopy is most commonly used to screen for gastric cancer.

Diagnosis of Gastric Cancer

If your doctor suspects your signs and symptoms are indicative of gastric cancer, they will need to confirm if it is cancer or another condition with similar symptoms.

To do so, your doctor will:

• Take a detailed personal and family medical history to understand your risk for the condition
• Perform a physical examination
• Run blood tests to check for anaemia (which may be a sign of bleeding in the stomach)
• Perform a stool test to check for occult blood

Your doctor may advise a few diagnostic tests to confirm gastric cancer diagnosis:

• Upper endoscopy with a biopsy
• Barium swallow
• CT scan
• Biomarker testing

If you have been diagnosed with gastric cancer, your doctor will recommend one or more of the following procedures/tests to determine the stage and grade of your cancer:

• PET scan
• Endoscopic ultrasound
• MRI with gadolinium
• Laparoscopy

Staging helps your doctor select the most effective treatment for the condition.

Treatment of Gastric Cancer

There are different types of treatment available for gastric cancer. The earlier the cancer is detected, the easier it is to treat it. Endoscopic resection is the most effective treatment for gastric cancer. Other treatment options include:

• Other surgical methods (before or after treatment, depending upon the location and stage of the tumour)
• Radiation therapy
• Chemotherapy
• Targeted therapy
• Immunotherapy
• Hyperthermic intraperitoneal chemotherapy (HIPEC)

In some cases, a clinical trial may be recommended.

Prognosis of Gastric Cancer

If you’ve been diagnosed with gastric cancer, it is natural to have questions about the seriousness of your cancer and the outlook of your treatment. The prognosis of your cancer depends upon several factors, including the stage and spread of the tumour. The earlier that stomach cancer is diagnosed, the better the chances of recovery.

Key Takeaway!

Gastric cancer often shows no symptoms early on, but watch for frequent heartburn, unexplained weight loss, and trouble swallowing. Early detection is vital when it comes to gastric cancer. Doctors use endoscopy and biopsies to diagnose the condition, and treatment depends on the stage at which the condition is diagnosed. Talk to your doctor if you're concerned or are experiencing one or more unusual symptoms. It is always helpful to get a second opinion on your cancer diagnosis before beginning treatment.

References

• https://www.cancer.gov/types/stomach/screening
• https://www.cancerresearchuk.org/about-cancer/stomach-cancer/getting-diagnosed/screening
• https://www.cancer.gov/types/stomach/diagnosis
• https://www.hopkinsmedicine.org/health/conditions-and-diseases/stomach-gastric-cancer
• https://www.cancer.gov/types/stomach/treatment