Stomach Cancer

Overview of Stomach Cancer in India

Cancer develops when stomach cells undergo uncontrolled growth to form gastric tumors. The cancer cells grow and divide uncontrollably in the stomach. The stomach cancer cells can spread through the entire stomach area, yet most cancer cases occur in the central stomach region, which represents the stomach's main body. The cancer cells show additional spread to the tube, which serves as the pathway for food delivery to the stomach. Stomach cancer requires treatment through medication and radiotherapy before doctors proceed with surgical procedures. 

Stomach cancer begins without evident symptoms, which become visible only when the illness reaches its final phase. The disease presents no worse symptoms at its early stage, which allows doctors to treat the cancer with chemotherapy until the disease advances to its later stages, at which point multiple treatments become necessary to combat the aggressive cancer cells. The treatment of stomach cancer proves easier when the cancer remains confined to the stomach because this situation leads to better patient outcomes. The treatment becomes harder when cancerous cells extend beyond their original boundaries, while in this situation, patient outcomes become less favourable. 

Stomach cancer develops when people experience stomach lining damage which leads to irritation, according to research studies. The stomach cells start to multiply at an uncontrolled rate because their inner layers face persistent irritation. The situation of the event can differ between various occurrences. The presentation of a disease is different in individuals with even the same disease.

What Is Stomach Cancer (Gastric Cancer)?

Stomach cancer is known as Gastric Cancer as well. Essentially, stomach cancer is a mass of uncontrolled growth of cancer cells that grows in the stomach. Stomach Cancer can happen anywhere in your stomach, but the majority of people in the USA with Stomach Cancer will have uncontrolled cell growth, or cancer, in their gastroesophageal junction (the place where your stomach and esophagus meet). In other parts of the world, where gastric cancer is more prevalent, they usually get Stomach Cancer in the main body of the stomach.

Most of the time, about 95% of cases with Stomach Cancer will originate in the stomach lining, develop slowly and if not treated, a mass of tumour cells will develop and grow into the stomach walls. The tumour can lead to metastasis, spreading cancer to the liver and pancreas.

Types of Stomach Cancer:

Stomach cancer can be classified according to the type of cells involved:

Adenocarcinoma

In general, adenocarcinomas are the most common type of stomach cancer and are made up of glandular cells that produce mucus. Almost all stomach cancers are adenocarcinoma.

Gastrointestinal stromal tumors (GIST)

Gastrointestinal stromal tumors (GISTs) are soft tissue sarcomas that arise from specialised nerve cells found in the stomach and other parts of the digestive tract.

Carcinoid tumors

Carcinoid tumors arise from neuroendocrine cells, which can be found throughout the body and function as both nerve and hormone-producing cells. Carcinoids are a subtype of neuroendocrine tumor.

Lymphoma

Lymphomas arise from the immune system and may develop in the stomach in response to an infection or other stimuli that cause the immune system to send cells to the stomach area. Most lymphomas that develop in the stomach are classified as non-Hodgkin lymphoma.

Procedure:

Stomach Cancer Surgery

Surgery is intended to eliminate all of the cancer and enough healthy tissue to allow for an adequate margin of resection; the surgeon may be able to do so in the following ways:

The small, early-stage tumors that are confined only to the inside lining (mucosa) of the stomach may be removed by endoscopic mucosal resection (EMR). The surgeon will use a thin, lighted endoscope with a camera on the end to visualise the inside of your stomach. Once the tumor has been identified, the surgeon uses special instruments to remove both the tumor and a margin of surrounding healthy tissue.

Subtotal gastrectomy is the procedure in which the surgeon removes the part of the stomach that is cancerous.

Total gastrectomy is when the surgeon removes the total stomach along with the tissue surrounding the stomach, producing a direct connection between your esophagus and your small intestine for digestion.

The surgeon will remove the abdominal (peritoneal) lymph nodes and evaluate them for the presence of cancer.

Surgery does not cure cancer, but removing part or all of the stomach can relieve symptoms caused by advanced stomach cancer and increase your comfort.

Radiation Therapy

Radiation therapy may be performed before surgery in order to decrease the size of the tumour and make it easier to remove. After surgery, adjuvant radiation therapy may be administered to eliminate remaining cancer cells from surrounding tissues. Proton Therapy is an advanced form of radiation therapy used in the treatment of hard-to-access tumours. Due to its targeted nature, proton therapy can treat stomach cancers without damaging surrounding organs. Chemotherapy often accompanies radiation when treating stomach cancer.

Chemotherapy

Chemotherapy, as a form of drug therapy, uses medications that are designed to kill cancerous cells, which may have metastasised away from the original (gastric) site of the disease.

Neoadjuvant Chemotherapy is the term given to chemotherapy used prior to surgery to shrink and localise a tumour to permit easier removal at the time of surgery. Adjuvant chemotherapy, on the other hand, refers to chemotherapy prescribed post-operatively in order to kill any remaining cancer cells that could exist in the body/circulatory system. Chemotherapy is also frequently combined with radiation therapy in order to produce the greatest potential of killing as many of the cancer cells as possible. In some instances of advanced cancer, chemotherapy can be used alone in order to effectively alleviate the signs/symptoms that may be present.

Targeted Drugs

Targeted therapies utilise medications to treat the associated specific abnormalities found in cancerous cells, including:

• Stomach cancer cells overproducing HER2 can be treated with Trastuzumab (Herceptin).
• Imatinib (Gleevec) can be used to treat gastrointestinal stromal tumors which are a rare type of stomach cancer.
• Sunitinib (Sutent) can also be used to treat gastrointestinal stromal tumors.

Immunotherapy

Immunotherapy medications are utilised to enhance your body's immune system. They will help prepare your immune system for the identification of cancerous cells and the attack on those cells. Immunotherapy drugs have been proven successful in treating advanced stomach cancer in many patients.

Palliative care

If cancer metastasises to adjacent organs, it cannot be treated, and pain relief and quality-of-life issues are the primary focus of care.