Stomach Cancer – Causes, Symptoms, Diagnosis, and Treatment

Stomach Cancer – Causes, Symptoms, Diagnosis, and Treatment: The stomach is a ‘J’ shaped organ situated in the upper abdomen. It is mainly responsible for the digestion of the nutrients present in our food and assists in the defecation of waste material from the body. Our stomach consists of five tissue layers. The innermost is mucosa, then there is the submucosa, muscle, sub-serosa (the connective tissue between the muscles and the outermost layer), and then the outermost layer is serosa.

Stomach Cancer

Usually, stomach cancer starts from the innermost layer, which is the mucosa, and gradually grows towards the outermost layer, which is the serosa, although can happen in any part of the stomach. Stomach cancer is identified by the increase in the gastric cells in the stomach and these cells gradually form a lump of cells known as tumors. It is also known as gastric cancer.

It can be of different types such as adenocarcinomas, lymphomas, mesenchymal tumors, etc. Its primary symptoms may include abdominal pain, a burning sensation in the heart, nausea, vomiting, and loss of appetite. And secondary symptoms may include, pale skin, abnormal weight loss, abnormal white eyes, blood in stools, vomiting, etc.  It can further spread to surrounding organs like the liver, lymph nodes, bones and ribs, lungs, the lining of the intestine, etc.

 Infection can worsen cancer, and it can happen due to H. pylori. Further lifestyle habits such as lacking exercise, eating fast food, obesity, and hereditary factors can be responsible for Stomach cancer. Although cancer can be treated in several ways such as therapies, surgery, and medication, and can also be prevented by adopting healthy lifestyles, eating fruits rich in antioxidants, exercising daily, by getting proper treatment for stomach cancer.

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Stomach Cancer Symptoms

Stomach cancer usually produces no symptoms (asymptomatic), and if produces symptoms, those are not specific symptoms and can also be caused due to some other stomach disorders. The specific symptoms are produced very late, till then cancer had spread to the different parts of the stomach and other organs as well. Its poor prognosis is due to these delayed and unspecified symptoms.

Primary symptoms include-

• Dyspepsia – it is the inability to digest food, it causes stomach discomfort. This also causes reflux which further damages the tissues of the stomach. Further its symptoms may include belching, burning stomach, sense of fullness, etc.
• Bloating – excessive gas and pain cause the stomach to bloat, these gas and digestive content build in the stomach due to intolerance to food or dyspepsia.
• Nausea– it is the stomach discomfort that makes a person want to puke. This can also be a side-effect of the treatment of cancer or due to gastric cancer.
• Anorexia– it is the medical term for the loss of appetite, in this condition the person does not feel hungry and doesn’t get enough nutrients that are required.
• Pyrosis cardialgia – it is also known as acid indigestion, is caused by acid refluxes and causes a burning sensation in the heart.
• Weakness and fatigue – weakness is the inability of the body to do some action, it is the loss of strength to perform any action, whereas fatigue refers to the tiredness that is not resolved after proper rest and sleep.

Other consists of the late symptoms, which include-

• Severe stomach pain – the tumor in the stomach kills the normal cells and disrupts many functions causing severe discomfort and pain in the stomach. Although it is also caused by some non-specific mild disorders.
• Blood in stool – it is also known as rectal bleeding. When the upper, and lower abdomen and anal blood vessels rupture due to cancer cells it results in rectal bleeding.  If appeared blood is black in color then this medical condition is known as Melena.
• Abrupt weight loss – due to loss of appetite, weakness, and inability to digest, there is a sudden loss in weight. Also due to cancer, the metabolism of the body is disturbed.
• Jaundice – it happens when the liver stops working and the bile duct is checked.  It is the yellowing of the skin, along with pale, white skin. The color of urine and stool becomes darker and color. Fevers and body aches are its other symptoms. 
• Ascites – these also occur in patients with liver disease, although in stomach cancer, in the late stages, the tumor cells are found in the fluid of the stomach. These tumor cells accumulate fluid in the stomach and therefore swell.
•  Dysphagia – it is a medical disorder in which the patient finds it very discomforting and difficult to swallow.
• Hematemesis – it is a medical condition in which the cells of the upper gastrointestinal tract are destroyed. This is basically the vomiting of red blood from the body. Both this and rectal bleeding in a severe state can cause anemia.

Causes of Stomach Cancer

It is more common in old age people. And among all, males are at more risk than females as estrogen, a female hormone protects them from getting this cancer. The other factors may include –

• Infections – the most common risk factor for getting stomach cancer is the infection of Helicobacter pylori i.e., 70-80%. Among these only, 2% of infected patients get gastric cancer. These bacteria consist of CagA as a virulence factor, which also plays a carcinogenic role. It causes chronic inflammation to cause cancer. The CagA protein interacts with the tyrosine phosphatase of the host cell, and it is more active and changes its morphology to the hummingbird phenotype. This caused cells to indulge in hepatocyte growth factor, comprising metastasis as one function. Other infections that may include elevated risk are the Epstein-Barr virus and AIDS.

• Smoking –smokers are at 40-50% risk, whereas heavy smokers are at 82-85% risk of getting stomach cancer. These people usually get cancer in the esophagus, i.e., in the upper part of the stomach. Along with Smoking, vaping and chewing tobacco are also the cause for the same.
• Alcohol – consumption of alcohol is not only associated with stomach cancer but also with other cancers such as lungs, kidneys, liver, breast, colon, etc. it’s the metabolic derivative of alcohol responsible for causing cancer, known as acetaldehyde.  The main mechanism includes DNA methylation, Oxidative Stress, and Hormone alteration.
• Diet – well, the diet has not that direct effect in producing cancer. Although, research says that salty food, fried food, processed meat, pickle, and bracken are some of the risks for it.
• Obesity – it is often linked with the occurrence of gastroesophageal refluxes disease, which further causes ulcers and sores in the stomach due to high acidity.  The increased pressure of dietary fat on the stomach may be the risk for the development of gastric cancer.
• Genetics – the syndromes inherited from the family are the 3% of gastric cancer cases, such as hereditary diffuse gastric cancer. CDH1 is the genetic mutation in the hereditary diffuse gastric cancer, therefore a risk factor.
• Others – exposure to coal, metal, and rubber, diseases such as autoimmune atrophic gastritis, diabetes, anemia, menetrier disease, intestinal metaplasia.

Diagnosis of Stomach Cancer

The doctor might ask for the past medical history, symptoms, and any prior treatment you had to seek for any of the treatment, family medical history for some serious illness. After this, they might write you some tests and physical examinations.

In the case of cancer, the diagnosis also allows the doctor to know the stage of cancer. Stage 0, is the lowest stage (cancer is restricted to the lining of the stomach), and stage IV (cancer has already spread to nearby organs). The tests include –

• Endoscopy – the endoscope is inserted into the patient’s stomach via mouth, which is attached to the camera. Along with the endoscope, a small surgical instrument is attached. This instrument is used to take a part of the tumor for biopsy.  
• Endoscopic ultrasound – it is used to stage cancer. In this, the endoscope is attached to an ultrasound probe and with its help, the doctors can even take pictures of the tumor. This helps to identify the location and spread of the tumor in the stomach.
• Radiological tests – These tests include CT scans, MRIs, and PET scans. Another test includes barium swallow, in which the patient is given a drink that makes their stomach lining more visible.
• Blood test – it includes normal routine blood tests that give the profile of your body functioning parameters. Other tests include liquid biopsy, in which a blood sample is taken to test under the microscope.
• Laparoscopy – this test is done when the less invasive test does not produce reproducible results. In this, small cuts are made over the infected organ and then an endoscope-like device known as a laparoscope is inserted through these cuts.

Stomach Cancer Treatment

The treatment is decided on some demographic details such as age and sex. Other factors include the spread of cancer and the patient’s capacity to survive the side effect of the treatment. The following can be the options for cancer treatment –

• Upper endoscopy – the endoscope is inserted into the patient’s stomach via mouth, which is attached to the camera. Then with the help of the cameras, the oncologist identifies the exact location of the tumor and dissects it through the mouth. It is done only in case of superficial cancers.
• Gastrectomy –it is the surgical removal of the infected parts of the stomach. It is of further two types. Subtotal gastrectomy, in which only the infected parts of the stomach are removed. Another type is total gastrectomy, in which when cancer has spread to the entire stomach, the whole stomach is removed. After this procedure, the oncologist will connect your esophagus to a small intestine. This allows the patient to eat after total gastrectomy.
• Chemotherapy –it is given either before surgery to shrink cancer cells, and to prepare the patient for surgery or after surgery to kill the remaining tumor cells after surgery. It is also used with other therapies to increase the effectiveness of treatment.
• Radiation therapy –is mainly given to relieve symptoms as it alone is not sufficient for the treatment. It uses X-rays to kill cancer cells and is mostly used in conjunction with other therapies such as chemo.
• Targeted therapy –recent research advancement has proven that the treatment with HER2 (Human Epidermal growth factor receptor 2), and trastuzumab are effective in the whole survival of patients with an inoperable tumor. In surplus to this HER is 13-22% more effective in the case of gastric cancers.
• Immunotherapy –this is given not only to enhance immune response but also to develop an immune response. Such as artificially synthesized protein that targets the surface of cancer cells and attaches to it. This makes the cancer cells more43 identifiable from the immune cells. Another example of developed immunity is car-T cell therapy, in which the T cells are infused into the body to develop an immune response specific to the type of cancer prevalent to the patient.
• Palliative care – it is the special care provided by nurses and doctors or some caretakers to help with the symptoms and your personal help. This also relieves the patient’s family from being there 24/7.

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