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Gastric Carcinoma

 
General Info
The stomach is part of the digestive system. It is located in the upper abdomen, under the ribs on the left side. The upper part of the stomach connects to the esophagus, and the lower part leads into the small intestine.
The stomach is shaped like the letter J.Nearby, the stomach, are organs such as the liver, left kidney with left adrenal gland, pancreas, colon, and spleen.
The clinical term for cancer of the stomach is gastric cancer.
Approximately 24,000 new cases of gastric cancer are diagnosed each year in this country. And there are about 700,000 new cases diagnosed worldwide.
The disease is found most often in people over age 55. It affects men twice as often as women, and is more common in black people than in white people.
Also, stomach cancer is more common in some parts of the world--such as Japan, Korea, parts of Eastern Europe, and Latin America--than in the United States.
 
Causes
 
The continuous ingestion of high concentrations of salt irritates the stomach lining, and this has been proposed as a potential cause of gastric cancer.
When people eat variety of foods that are preserved by drying, smoking, salting, or pickling they are at a higher risk of developing stomach cancer.
Low Fruits and Vegetables in the diet, and high fat content can lead to stomach cancer.
Chemical carcinogens like rubber by products, coal tar and asbestos have increased cancers in industrial workers.
Long standing ulcers, with the common bacteria 'Heliobacter Pylori ' may become malignant over time.
Research shows that people who have had stomach surgery or have a type of anaemia called pernicious anemia, this generally results in lower than normal amounts of digestive juices) have an increased risk of gastric cancer.
Rare Genetic Diseases such as Plummer-Vinson syndrome and Peutz-Jeghers syndrome with multiple polyps have a higher risk.
Smoking and alcohol abuse. The irritation caused by these habits particularly increase the risk of cancer of the upper part of the stomach, the portion closest to the esophagus.
Genetics. Stomach cancers are two to four times more common for immediate family members of people who have had the disease.
 
Symptoms
 
Stomach cancer can be hard to find early. Often there are no symptoms in the early stages and, in many cases, the cancer has spread before it is found. 
Stomach cancer can cause the following:
Indigestion or a burning sensation (heartburn).
Discomfort or pain in the abdomen.
Nausea and vomiting.
Diarrhea or constipation.
Bloating of the stomach after meals.
Loss of appetite.
Weakness and fatigue.
Persistent low grade fever.
Black tarry stools.
Vomiting of blood or bleeding in stools.
 
Diagnosis
 
First step involves in undergoing a general physical examination and a discussion with the doctor of your medical history.
Endoscopy and Biopsy: Using a small flexible tube with a light (endoscope), the doctor can insert a small ultrasound device into the stomach to generate a close-up image of your stomach on a computer screen. This procedure may help him determine the extent of the cancer.
Computerized tomography (CT) scan: To see if the cancer has spread to nearby organs, such as the lymph nodes, pancreas and liver, your doctor may have you undergo a CT scan. A CT scan allows your doctor to see your internal organs.
X-rays of the esophagus and stomach: The x-rays are taken after the patient drinks a barium solution, a thick, chalky liquid. (This test is sometimes called a barium swallow.) The barium outlines the stomach on the x-rays, helping the doctor find tumors or other abnormal areas.
Blood test: 
A test called a Complete Blood Count (CBC) can indicate anemia.
Fecal Occult Blood Test (FOBT)--a check for hidden (occult) blood in the stool is also done.
  
Treatment
 
Cancer of the stomach is difficult to cure unless it is found at an early stage
Surgery: Surgery is the most common treatment for stomach cancer. The operation is called gastrectomy. The surgeon removes part (subtotal or partial gastrectomy) or all (total gastrectomy) of the stomach, as well as some of the tissue around the stomach. After a subtotal gastrectomy, the doctor connects the remaining part of the stomach to the esophagus or the small intestine. After a total gastrectomy, the doctor connects the esophagus directly to the small intestine.
Chemotherapy: Chemotherapy is the use of drugs to kill cancer cells. This type of treatment is called systemic therapy because the drugs enter the bloodstream and travel through the body. Doctors are testing a treatment in which anticancer drugs are put directly into the abdomen (intraperitoneal chemotherapy). Most anticancer drugs are given by injection; some are taken by mouth. The doctor may use one drug or a combination of drugs. Chemotherapy is given in cycles: a treatment period followed by a recovery period, then another treatment, and so on.
Radiation Therapy: Radiation therapy is the use of high-energy rays to damage cancer cells and stop them from growing. Like surgery, it is local therapy; the radiation can affect cancer cells only in the treated area. Radiation therapy is sometimes given after surgery to destroy cancer cells that may remain in the area.
Biological Therapy: Biological therapy (also called immunotherapy) is a form of treatment that helps the body's immune system attack and destroy cancer cells; it may also help the body recover from some of the side effects of treatment.
Prevention:
There's no sure way of preventing stomach cancer, but a person can reduce some of the risk factors.
Stomach cancer risk can be reduced by avoiding foods preserved with nitrates
   and nitrites and consuming a diet high in fresh fruits and vegetables and whole
   grains.
In addition, one should also refrain from smoking and drinking alcohol. Smoking and
   excessive alcohol consumption increase the risk of cancer of the upper portion of
   the stomach.
 
Do's and Dont's
 
Take smaller frequent meals.

Taking prescription of vitamins may help you maintain your body's proper level of vitamins. Some of these vitamins can be taken only by injection. (eg. Vit B12).
Know what to expect. Find out everything you about the cancer — the type, stage, treatment options and their side effects. The more you know, the more active you can be in your own care. In addition to talking with your doctor, look for information in your local library and on the Internet. 
Take time for yourself. Eating well, relaxing and getting enough rest can help combat the stress and fatigue of cancer.
Maintain a strong support system. Having a support system can help you cope with any issues, pain and anxieties that might occur.
Set reasonable goals. Having goals helps you feel in control and can give you a sense of purpose.
Having a strong faith seems to be a key factor in successfully coping with cancer.
 
FAQ's
 
What does the stomach do ? 
The stomach is a hollow bag which joins up to the mouth via the esophagus (throat) and empties into the small intestine where most of the digestion of food occurs. The main function of the stomach is to act as a temporary reservoir (it can hold 1 to 1.5 litres) for foods and fluids intaken and fluids since the bowel cannot cope with digesting a large amount of food at once. 
 
How good is the prognosis of Gastric cancer ?
When cancer is detected early, the survival rate 5 years after diagnosis is 50%, without metastasis. 

Which doctor treats cancer ?
An oncologist, is a cancer specialist.

What is GERD?
GERD means Gastroesophageal Reflux Disease. Gastroesophageal reflux describes a backflow of acid from the stomach into the swallowing tube or esophagus. The usual symptom is heartburn, an uncomfortable burning sensation behind the breastbone, most commonly occurs after a meal.
 
Glossary
 
Abdomen - The part of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
Achlorhydria - A lack of hydrochloric acid in the digestive juices in the stomach. Hydrochloric acid helps digest food.
Carcinogens - Cancer causing agents
Colon - The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.
Digestive system - The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, intestines, and rectum.
Endoscopy - The use of a thin, lighted tube (called an endoscope) to examine the inside of the body.
Esophagus - The muscular tube through which food passes from the throat to the stomach.
Fecal occult blood test - A test to check for blood in stool. (Fecal refers to stool. Occult means hidden.)
Gastrectomy - An operation to remove all or part of the stomach. gastric (GAS-trik): Having to do with the stomach.
Gastric atrophy - A condition in which the stomach muscles shrink and become weak. The digestive (peptic) glands may also shrink, resulting in a lack of digestive juices.
Gastroenterologist - A doctor who specializes in diagnosing and treating disorders of the digestive system.
Gastroscope - A thin, lighted tube used to view the inside of the stomach.
Gland - An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production.
Helicobacter pylori - Bacteria that cause inflammation and ulcers in the stomach.
Intraperitoneal chemotherapy - Treatment in which anticancer drugs are put directly into the abdominal cavity through a thin tube.
Liver - A large, glandular organ, located in the upper abdomen, that cleanses the blood and aids in digestion by secreting bile.
Ovaries - The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.
Pancreas - A glandular organ located in the abdomen. It makes pancreatic juices, and it produces several hormones, including insulin. The pancreas is surrounded by the stomach, intestines, and other organs.
Pernicious anemia - A type of anemia (low red blood cell count) caused by a lack of vitamin B12.
Small intestine - The part of the digestive tract that is located between the stomach and the large intestine.
Stomach - An organ that is part of the digestive system. It helps in the digestion of food by mixing it with digestive juices and churning it into a thin liquid.
Stool - The waste matter discharged in a bowel movement; feces.
Ultrasound test - A test that bounces sound waves off tissues and internal organs and changes the echoes into pictures (sonograms).
Plummer vinson syndrome - A disorder linked to severe, long-term iron deficiency anemia; resulting in swallowing difficulty caused by "webs" of tissue that grow in the hypopharynx or esophagus.
Peutz Jegher syndrome - Hereditary condition that results in gastrointestinal polyps and freckles on the skin.

 
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