Stomach Cancer (Gastric Cancer)

Stomach Cancer (Gastric Cancer)

Stomach cancer can develop in any part of the stomach and spread to other organs. It usually begins in cells in the inner layer of the stomach. Over time, the cancer may invade more deeply into the stomach wall. A stomach tumor can grow through the stomach’s outer layer into nearby organs, such as the liver, pancreas, esophagus, or intestine. Stomach cancer cells can spread by breaking away from the original tumor. They enter blood vessels or lymph vessels, which branch into all the tissues of the body. The cancer cells may be found in lymph nodes near the stomach. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.

Risk Factors:

• Helicobacter pylori infection

H. pylori is a bacterium that commonly infects the inner lining of the stomach, thereby causing stomach inflammation and peptic ulcers. It also increases the risk of stomach cancer, but only a small number of infected people develop stomach cancer.

• Long-term inflammation of the stomach

People who have conditions associated with chronic stomach inflammation, such as those with pernicious anemia are at increased risk of stomach cancer. Also, people who have had part of their stomach removed may have long-term stomach inflammation and increased risk of stomach cancer.

• Smoking

Heavy smokers are most at risk.

• Family history

Family members and close relatives of a person with a history of stomach cancer are somewhat more likely to develop the disease themselves. If many family members have a history of stomach cancer, the risk is even greater.

• Poor diet, lack of physical activity, or obesity

People who highly consume foods that are smoked, salted, or pickled have an increased risk for stomach cancer. On the other hand, people who eat a diet high in fresh fruits and vegetables may have a lower risk of this disease. Lack of exercise and obesity are often linked with most cancers.

Symptoms:

Symptoms of stomach cancer are often vague. Early stomach cancer often does not cause symptoms. As the cancer grows, the most common symptoms are:

• Discomfort or pain in the stomach area
• Difficulty swallowing
• Nausea and vomiting
• Weight loss
• Feeling full or bloated after a small meal
• Vomiting blood or having blood in the stool

Diagnostic Evaluation:

• Physical exam

The doctor feels the abdomen for fluid, swelling, or other changes. He will also check for swollen lymph nodes.

• Endoscopy

Direct visualization of the stomach through a lighted tube (endoscope).  The tube is passed through your mouth and esophagus to the stomach.

• Biopsy

An endoscope has a tool for removing tissue. The doctor uses the endoscope to remove tissue from the stomach. A pathologist checks the tissue under a microscope for cancer cells. A biopsy is the only sure way to know if cancer cells are present.

When stomach cancer spreads, cancer cells may be found in nearby lymph nodes, the liver, the pancreas, esophagus, intestine, or other organs. The following tests may be ordered:

• Chest x-ray
• CT scan
• Endoscopic ultrasound
• Laparoscopy

Medical Management:

Treatment of stomach cancer depends on the size, location, and extent of the tumor, the stage of the disease, and the health of the patient. It may involve surgery, chemotherapy, or radiation therapy. A combination of these treatments may also be done.

Surgery

The type of surgery for stomach cancer depends mainly on where the cancer is located. The surgeon may remove the whole stomach or only the part that has the cancer.

• Partial (subtotal) gastrectomy for tumors at the lower part of the stomach

Removal the lower part of the stomach with the cancer. The surgeon attaches the remaining part of the stomach to the intestine. Nearby lymph nodes and other tissues may also be removed.

• Total gastrectomy for tumors at the upper part of the stomach

Removal of the entire stomach, nearby lymph nodes, parts of the esophagus and small intestine, and other tissues near the tumor. Rarely, the spleen also may be removed. The surgeon then connects the esophagus directly to the small intestine.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It may be given before or after surgery. After surgery, radiation therapy may be given along with chemotherapy. The drugs that treat stomach cancer are usually given intravenously.

The side effects depend mainly on which drugs are given and how much. Chemotherapy kills fast-growing cancer cells, but the drugs can also harm normal cells that divide rapidly.

Radiation therapy

Radiation therapy uses high-energy rays to kill cancer cells. It affects cells only in the part of the body that is treated. Radiation therapy is usually given with chemotherapy to treat stomach cancer. Treatments are usually 5 days a week for several weeks. Side effects depend mainly on the dose and type of radiation.

Nursing Management:

• Plan to have smaller, more frequent meals a day.
• Drink liquids before or after meals
• Cut down on very sweet foods and drinks such as cookies, candy, soda, and juices.

• Help the patient and the family cope positively with the disease.
• Listen when the patient airs out their concerns regarding the treatments, side effects and hospital stay.
• Encourage them to ask for clarifications when they are in doubt or when they need facts regarding the disease process.

Photo credits: www.medkast.libsyn.com

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