Most stomach cancers are adenocarcinomas, malignancies that arise in the glandular cells that line the stomach and produce various hormones and mucus. Less common types are gastric lymphomas, tumors that form in the stomach’s lymph tissue, and gastric sarcomas, which develop in connective tissue. Although stomach cancer is now a relatively rare form of intestinal cancer with about 24,000 new cases and 14,000 deaths a year only 50 years ago it was the leading cause of cancer mortality in American men and third for women. Dietary changes appear to be a factor in this decline, in particular, less consumption of nitrates. (In Japan, which leads the world in stomach cancer, studies implicate nitrates preservatives in pickled vegetables, salty sauces, and dried salted fish all staples in the Japanese diet.) Some cases of stomach cancer have been linked to drinking water that is naturally high in nitrates. The risk of stomach cancer increases with digestive disorders that reduce stomach acidity; for example, chronic bile reflux and atrophic gastritis. Pernicious anemia, which is marked by reduced production of a substance called intrinsic factor, is also linked to an increased risk of stomach cancer. People who have had part of their stomach removed sometimes develop gastric cancer 15 to 20 years later. In its early stages, stomach cancer is often easy to overlook because its symptoms persistent heartburn, bloating and discomfort after eating, nausea, loss of appetite, and sometimes mild abdominal painare vague and similar to those of other digestive disorders. Later, additional symptoms may include weight loss, fatigue, vomiting, blood in stools, and more severe pain.
Diagnostic Studies And Procedures
Iron deficiency anemia and blood in the stools should alert a doctor to possible intestinal cancer. When the stomach appears the likely site, tests will include an upper GI series-X-rays taken after swallowing barium, a chalky substance that coats the upper GI tract to make it more visible on film. Any abnormality calls for gastroscopy, a procedure in which a viewing tube is inserted through the mouth and esophagus into the stomach, allowing a doctor to inspect its lining and collect biopsy samples from any suspicious area. Cells shed from the stomach lining can also be collected by using a washing technique, called gastric lavage, or by scraping the lining. These cells are then studied microscopically for cancer. If cancer is diagnosed, CT scans, MRI, and ultrasonography may determine whether it has spread.
Medical Treatments
Treatment depends on the stage of the cancer and such considerations as age, overall health, and previous history of cancer. The usual treatment involves surgical removal of the malignant tumor, which may entail taking out all or part of the stomach and possibly portions of other digestive organs if the cancer has spread to them. Surgery is usually followed by chemotherapy with a combination of anti cancer drugs, especially if the cancer has spread beyond the stomach. Some cancer specialists advocate adjuvant chemotherapy even if it appears that the cancer has not spread, because more than two thirds of these patients eventually develop metastases. Radiation is generally of little value as a primary treatment for stomach cancer, as the dosage needed would cause extensive internal damage. Unde study, however, is a technique called intraoperative radiotherapy, in which a single large dose of radiation is beamec directly into the tumor site at the time of surgery. In advanced cases, low dose palliative radiation therapy may be used to alleviate pain.
Alternative Therapies
These may relieve pain and minimize the adverse effects of chemotherapy and other medical treatments. Effective pain control techniques may include meditation, guided imagery, hypnosis. and biofeedback. Other, more controversial therapies include the following:
Herbal Medicine
Western herbalists use Siberian ginseng, sarsaparilla, ane. wild Oregon grape, in capsule or extract forms, to minimize the side effects of chemotherapy.
Homeopathy
Euphorbium is prescribed every two hours for pain.
Nutrition Therapy
For the first few days after removal of all or part of the stomach, nutrients are given intravenously or via a feeding tube insertee. directly into the remaining portion of the stomach through a small incision. Normal eating begins with a liquid die: for a few days, followed by gradual reintroduction of solid foods. Before leaving the hospital, the patient will be given a detailed eating plan and may also be advised to take supplements. Good nutrition also plays a role in preventing stomach cancer. A diet made up mostly of fruits, vegetables, legumes, ane grains probably helps prevent all types 0: intestinal cancers. These foods are high in fiber, vitamin C and other antioxidants, and other natural chemicals that are believed to protect against cancer.
Self Treatment
Patients can still eat many of their favorite foods, even after removal of the stomach. However, a different meal pattern will be necessary to prevent toe much food from entering the small intestine at once; this condition, referred to as dumping syndrome, can produce weakness, dizziness, sweating, nausea. vomiting, and palpitations. The best approach is to eat six to eight small meals a day, emphasizing foods high ir. protein and low in sugar and fat.
Other Causes of Stomach Symptoms
Digestive disorders that produce symptoms similar to those of stomach cance include ulcers, gastritis, pancreatitis, diverticulosis, and gallstones.