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» Gastric Cancer Surgery |
INTRODUCTION |
Stomach cancer is the fourth most common cancer worldwide. It is a disease with a high death rate making it the second most common cause of cancer death worldwide after lung cancer.
It is associated with high salt in the diet, smoking, and low intake of fruits and vegetables. Infection with the bacterium H. pylori is the main risk factor in about 80% or more of gastric cancers. Helicobacter pylori (H. pylori) live deep in the mucous layer that coats the lining of the stomach. H. pylori infection frequently occurs in childhood and can last throughout life if not treated. It's the primary cause of stomach ulcers. Gastric cancer shows a male predominance in its incidence as up to 3 males are affected for every female. Estrogen may protect women against the development of this cancer form. |
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Symptoms
- Indigestion or a burning sensation (heartburn)
- Loss of appetite, especially for meat
- Abdominal pain or discomfort in the upper abdomen
- Nausea and vomiting
- Diarrhea or constipation
- Bloating of the stomach after meals
- Weight loss
- Weakness and fatigue
- Bleeding (vomiting blood or having blood in the stool), which can lead to anemia
Tests that examine the stomach and esophagus are used to detect and diagnose gastric cancer.
Upper GI Endoscopy: A procedure to look inside the esophagus, stomach, and duodenum (first part of the small intestine) to check for abnormal areas. An endoscope (a thin, lighted tube) is passed through the mouth and down the throat into the esophagus.
Fecal occult blood test: A test to check stool (solid waste) for blood that can only be seen with a microscope..
Barium swallow: A series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. A biopsy of the stomach is usually done during the endoscopy.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.. |
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Staging
If cancer cells are found in the tissue sample, the next step is to stage, or find out the extent of the disease. Stomach cancer can spread to the liver, the pancreas, and other organs near the stomach as well as to the lungs, a CT scan, a PET scan, an endoscopic ultrasound exam, or other tests to check these areas. Blood tests for tumor markers, such as carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) may be ordered, as their levels correlate to extent of metastasis. |
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Treatment
Like any cancer, treatment is adapted to fit each person's individual needs and depends on the size, location, and extent of the tumor, the stage of the disease, and general health. Other treatments for stomach cancer may include chemotherapy, and/or radiation therapy.
Surgical Treatment of Gastric Cancer
Individuals with gastric cancer are frequently treated with surgical removal of the stomach called a gastrectomy, to remove the cancer and prevent recurrence of the cancer. Lymph nodes (parts of the body's lymph system) around the stomach are also removed and examined to determine whether or not the cancer has spread to these areas.
Endoscopic Surgery
Early cancers, stage 0 and I, can often be removed through an endoscope passed through the esophagus. Another procedure, called laparoscopic surgery, is performed through an endoscope passed into the abdomen through a small incision. Laparoscopic resection of early gastric cancer has been shown to be safe and effective. The primary advantage of laparoscopic surgery is more rapid recovery after surgery.
Radiation therapy
Radiation therapy (also called radiotherapy) is the use of high-energy rays to damage cancer cells and stop them from growing. |
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