What is stomach cancer?
Stomach cancer, or gastric cancer, is an abnormal growth of cells originating in the stomach. The stomach is a muscular bag that holds your food and secretes acids and enzymes that help in digestion. It is located in the upper part of the abdomen on the left side, right below your ribs.
What are the types of stomach cancer?
Stomach cancers are classified into different kinds based on the type of cells that they originate from. These different types include:
- Adenocarcinoma (the most common type that develops from the gland cells lining the stomach)
- Gastrointestinal stromal tumours (originate from cells on the wall of the stomach)
- Neuroendocrine tumours (these develop from the specialised ‘neuroendocrine cells’, which have properties of both hormones and nerve cells )
- Lymphomas (these arise from the lymphatic system)
- Other types (eg., squamous cell carcinoma, small cell carcinomas, leiomyosarcomas, etc.)
What is metastatic stomach cancer?
What are the risk factors for stomach cancer?
- Helicobactor Pylori bacterial infection
- Family history
- Genetics
- High-salt diet
- Previous stomach surgery
- Health conditions (pernicious anaemia, achlorhydria)
- Smoking
- Low vitamin A or C in the diet
- Obesity and high-calorie consumption
- Occupational exposure to chemicals used for rubber, metal, and coal processing and tin mining
- Gastric ulcers, gastric polyps, etc.
How do I minimise the risk of stomach cancer?
You can minimise your risk of stomach cancer by making specific lifestyle changes which include:
- Consuming a diet rich in fibre, vegetables, and fruits and having minimal salt and
- smoked foods
- Maintaining a healthy weight
- Avoiding smoking
- Avoiding or limiting alcohol intake
- Getting treated for H. pylori infection
What are the symptoms of stomach cancer?
- Unexplained weight loss
- Stomach pain
- Difficulty swallowing food
- Vomiting of blood
- Loss of appetite
- Nausea and vomiting
- Bloating
- Fullness after eating small amounts of food
- Indigestion
- Heartburn
When should I consult a doctor?
If you have persistent symptoms such as bloating and vomiting along with sudden, unexplained weight loss, it is always better to consult your doctor. These symptoms don’t necessarily mean that you have gastric cancer. Your doctor will examine you and perform the necessary tests to rule out the possibility.
Can stomach cancer go undetected?
In its early stages, stomach cancer does not produce any symptoms and, hence, can go undetected for years. Initially, the symptoms may be mild and can go ignored or misdiagnosed as ‘gastrointestinal issues’.
How is stomach cancer diagnosed?
- Medical history and physical examination: The doctor may question you for signs and physically examine you for symptoms of stomach cancer
- Blood tests: For evaluating anaemia
- Stool sample evaluation: For signs of blood in your stools
- Upper endoscopy: A thin flexible tube fitted with a small video camera is inserted down the throat, which helps your doctor see your food pipe (oesophagus), stomach, and the first part of the intestine and look for any abnormalities
- Imaging: Ultrasound, X-rays, CT, MRI, and PET scans to evaluate the site, size, and extent of cancer
- Biopsy: The cancer cells are examined under a microscope to confirm cancer and to find out the type of cancer
How is stomach cancer treated?
The treatment of stomach cancer is planned based on the stage of the cancer.
- Endoscopic surgical resection: For early-stage cancers which are limited to superficial cells of the stomach, a thin flexible lighted tube fitted with a video camera called an endoscope is inserted through the throat into the stomach. Surgical instruments are introduced through the endoscope to remove the area of cancer with some healthy cells from the surrounding area.
- Surgery and removal of lymph nodes (lymphadenectomy): For advanced cancers
- Chemotherapy
- Radiation therapy
What are the complications of surgery for stomach cancer (gastrectomy)?
Some of the complications of stomach cancer surgery include:
- Bleeding from the surgery site
- Blood clots
- Damage to surrounding areas
- Sometimes, leakage from the new connections made between the food pipe (oesophagus), stomach, and intestine
What will my life be like after stomach cancer surgery (gastrectomy)?
- For a few days after a gastrectomy, you will not be allowed to eat or drink anything. This is to allow for healing and to ensure that there is no leakage from the new connections established during surgery
- You will be recovering in the hospital for about 5 days until you are able to eat through your mouth
- Food normally passes into your stomach, where it is digested, and then slowly passes into your small intestine. The absence of a stomach, whether complete or partial, means that you will feel fuller faster. Your body may also respond differently to certain foods
- You may also develop an intolerance to certain foods after gastric surgery. This means that you may have to change your diet as well as your eating pattern after a gastrectomy
- Your body may take up to 2 years to adapt to a gastrectomy
Do I have to modify my diet after a gastrectomy?
- Eat smaller, more frequent meals instead of 3 meals a day
- Chew well and eat slowly, as it helps with digestion and prevents feeling full
- Drink plenty of water, but avoid drinking more than half a cup of water with food
- Introduce sugar, fats, and dairy products slowly into the diet
- Limit fibre consumption, as it can cause a feeling of fullness and discomfort
- Limit caffeine and avoid alcohol
- Follow a diet that is high in calories, low in sugar, and nutrient-dense
- You may develop an intolerance to sugar, fat, and dairy products after surgery. Keep track of what you eat to know what is causing diarrhoea and discomfort, and modify your diet accordingly
- Seek help from your nutritionist to plan your diet
Can stomach cancer recur?
After surgical removal of cancer, the likelihood of stomach cancer recurring varies with time and is not constant. Within five years of surgery, more than 90% of patients relapse, and 70% do so within two years.
It is therefore important to follow up after surgery. Your doctor may ask you to report for follow-up once every 3 to 6 months for the first few years and less frequently thereafter. You will be evaluated for the signs and symptoms of recurrence and evaluated through various imaging techniques to eliminate the possibilities. In addition, you will also be evaluated to understand how you are coping with the surgery during these follow-ups.
