Gastric cancer, commonly referred to as stomach cancer, originates from the lining of the stomach and can progress to invade other organs if not detected and treated promptly. This malignancy poses significant health challenges globally, necessitating a thorough understanding of its aspects.
Epidemiology
Gastric cancer ranks among the most prevalent cancers worldwide, though its incidence varies by region. While it is relatively rare in the United States, accounting for about 1.5% of new cancer diagnoses annually, it remains more common in countries like South and Central America, Eastern Europe, and parts of Asia.
Risk Factors
Several factors increase the likelihood of developing gastric cancer:
- Helicobacter pylori (H. pylori) Infection: Chronic infection with H. pylori bacteria is a significant risk factor, leading to conditions like gastritis and peptic ulcers, which can progress to cancer.
- Dietary Habits: Consuming a diet high in salty, smoked, or pickled foods and low in fruits and vegetables can elevate risk.
- Genetic Predisposition: A family history of stomach cancer or inherited genetic syndromes, such as hereditary diffuse gastric cancer, Lynch syndrome, or familial adenomatous polyposis, increases susceptibility.
- Medical Conditions: Conditions like chronic atrophic gastritis, pernicious anemia, and Epstein-Barr virus infection have been linked to higher gastric cancer risk.
- Lifestyle Factors: Smoking, excessive alcohol consumption, and obesity are notable contributors.
Symptoms
Early-stage gastric cancer often presents without noticeable symptoms, making early detection challenging. As the disease progresses, individuals may experience:
- Persistent indigestion or heartburn
- Abdominal discomfort or pain above the navel
- Nausea or vomiting, occasionally with blood
- Unexplained weight loss
- Loss of appetite
- Feeling full after consuming small amounts of food
- Fatigue or weakness
- Presence of blood in stool, leading to dark or black stools
- Swelling or fluid accumulation in the abdomen
- Jaundice (yellowing of the skin and eyes) if the cancer spreads to the liver
Diagnosis
Accurate diagnosis involves several steps:
- Medical History and Physical Examination: Assessing symptoms and risk factors.
- Endoscopy: Using a flexible tube with a camera to visualize the stomach lining and obtain tissue samples (biopsy).
- Imaging Tests: Techniques like CT scans, PET scans, and X-rays help determine cancer’s extent and spread.
- Laboratory Tests: Blood tests to check for anemia or tumor markers.
Staging
Understanding the cancer’s stage is crucial for treatment planning. Staging considers:
- Tumor Size and Depth: How deeply the tumor has invaded the stomach wall.
- Lymph Node Involvement: Whether cancer has spread to nearby lymph nodes.
- Metastasis: Presence of cancer in distant organs.
Treatment Options
Treatment strategies depend on the cancer’s stage, location, and the patient’s overall health:
- Surgery: Removing part (subtotal gastrectomy) or all (total gastrectomy) of the stomach, along with nearby lymph nodes.
- Chemotherapy: Using drugs to kill cancer cells, either before surgery (neoadjuvant) to shrink tumors or after (adjuvant) to eliminate residual cells.
- Radiation Therapy: Targeting cancer cells with high-energy rays, often combined with chemotherapy.
- Targeted Therapy: Employing drugs that specifically attack cancer cell mechanisms. For instance, the FDA approved Astellas’ therapy, Vyloy (zolbetuximab), for treating certain gastric cancers at the gastroesophageal junction. reuters.com
- Immunotherapy: Boosting the immune system to recognize and destroy cancer cells.
Prevention
Preventative measures include:
- Dietary Modifications: Increasing intake of fruits and vegetables while reducing salty and smoked foods.
- Lifestyle Changes: Quitting smoking and limiting alcohol consumption.
- Medical Intervention: Treating H. pylori infections promptly to reduce cancer risk.
- Regular Screenings: Especially for individuals with a family history or genetic predisposition.
Gastric cancer remains a significant global health concern. Early detection through awareness of risk factors and symptoms, combined with advancements in treatment, offers hope for improved outcomes. Individuals are encouraged to adopt preventive measures and seek medical advice if they experience concerning symptoms.
