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Stomach Cancer: From the First Symptoms to the New Era of
Treatment

What is stomach cancer?

Stomach cancer (gastric cancer) is a malignancy of the digestive system that begins in the stomach mucosa. Although its incidence has decreased internationally, it remains a significant cause of morbidity and mortality, especially in people over 60 years of age.

It is crucial to inform citizens about the factors that increase the risk of developing the disease, in order to strengthen prevention and early diagnosis.

Epidemiological data in Greece

In Greece, approximately 1,000–1,200 new cases of gastric cancer are recorded annually. The disease occurs more frequently in men and in older people. Improved dietary habits and a reduction in smoking have contributed to the gradual reduction in incidence.

In recent years, the use of endoscopy, biopsies and modern imaging techniques (CT, PET-CT) has significantly increased the likelihood of early diagnosis. In addition, detection of the bacterium Helicobacter pylori and its treatment reduce the risk of progression to cancer.

What increases the risk?

• Chronic infection with the bacterium Helicobacter pylori: This is a microorganism that causes chronic inflammation in the gastric mucosa and can lead to precancerous lesions.
• Diet rich in salted, smoked or processed foods:
• Low consumption of fruits and vegetables
• Habits that seriously burden the gastric environment (smoking, alcohol)
• Family history or genetic mutations.
• Precancerous conditions: Mucosal lesions that can develop into malignancy.

Information is the first step towards prevention. Gastric cancer can be effectively treated when detected early, with the appearance of suspicious symptoms such as indigestion, nausea, unexplained weight loss, persistent abdominal pain and general weakness with blood in the stool or hematemesis.

Diagnosis

Gastroscopy is the main method for imaging the gastric mucosa, which allows for the direct observation of suspicious lesions and the taking of biopsies for histological examination.

Histological examinations of samples taken during endoscopy confirm the presence of cancer cells, determine the type of tumor (e.g. adenocarcinoma) and provide information on the differentiation and aggressiveness of the disease. In addition, CT or MRI scans and PET-CT are used to map the disease and search for metastases.

Treatment

The treatment of gastric cancer has evolved significantly in the last decade, with science now turning to more targeted and personalized approaches. The choice of appropriate treatment depends on the stage of the disease, the general condition of the patient and the biological characteristics of the tumor.

Surgical treatment continues to be the basis of treatment when the disease is localized.

Chemotherapy is applied preoperatively or adjunctively with the aim of downstaging and reducing possible recurrence of the disease.

Radiation therapy can be combined with chemotherapy for locally advanced or inoperable carcinoma.

There are innovative targeted therapies based on gene mutations (HER2), that trigger molecular pathways of carcinogenesis, which show spectacular results in overall survival.

Immunotherapy in combination with chemotherapy, as shown by data from recent oncology studies (Matterhorn study), significantly increases the complete pathological response and the survival of patients without disease recurrence.

Personalization: The future of oncology

The modern therapeutic approach is no longer “one solution for all”.

The analysis of the genetic profile of the tumor, the evaluation of the patient’s clinical condition and the use of biomarkers lead to innovative therapies adapted to the needs of each patient both in terms of overall survival and optimal quality of life.