Blog

What is stomach cancer and where does it come from?

Like all cancers, stomach cancer is created by cells, the very small building blocks that make up the tissues and organs of the body.

Adenocarcinomas are by far the most common malignant tumors of the stomach and arise from the cells of the inner layer of the stomach wall, called the mucosa.

The incidence of stomach cancer varies significantly geographically and is much more common in East Asia, South America and Eastern Europe. It is also more common in men and is usually diagnosed in people between the ages of 60 and 80.

As with most cancers, the causes of stomach cancer are not known. However, several risk factors have been identified that significantly increase the risk of developing stomach cancer and include Helicobacter pylori infection, a diet high in salt and cured meats and low in fruits and vegetables, smoking, a family history of stomach cancer in first-degree relatives, certain inherited gene mutations, blood type A, male gender, and certain medical conditions such as previous stomach surgery for benign disease, pernicious anemia, and adenomatous gastric polyps.

How is stomach cancer diagnosed?

In relatively early stages, stomach cancer either causes no symptoms at all or the symptoms it causes are vague and resemble other benign diseases. Symptoms that raise the suspicion of stomach cancer are the following: feeling of fullness even after small meals, abdominal pain or discomfort, new-onset indigestion, nausea and vomiting especially when there is blood, anorexia and unexplained weight loss. Chronic blood loss from a tumor in the stomach can also cause anemia and easy fatigue.

The diagnosis of stomach cancer after taking a careful history and clinical examination is based on upper digestive endoscopy (gastroscopy). If suspicious areas are found during endoscopy, small pieces of tissue (biopsies) are collected from the lesion and sent to the laboratory for examination under a microscope (histopathological examination).

Is a biopsy the only way to determine with certainty whether or not cancer cells are present?

After the diagnosis is confirmed, the disease is staged, during which special tests are performed to determine whether the tumor has spread beyond the stomach wall to neighboring organs or lymph nodes or through the circulation to distant organs such as the liver or lungs (the so-called metastases). These tests always include a CT scan of the chest and abdomen and, if indicated, endoscopic ultrasound, laparoscopy and PET scan. Accurate tumor staging is essential both to make the right treatment decisions and to more accurately assess the prognosis of the disease.

How is stomach cancer treated?

The treatment of stomach cancer should be planned by a multidisciplinary team of doctors and within the framework of the so-called oncology council.

In the first phase, it is assessed whether the tumor is resectable (operable), that is, whether the entire tumor can be surgically removed or not. In general, earlier tumors are more likely to be resectable. In any case, surgery remains the only form of treatment that aims to cure cancer. If this is not possible, other treatments are given with the aim of relieving symptoms and possibly prolonging the patient’s survival.

Depending on the size and location of the tumor, during the operation the tumor is removed along with part or all of the stomach (subtotal or total gastrectomy, respectively). It has been found that to optimize the oncological result and therefore the patient’s outcome, it is important to remove the entire tumor with healthy margins (the so-called R0 resection) along with a sufficient number of lymph nodes located around the stomach. In some cases of larger tumors, in order to achieve complete excision, co-removal of adjacent organs such as the pancreas or spleen may be required, which increases the severity of the surgery even further. Gastrectomy surgery is usually performed open and in selected cases laparoscopically, provided that the oncological adequacy of the operation is not compromised.

Large multicenter studies have shown that the outcome of patients with locally advanced but operable tumors is significantly improved when surgery is combined with some form of drug treatment (chemotherapy and/or immunotherapy). In many cases, the results are even better when chemotherapy is administered both before and after surgery (perioperative chemotherapy).

In conclusion, the modern treatment of stomach cancer is complex and requires a surgeon with expertise in upper digestive surgery and an oncology team with knowledge and experience in the application of modern chemotherapy protocols. The Psychiko Medical Center has the most advanced technological equipment as well as highly specialized medical and paramedical staff for the safe and effective treatment of patients with stomach cancer.