Stomach Cancer

Stomach Cancer

Overview

Gastric cancer is the fifth most common cancer in the world and the third leading cause of cancer death in both sexes worldwide

It is a difficult disease to cure mainly because most patients present with advanced disease

Risk Factors

Certain risk factors can play a role in the development of stomach cancer. These include

  • Pre-existing conditions – Including chronic atrophic gastritis , stomach polyps or pernicious anaemia
  • High alcohol consumption
  • Smoking
  • Family history – Having one or more family members with stomach cancer increases the risk of developing stomach cancer
  • Eating salted, preserved foods
  • H-pylori infection

What are the signs and symptoms?

Early symptoms are usually ignored by patients and presentation is usually delayed.

  • Nonspecific with dyspepsia,
  • Rapid weight loss and loss of appetite
  • Vomiting, difficulty in eating , blood in vomit or blackish stools
  • Anaemia and easy fatigue
  • 70% of patients with early gastric cancer only have symptoms of uncomplicated dyspepsia
  • All at-risk patients with dyspepsia should be considered for endoscopy.
  • The majority of patients present with advanced disease and symptoms such as weight loss, vomiting, anorexia, abdominal pain and anaemia.

Evaluation

  • Basic Blood tests including Hemoglobin and Liver function tests
  • All suspected patients should undergo Upper GI endoscopy and biopsy of suspicious lesions
  • CECT of abdomen might be needed for staging of disease.
  • Endoscopic Ultrasound for staging of disease is done
  • PET CT is done for staging in metastatic disease patients
  • Staging Laparoscopy is done for assessing operability of advanced diseases

Treatment options

Being an aggressive disease, patients require multimodality management including surgery, chemotherapy, radiotherapy and targeted therapy and combination of these.

  • Surgery: Surgery is the treatment of choice for gastric cancer. The most important indicator for resectability and survival after surgery is early diagnosis and therefore early stage of disease at operation.
  • Adjuvant and perioperative chemotherapy
  • Perioperative combination chemotherapy has become the standard of care for localised gastric cancer
  • Adjuvant chemotherapy and radiotherapy are used in advanced gastric cancers.
  • Targeted therapy is useful in metastatic cancers.

What we offer in our centre?

Multimodality treatment options are available. All surgical options for early, locally advanced and metastatic stomach cancers including -

  1. Laparoscopic and open surgeries for Gastric cancer
    • Distal radical gastrectomy + D2 lymphadenectomy
    • Total gastrectomy + D2 lymphadenectomy
    • Subtotal gastrectomy+ D2 lymphadenectomy
    • Partial gastrectomy with D2 lymphadenectomy
    • GIST of stomach – Partial / subtotal gastrectomy
    • Gastrojejunostomy for bypass
    • Feeding jejunostomy for advanced cases
  2. Perioperative and adjuvant chemotherapy
  3. Radiotherapy
  4. Targeted therapy and Immunotherapy for advanced gastric cancers

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