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Stomach cancer is the 4th most common cancer in the world and the 17th most common cancer in the UK. Every year, around 6,600 new cases are registered in the UK, and it usually affects people over 45 years old.
The major problem about stomach cancer is that it may not manifest clinically until late in the disease. As a result, this delay in diagnosis can make stomach cancer more challenging to treat.
Stomach cancer, also known as gastric cancer, is a serious medical condition characterised by the growth of unhealthy, cancerous cells usually within the inner lining of the stomach.
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Stomach cancer can be classified into different types. The main types of stomach cancers include:
Adenocarcinomas account for 90 to 95% of all stomach cancers. Linitis plastica is a type of adenocarcinoma that involves the entire stomach.
Lymphomas are cancers of the immune system. They are located in the stomach wall. Gastric lymphomas make up 5% of all stomach cancers.
Gastrointestinal Stromal Tumour (GIST) is a rare type of tumour accounting for less than 1% of all digestive tumours.
Carcinoid tumours are a type of neuroendocrine tumours. They usually start in the lining of the gastrointestinal system and grow slowly over time.
The human body is made up of cells which are the basic structural and functional units of every organism. Every cell contains a genetic material known as DNA.
Similarly, the stomach is lined by cells that help it carry out important functions, such as the secretion of acids, hormones and enzymes.
Sometimes, the cells of the stomach may be subjected to some kind of 'injury' or may be genetically predisposed to damage. When damage occurs to the genetic material found within a cell, this can cause a change in the code present in DNA. This process is what scientists refer to as 'mutation'.
Unhealthy, damaged, mutated cells tend to grow and divide uncontrollably, giving rise to what is commonly referred to as cancer. If mutation occurs in the cells that line the stomach, the condition is referred to as stomach cancer.
The risk factors of stomach cancer are numerous and include:
Helicobacter pylori are a type of bacteria that can disrupt the mucus barrier of the stomach.
Medical conditions can contribute to an increased risk of stomach cancer. These include pernicious anaemia, gastritis, gastric polyps, gastric atrophy and lymphomas.
Some studies have identified a link between nutritional factors, such as the consumption of nitrosamine, high nitrate-containing foods, eating a lot of salted processed foods and having a history of alcohol abuse.
Studies show that individuals with blood group type A have a slightly increased risk of developing gastric cancer.
Studies show that more than 50% of gastric cancer cases occur in Eastern Asia. Scientists suggest that this may be attributed to the regular consumption of salted, smoked foods and helicobacter pylori infection.
Having a family member with stomach cancer is also a risk factor for gastric cancer, as it indicates that there might be some problems on a hereditary level.
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The clinical presentation of stomach cancer can vary from person-to-person and will depend on the stage of the disease. The most common symptoms of stomach cancer are:
Diagnosing stomach cancer can be challenging, as most patients do not present with symptoms early on in the disease.
To diagnose stomach cancer, your doctor will want to carry out specific tests on samples of your blood. Your general practitioner will refer you to a specialist if there is a need for more advanced investigations.
Below are the investigations that are commonly ordered to confirm a diagnosis of stomach cancer:
General blood tests, such as a full blood count, electrolyte levels, and renal function tests will be carried out on samples of your blood.
Your doctor may request an upper gastrointestinal endoscopy. This is a particular procedure in which your doctor will use a device attached to a special kind of camera to visualise the inner aspects of your stomach.
If your doctor notices or suspects illness, he will take a few samples of the abnormal area and send it to the laboratory for microscopic analysis. The samples are known as biopsies.
Endoscopic ultrasound is a more advanced instrument that uses ultrasound to create images of the inside of your stomach. The advantage of endoscopic ultrasound over simple endoscopy is that with endoscopic ultrasound, your doctor can visualize the different layers involved, thus allowing him to assess the depth of invasion of the cancer.
CT or PET Scans are usually requested for staging of the disease. That is, they can help your doctor determine the severity of the disease and how far it has spread.
You can learn more about how the NHS diagnoses stomach cancer by clicking on the following link: NHS Stomach Cancer Tests
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For anyone diagnosed with stomach cancer, it is disheartening. However, you do not have to suffer alone. There are multiple support groups available for stomach cancer survivors and several steps you can take to minimize your symptoms and improve the overall quality of your life. Also, if the cancer has not yet spread, it may be possible to destroy it in some instances.
If you have the symptoms mentioned above, it is advisable to consult a medical professional, as stomach cancer should not be taken lightly. Delaying diagnosis and treatment of stomach cancer only allows it to progress to a more serious stage. Once a diagnosis has been reached, your surgeon will select the best treatment option depending on the type and the stage of stomach cancer.
Stage 0 stomach cancers or early gastric cancers can be treated using surgery. If the cancer is very small, it can be removed by endoscopic resection. Chemotherapy and radiation are not needed for stage 0 cancers.
Stage 1, 2 and 3 stomach cancers can be removed by total or subtotal gastrectomy, which involves removing the affected part of the stomach. Radiation therapy and chemotherapy may be necessary.
In the last stage, that is stage 4 of stomach cancer, a cure is impossible. Treatment can only reduce symptoms and improve the quality of life. Stage 4 treatment options include surgery, such as gastric bypass or subtotal gastrectomy, chemotherapy or radiation therapy.
Stomach cancer can reduce your appetite and cause involuntary weight loss. So, even if you don’t feel like eating, it is important to force yourself to eat appropriately.
If you have already had surgery in which part of your stomach has been removed, you may experience nausea, bloating, diarrhoea and other gastrointestinal symptoms 10 to 30 minutes after a meal. This is known as the early dumping syndrome. The early dumping syndrome occurs as a result of the rapid movement of fluid into the intestines. To reduce the symptoms of this syndrome, you should avoid eating a large meal at one sitting, but instead eat small portions of food more frequently. Choosing foods that are high in fibre, avoiding very hot or cold foods, chewing well before swallowing, not drinking liquids while eating, can also prevent the dumping syndrome.
After your surgery, you may also experience the late dumping syndrome. The late dumping syndrome, also known as reactive hypoglycaemic attack, occurs 90 minutes to 3 hours after a high-sugar meal. It happens because your body releases a large amount of the hormone insulin to absorb the high amount of sugar. Late dumping syndrome may present as black-outs, seizures, weakness, or confusion. To reduce the risk of having a hypoglycaemic attack, you should decrease the carbohydrate load in your diet.
Gastrectomy may also cause vitamin B12 deficiency which can, in turn, lead to nutritional anaemia. Vitamin B12 deficiency can cause numbness, weakness, memory loss, depression and nerve problems. You should increase your dietary intake of vitamin B12. Your doctor will also prescribe monthly injections of vitamin B12 to prevent complications.
It is helpful to store all your medical documents such as blood investigations, endoscopic reports, health insurance documents and surgical reports all together in a file so you can take it along with you whenever you visit your doctor. This can help your doctor provide the highest quality of care, as they will have all the information at hand to choose the best treatment strategy for you. Keeping medical records can help you better track your progress, understand your medical condition and can unconsciously keep you motivated to take care of yourself.
Feelings of depression are common among cancer patients and their family members. It is completely normal to experience some degree of grief and sadness. However, constant grief can take a toll on a patient and trigger symptoms of depression.
Studies report that patients with stomach cancer experience higher levels of depression and anxiety than any other type of cancer. So, it is important to maintain a positive state of mental health. Talk about your worries to a person you can trust. You can find help from support groups, counsellors and psychologists who are well-trained in delivering mental health therapies.
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Guts UK! was founded in 1970 by the Council of the British Society of Gastroenterology. Guts UK is a registered charity run by a dedicated team of healthcare professionals, all working towards a common goal – that of increasing the levels of research about diseases of the gut, liver and pancreas. Click here to visit their website.
The mission of No Stomach For Cancer is to provide hope and encouragement to patients and families of patients affected by stomach cancer. They work to unite the caring willingness of patients from all around the world to help each other live a better life. Find out more about No Stomach For Cancer by visiting their website through the following link: No Stomach For Cancer
Penny Brohn UK, Living Well with Cancer is a charity that dedicates its time and efforts to the fight against cancer. It has a helpline that can assist you in getting started with the Bristol Whole Life Approach. Find out more about Penny Brohn UK here.
Cancer Research UK is a registered charity governed by a council of trustees that provides support, hope and evidence-based information to patients suffering from cancer. You can visit Cancer Research UK by clicking here.
World Cancer Research Fund is another leading cancer-fighting charity that aims at preventing cancer, improving quality of life and promoting survival of patients. You can visit World Cancer Research Fund by clicking on this link: World Cancer Research Fund
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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.
Cell – is a structural unit that makes up an organism
DNA – stands for deoxyribonucleic acid. DNA is the genetic material found in cells that contains the 'biological codes' that determine function, growth, development and confer distinctive characteristics to every individual
Insulin – is a hormone produced by the pancreas. It is responsible for promoting body cells to take in sugar or glucose from the blood. Too much insulin can make cells absorb too much glucose resulting in low levels of glucose in the blood
