Signs and symptoms
People with early-stage stomach cancer have no obvious symptoms of the disease. As the disease progresses, they will experience abdominal pain, loss of appetite, nausea, vomiting, fatigue, and weight loss. The signs and symptoms of gastric cancer may include:
- abdominal pain
- a sense of fullness in the abdomen after eating a small meal
- loss of appetite
- nausea and vomiting
- persistent fatigue
- weight loss
- blood in the stool
- hematemesis
Risk factors
Age: The incidence risk for stomach cancer increases with age, and people aged above 55 are at high risk of gastric cancer.
Gender: Males are twice more likely than female to get gastric cancers.
Smoking: Smoking is associated with stomach cancer, and it is found that smokers are 1.53 times higher risk of getting stomach cancer than non-smokers.
Helicobacter pylori infection: Helicobacter pylori infection triggers inflammation in the mucosa of the stomach, eventually leading to stomach cancer.
Unhealthy diets: High-salt, high-fat and low-vitamin food will increase the risk of developing stomach cancer.
Family history: People with a mother, father, sister, or brother who has had stomach cancer are at risk of getting this disease.
Existing stomach diseases: Stomach diseases like gastric ulcer, gastric polyps, atrophic gastritis, etc., if not properly treated, would increase the risk of developing stomach cancer.
Diagnosis
If you have some symptoms and suspect that you get stomach cancer, the doctor may ask you to have a physical examination. You may have a blood routine test, fecal occult blood test and gastroscopy. If a suspicious condition is found in gastroscopy, a biopsy will be later performed for pathological examination to see whether it is stomach cancer.
Once stomach cancer is diagnosed, you will be asked to have a chest X-ray, total abdominal (including pelvic) CT or magnetic resonance imaging test to identify the staging of stomach cancer. Furthermore, liver and kidney function, the cardiopulmonary function will be done to determine whether your general conditions can tolerate the next treatment.
Staging
The staging of stomach cancer depends on the size of the tumor, the depth of infiltration and the spread to nearby lymph nodes, and the metastasis to distant sites. At present, there are many staging systems and the most used is the TNM staging standard， which is based on three key points: the extent (size) of the tumor (T), the spread to nearby lymph nodes (N) and the metastasis to distant sites (M).
Treatment
It is a common question of whether stomach cancer can be cured. Thanks to the availability of advanced medical equipment and more effective anticancer medicine, most patients with early-stage stomach cancers can be cured.
When detected with stomach cancer, patients are required to receive relevant examinations to identify the staging. When the tumor is at stage I, II or III, patients will be arranged to receive surgical treatment, if their health conditions can tolerate the procedure, followed by the postoperative chemoradiotherapy, immunotherapy, etc. Patients with stage IV gastric cancer is usually recommended to adopt chemotherapy-dominant palliative treatment. Some patients may be given targeted therapy when gene mutation is found in the testing.
Surgical resection
Surgical resection is a primary treatment for gastric cancer. The section usually ranges at least 5 cm away from the tumor edge, and the surgeon may remove two-thirds of the stomach. How much the surgeon removes depends on the size and position of the tumor, the surrounding area, local lymph nodes, etc. Some people may need to remove the whole stomach.
Chemotherapy after surgery
Stomach cancer is a kind of malignant tumor with the chance of recurrence and metastasis. In some cases, stomach cancer will recur and metastasize after surgery, and clinical trials have found that adjuvant chemotherapy after surgery can reduce the chance of recurrence or metastasis. However, this does not mean all gastric cancer patients require postoperative chemotherapy.
Chemotherapy
Chemotherapy is another primary treatment for gastric cancer. Generally, patients with stage I stomach cancer do not need chemotherapy, but when it is at stage II or stage III, chemotherapy is recommended.
Depending on patients’ cancer staging and health condition, a single drug regimen or combination regimen will be given. Usually, patients are given a combination of 2 or 3 drugs in a regimen. The commonly used chemotherapy drugs for stomach cancer include:
- Fluorouracil (5FU)
- Capecitabine
- Cisplatin
- Oxaliplatin
- Doxorubicin
- Irinotecan
- Paclitaxel
Side effects of chemotherapy
It is a misconception that chemotherapy drugs for gastric cancer will definitely cause hair loss and vomiting. In fact, only a small proportion of chemotherapy drugs will cause severe hair loss, and many of them won’t bring big troubles to hair, and the hair will grow after chemotherapy. Also, chemotherapy won’t cause severe vomiting and antiemetic drugs will be given to patients in advance to prevent severe vomiting.
Some possible side effects of chemotherapy include:
- loss of appetite
- losing weight
- fatigue
- bleeding and bruising easily
- diarrhea or constipation
- nausea and vomiting
- hair loss
Prevention
Based on the risk factors for stomach cancer, people can develop a good lifestyle and habit to prevent gastric cancer. Here are some tips for preventing stomach cancer:
Quit smoking: The chance of getting gastric cancer reportedly increased with the number of cigarettes consumed a day and the number of years of smoking. The risk can reduce after quitting for over ten years.
Keep a healthy diet: Avoid spicy, high-temperature and high-salt foods which do harm to the gastric mucosa. Do not eat overnight food.
Do regular exercise: A regular exercise can help improve intestines and stomach functions.
Get a regular physical examination: A physical examination can help detect gastric cancer to receive early treatment.