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Stomach Cancer

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Overview

Stomach cancer also known as gastric cancer begins with abnormal growth in the stomach. It is one of the most common causes of cancer deaths worldwide. It is the fifth most leading cause of cancer death in India. According to the Globocan 2018 report, the incidence rate and mortality rate for stomach cancer was found to be 5% and 6.6% respectively [1].

Types of Stomach Cancer

Adenocarcinoma

This is the most common type of stomach cancer and develops in the mucosa, innermost lining of the stomach known as mucosa.

Lymphoma

These usually occur in the wall of the stomach and are very rare.

Gastrointestinal stromal tumor (GIST)

It is a very rare type of stomach cancer that occurs in the interstitial cells of Cajal. Some cancers also starts forming in the hormone- producing cells of the stomach called carcinoid tumor.

Other cancers

Other rare forms of stomach cancer are squamous cell carcinoma, leiomyosarcoma, and small cell carcinoma.

Causes

Many conditions begin as harmless lesions and then turn cancerous. In chronic atrophic gastritis, normal glands of the stomach are missing with some form of inflammation. Atrophic gastritis is often caused by H pylori infection. In another condition called intestinal metaplasia, the cells lining the stomach are replaced with cells lining the intestine.

Risk Factors

Helicobacter pylori (H. pylori) infection.

Age: >50 years.

Severe heartburn, pernicious anemia affecting the immune system.

Family history of stomach cancer.

Smoking

Obesity

Alcohol consumption

Signs & symptoms

The most common signs & symptoms of stomach cancer are:

Heartburn

Indigestion

Difficulty in swallowing

Loss of appetite

Lack of energy

Nausea or vomiting

Anaemia

Diagnosis

Upper endoscopy:

It is also called as esophagogastroduodenoscopy or EGD. It is an important test to diagnose stomach cancer.

Endoscopic ultrasound (EUS):

EUS is most useful in assessing the spread of cancer- spread into the wall of the stomach/nearby tissues/nearby lymph nodes. Also used to help guide a needle into a suspicious area to get a tissue sample (EUS-guided needle biopsy).

Biopsy

Biopsies to check for stomach cancer are most often obtained during upper endoscopy. Stomach cancers that are found to be HER2-positive are treated with targeted drugs such as trastuzumab.

Imaging tests

X-rays, ultrasounds, MRI

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References