– Stomach

– – Cancer of the stomach : Definition

What is the cancer of the stomach?

The stomach is a muscular body in the shape of bag, placed in the upper part of the abdomen. The stomach is part of the digestive system, which is composed of various bodies whose role is to transform food into energy and to eliminate waste from the organization.

Absorptive by the mouth, the food crosses the oesophagus to arrive at the stomach, where they are mixed with gastric juices (enzymes and acids) secreted by glands papering the wall of the stomach. The semi-solid mixture which results from it leaves then the stomach by an opening surrounded by a muscle in the shape of ring, called sphincter pyloric, and penetrates initially in the small intestine then in the colonist, where digestion finishes.

The wall of the stomach consists of four layers. The cancer of the stomach occurs in the cells of the internal layer, called mucous membrane. It can gradually extend to the other layers from the stomachic wall.

Cancers of the stomach which are born in the lymphatic fabrics (lymphoma) or muscular (sarcoma) from the stomach, or in the fabrics which support the bodies of the digestive system (gastro-intestinal tumour stromale) are less current and require different treatments.

The men are more likely to develop a cancer of the stomach than the women.

The cancer of the stomach is not ascribable to a single cause but certain factors increase the risk to develop the disease:

• a food mode rich in salt and fume or salted meats,
• a food mode low in vegetables and fruits,
• an ignition or other problems on the level of the stomach, such as:

– chronic gastritis (prolonged ignition of the stomachic wall)
– intestinal metaplasy (modification of the cells of the stomachic wall)
– weakens pernicious (blood disease which affects the stomach)
– former surgery of the stomach, production of gastric acid lower than the normal
– an infection caused by the bacterium Helicobacter pylori (H. pylori), frequently presents in the stomach

– the age, in particular after 50 years
– tobacco addiction
– family antecedents of cancer of the stomach
– a professional exposure related on the treatment of rubber and the manufacturing of lead

The cancer of the stomach can sometimes develop in the absence of all these risk factors.

– – Signs and Symptoms

Signs and Symptoms of the cancer of the stomach

The cancer of the stomach is often asymptomatic during its first stages.

The most frequent symptom is a light pain in the abdomen, similar to that caused by an indigestion.

The other symptoms of the cancer of the stomach are in particular the following:

• loss of appetite
• heartburn
• indigestion which does not reabsorb
• nauseas and vomiting
• feeling of distension after having eaten
• saddle unusual
• unexplained weight loss
• feeling of great tiredness

Other health problems can cause certain similar symptoms. Thorough analyses will make it possible to pose a diagnosis.

– – Cancer of the stomach : diagnostic

Diagnosis of the cancer of the stomach

Perhaps after you to have questioned on your health status and to have examined to you, your doctor will suspect the presence of a cancer of the stomach.

To confirm his diagnosis, the doctor will resort to certain analyses, which will be able to also make it possible to establish the “stage” and the “rank” of cancer. It may be that you have to pass one or more from the following tests.

Blood analyses

Starting from samples of your blood, one checks your red globules in order to see whether you suffer from an anaemia (weak numeration of the red globules) because as of blood losses caused by a tumour with the stomach. The taken samples also make it possible to see your bodies up to what point function normally and can indicate the possible presence of a cancer.

Test of search for blood occults in the saddles

A small sample of your saddles is analyzed in laboratory to detect the presence of detectable blood only under the microscope.

Technique of imagery

These techniques make it possible examine a closer examination of fabrics, bodies and bones.

Radiography, l’echography, tomodensitometry [TDM], the imagery by magnetic resonance [MRI] and the osseous scintiscanning are as many means for your medical team of obtaining an image of the tumour and of checking if it extended. These tests are generally without pain and do not require any anaesthesia.
Perhaps you will pass a series of radiographies of the oesophagus and the stomach called œso-gastro-duodenal transit (TOGD), or a swallowing or barytée mouthful. One will ask you to drink a thick and chalky liquid called barium, which will coat the interior of your oesophagus, your stomach and your small intestine. The doctor will be able better to then see these bodies on radiographies. If it notes signs of cancer, the doctor will be able to also check if the disease were propagated.

Gastroscopy

The gastroscopy makes it possible to examine the oesophagus and the stomach using a narrow and flexible tube (gastroscope), provided with a light at its end. To carry out the examination, the doctor inserts the gastroscope in your throat, which will be probably anaesthetized as a preliminary using a local anaesthetic. You will receive perhaps also a light sedative to help you to slacken you. You will undoubtedly have a sore throat after the examination, but they are a normal effect which will disappear at the end of one day or two.

Biopsy

If the doctor notices something of abnormal during a gastroscopy, it will be able to take several fabric samples using the endoscope.

The intervention which consists in taking cells of the organization in order to examine them under the microscope is a biopsy. A biopsy is usually necessary to establish with certainty a diagnosis of cancer. If the cells are cancerous, their speed will have then to be determined to multiply.
So fabrics must be taken, the intervention will perhaps be held under general anaesthesia.

Additional examinations

If the diagnosed tests indicate that you have a cancer of the stomach, your doctor will want to perhaps make you pass from other blood analyses and examinations of imagery, or perhaps a laparoscopy, to see whether cancer extended. At the time of a laparoscopy, a narrow and flexible tube, provided with a light and a camera at its end, is introduced by a small incision into the abdomen. After having examined the abdomen, the doctor will be able to take several small samples which will be sent in histological analysis (biopsy) and to withdraw some lymphatic ganglia.

– – Stadification

Stadification and histological classification of the cancer of the stomach

Once the diagnosis of cancer is confirmed and that your medical team collected all the necessary information, it is then necessary to determine the stage and the rank of cancer.

The stadification of cancer consists in defining the size of the tumour and checking if it developed beyond the site where it occurred.

Five stages were defined for the cancer of the stomach. Once the diagnosis of cancer is confirmed and that your medical team collected all the necessary information, it is then necessary to determine the stage and the rank of cancer.

The stadification of cancer consists in defining the size of the tumour and checking if it developed beyond the site where it occurred.

Five stages were defined for the cancer of the stomach:

    0Cancer cells are detected only in the surface layer of the wall of the stomach (mucous). The cancer of stage 0 is also called in situ carcinoma. 1

Cancer was propagated the cellular layer surface of the mucous membrane to the following layer (under mucous membrane) and the cancer cells reached from 1 to 6 lymphatic ganglia

OR cancer gained the muscular layer, without however reaching the lymphatic ganglia or other bodies.

2

Cancer extended only to the submucosa but the cancer cells reached from 7 to 15 lymphatic ganglia

OR cancer gained the muscular layer (muscular) and the cancer cells reached from 1 to 6 lymphatic ganglia

OR cancer was propagated with the external layer Fr the stomach (serous), without toutfois to reach the lymphatic ganglia or other bodies

3

Cancer gained the muscular layer and the cancer cells reached from 7 to 15 lymphatic ganglia

OR cancer was propagated with the layer external of the stomach and the cancer cells reached from 1 to 6 lymphatic ganglia

OR cancer reached the close bodies, without however reaching the lymphatic ganglia or other more distant bodies

4

Cancer was propagated with more than 15 lymphatic ganglia

OR cancer reached the close bodies and at least 1 lymphatic ganglion

OR cancer gained other parts of the body

The examination under the microscope of the sample taken during the biopsy makes it possible to carry out the histological classification (rank) of cancer. It is then a question of analyzing the appearance and the behavior of the cancer cells compared to normal cells. The histological classification of cancer makes it possible to the medical team to have an idea of the future development of the tumour.

One can determine the rank of the tumours of the stomach by means of the histological system of classification of Lauren. Two ranks are defined for the cancer of the stomach: intestinal or diffuse.
 

Intestinal

The cancer cells have an appearance and a behavior about similar to those of the intestinal cells.

Their growth is rather slow.

Diffuse

The cancer cells have an appearance and a behavior passably different from those of the normal cells.

They tend to develop quickly and to extend to the other parts of the stomach or the body.

It is important to know the stage and the rank of your cancer, because it is what will help you, like your medical team, to choose the treatment which is appropriate to you best.

– – Treatment for the cancer of the stomach

Treatment for the cancer of the stomach

Surgery

? The decision to resort to the surgery will depend on the size of the tumour and the place where it is. During the intervention, one will carry out ablation total or partial of the tumour and certain surrounding healthy fabrics. The intervention will be practised under general anaesthesia and you will be hospitalized during several days after the operation.

The surgery is the usual treatment in the cases of cancer of the stomach. The intervention which consists in withdrawing a part or totality of the stomach calls a gastrectomy. The type of practised gastrectomy depends on the stage of development of cancer and owing to the fact that it was propagated or not.

If cancer is detected very early, a partial gastrectomy could be the only necessary treatment. The surgeon then withdraws only the cancerous part of the stomach as well as the close lymphatic ganglia. According to the site of the tumour, it can also withdraw the lower part of the oesophagus or the upper part of the small intestine. A reconstructive surgery will be applied to the same moment to fix the remaining part of the stomach at the oesophagus or the small intestine.

In the event of a total gastrectomy, the surgeon carries out the ablation of the stomach in entirety, the close lymphatic ganglia, part of the oesophagus, part of the small intestine and other fabrics located close to the tumour. The failure can also be removed by the same occasion. A reconstructive surgery will be carried out during the same intervention in order to connect the oesophagus to the small intestine.

The palliative surgery does not cure cancer but can attenuate the symptoms of them. If the tumour cannot be removed and that it blocks the oesophagus, it is possible to install a hollow tube (endoprothèse) in the oesophagus to maintain it open. It will be thus easier to you to eat and swallow. If an inoperable tumour blocks the passage of food of the stomach to the small intestine, can the surgeon create a new conduit connecting the two bodies, so as to circumvent blocking (derivation or “by? not”).

After the intervention, it may be that you test certain pains or of nauseas. These side-effects are temporary and can be attenuated.

Perhaps at the time of surgical operation, one will install a probe of food in your small intestine in order to get the liquids and nutrients necessary to you until you can drink and eat by yourself. It can run out a few days before you are able to drink and to start again to eat soft food.

To feed well after an intervention for a cancer from the stomach can prove to be difficult; ask your medical team to direct you towards a dietetist or professional nutritionist. A personalized food mode could be to you prescribed to help itself to preserve your health, your wellness and your quality of life.

Chemotherapy

Chemotherapy can be managed in the form of compressed or by injection.

The drugs chimiotherapeutic prevent the development and the propagation of the cancer cells, but they damage also the cells which are in health.

Chemotherapy can be used in partnership with the radiotherapy to treat the cancer of the stomach after the surgery. It can also help to relieve the pain or to attenuate the symptoms if the tumour cannot be removed.

The healthy cells will be able to be restored with time, perhaps but in the interval, the treatment will cause on your premise certain side-effects such as: skin eruptions or itchings, nauseas, vomiting, loss of appetite, tiredness, loss of hair and increasing risk of infection. Your medical team can suggest you means of limiting these side-effects.

Radiotherapy

In external radiotherapy, one uses a large device which makes it possible to direct a beam of rays towards the precise place of the tumour. The radiation damages all the cells which are in the trajectory of the beam – the normal cells like the cancer cells. The radiotherapy can be used in partnership with chemotherapy to treat the cancer of the stomach after the surgery. It can also help to relieve the pain or to attenuate the symptoms if the tumour cannot be removed.

The side-effects of the radiotherapy are usually light. Perhaps that you will feel more tired than usually, will have the diarrhoea or will notice that your skin changed aspect (it can become red or be sensitive to the touch) at the treated place. Such effects result from the damage undergone by the healthy cells and will usually once grow blurred the finished treatment, once the normal cells will have been regenerated.

To cope with cancer?

However, whatever yours (cancer lately diagnosed, treatment in progress or role of helping near a person reached of cancer), you will have probably to solve many practical problems, to make difficult decisions and to manage a whole range of emotions.