Stomach cancer - the most common form of malignant neoplasms of the alimentary canal.Recently annually record about a million newly infected people.Stomach cancer among all cancers in the number of deaths is ranked third in women and second in men. Malignant tumors of the stomach is probably one of the most dangerous diseases later in life, as in 85% of patients develop metastases, with an average survival rate in the next six months, with early diagnosis is about 65%, while about 15% later.The disease is twice as common in men and is most common among the elderly.
Specific stomach cancer types localization :
- pyloric and antral - from 60 to 70% of cases
- Small curvature of the gastric body - from 10 to 15% of cases
- cardia - from 7 to 10% of cases
- rear and front walls of the stomach - from 2 to 5% of cases
Stomach cancer - causes of
reasons for the development of malignant tumors can be divided into the following types:
- Prior chronic diseases of the st
- Nutritional factors directly related to the characteristics of supply: exceeding the norm eat canned, spicy, fried and fatty foods.Chemically active substances have a damaging effect on the gastric mucosa, destroying the protective layer on the mucosal surface epithelium, and promote the penetration of causing cancer (carcinogenic substances) into the cells, which leads to their subsequent destruction or degeneration.In contrast, the inclusion in the daily diet of a large number of vitamins and minerals, fruits and vegetables significantly reduces the risk of the incidence of oncology
- Genetic factors.The risk of developing stomach cancer increases significantly if someone in the family - a close relative suffering from cancer of the gastrointestinal tract or other organs of the cancer
- The development of cancer affects alcohol abuse and smoking
- Hormonal activity and constitutional features.Increases the risk of cancers of the gastrointestinal tract and reproductive organs are those background diseases like obesity and very heavy (due to various endocrine disorders)
have about 80% of patients with early forms of gastric cancer is practically no symptoms, so it is often access to a doctorcaused by the presence of comorbidities.EXPRESS symptoms in most cases indicate that the cancer process has been very far
Stomach cancer - stage
Stage 1 → clear demarcation of small (up to two centimeters) located in the submucosa or thicker mucoussheath tumor.Regional metastases absent
Step 2 → tumor reached four - five centimeters in diameter and grows into the muscle layer of the stomach, thus not germinate serous covering it.The regional lymph nodes are observed nearby isolated metastases.Stomach retains its mobility
→ Stage 3 tumor reaches a considerable size, beyond the walls of the stomach limiting its mobility grows into adjacent organs;or tumor much smaller, but with multiple regional metastases.Often, there are various complications
→ Stage 4 tumor can be of any nature and extent, grows into adjacent organs: the great vessels of the abdomen and pancreas.Metastases may occur in the abdominal organs such as the liver, peritoneum, ovaries (in women), and so forth.
In the early stages of stomach cancer cure reaches almost hundred percent.In the later stages of the forecast survival depends on whether the deleted all completely tumor metastasis, but in view of the fact that it is virtually impossible, the survival rate is less than ten percent
Stomach cancer - types
On histological features the following typesTumor: undifferentiated, slimy (colloidal), solid (trabecular) medulyarny (mozgovidny) and fibrotic (scirrhoma) cancer and adenocarcinoma.Grossly release forms: infiltrative (diffuse infiltrative and ulcerative cancer) Limited (flat, saucer-shaped, mushroom and polypoid cancer), transitional (colloidal and fibrous cancer).
tumor process spreads through the blood and lymphatic system, and by contact in the case of tumor invasion of adjacent organs and tissues.Most often lymphogenous metastasis is in periportal, mesenteric, inguinal, subclavian and peribronchial lymph nodes.When the blood (hematogenous) path is metastasis to the ovaries, adrenal glands, pancreas, pararectal fat, kidneys, pleura, lungs and liver.
infiltrative forms of cancer as well as malignant tumor, located in the outlet of the stomach have the highest malignancy
Stomach Cancer - Symptoms
specific symptoms that accurately characterize the presence of human gastric cancer, there is, however, identifies a number of symptomsthrough which it is possible to suspect the presence of the disease.All symptoms can be divided into specific and nonspecific.
Specific symptoms include : weight loss, lack / loss of appetite, rise in body temperature, general weakness.
nonspecific symptoms include :
- nausea and / or vomiting: usually a symptom of diseases of the stomach as a peptic ulcer and acute gastritis, but in cancer, this symptomatology is characterized by the presence of a tumor large enough that overlaps the exit from the stomach
- Abdominal pain: it is often a dull, nagging, aching epigastric pain, which can occur periodically, and more often after a meal.When tumor invasion of adjacent organs, or by joining the accompanying inflammation, pain becomes constant
- Vomiting eaten on the eve of food (in one - two days): occurs when tumors antral (output) of the stomach, on the border with the duodenum, which causestenosis and lead to stagnation of the lumen of the stomach the contents from several hours to several days.Vomiting stagnant content causes painful feelings and leads to depletion of the patient
- Black loose stools and vomiting "coffee grounds" characterizes the presence of a tumor or bleeding stomach ulcers.In the presence of these symptoms requires urgent remedial measures to stop the bleeding
- fast satiety, feeling of fullness, discomfort and heaviness after eating, belching, heartburn gain
- The difficulty of the passage of food, sometimes to the complete impossibility of passing the liquid.This expression is a symptom of cancer of the initial part of the stomach and esophagus
Symptoms far-gone process :
- By increasing the liver or the presence of fluid, an increase in belly size
- In the stomach there is a palpable tumor
- As a result of anemia occurspallor, jaundice, skin
- The left axillary and supraclavicular lymph nodes were significantly increased (metastatic lesion)
Complications of gastric cancer include: tumor sprouting adjacent organs, perforation of the stomach wall, massive bleeding, intoxication, narrowing the antrum and pylorus;in the later stages of the disease observed cachexia
Stomach cancer - diagnosis
great importance for further effective treatment is the timely detection of gastric cancer in the early stages, as the first three stages of the cancerous tumor is still operable.
Comprehensive comprehensive examination includes:
- Targeted medical history (symptoms change over time, the syndrome of "small signs" precancerous stomach)
- Direct examination of the patient (decreased skin turgor, underweight, anemizatsiya etc..)
- Laboratory studies fibergastroscope with a biopsy, x-ray, computed tomography
complexity of early diagnosis of gastric cancer is hidden during the initial period of the disease, and property masquerade as a benign lesion of the stomach functional or inflammatory.Installing the correct diagnosis is possible only if a comprehensive survey (gastropically, histological, radiological) and follow-up (for two - three weeks).
Due to the existence of a definite connection between some benign diseases and malignant tumors of the stomach, is necessary to conduct differential diagnosis with chronic gastritis, peptic ulcer and gastric polyps.It is also necessary to take into account the possible presence of malignant ovarian tumors, biliary tract, intestines, liver, and anemia
Stomach cancer - treatment
In the treatment of gastric cancer and the only primary method that gives a chance for subsequent cure is surgery.Other methods are used as adjuvant therapy and supportive.
Surgery is the most effective, so the most common way to treat cancer of the stomach.In most cases the cost of partial gastrectomy (only removes part of the stomach).Often at the same time there is a removal of local lymph nodes.If conducting a partial gastrectomy is not possible, it held full gastrectomy (removes the entire stomach and spleen, along with the lower part of the esophagus) and the subsequent connection of the esophagus directly to the small intestine.
After healing, scarring, patients who have deleted a portion or all of the stomach, it is recommended to eat frequent, small meals several times a day, as the feeling of fullness after these changes in the body they occur very quickly.Also for the same reason, it is recommended to take drink apart from meals.People after the removal of the stomach takes time to experimentally find the right products and a power circuit.This is imperative to stick to a nutritious diet, as many patients with gastric cancer is very lose weight.
People who underwent gastrectomy, often observed failure of this chemical as an internal factor, which is produced in the stomach and is large enough for the normal absorption of vitamin B12.According to the patients, in order to prevent its failure, this vitamin is injected
Even in the case of timely surgical removal of the tumor and the lymph glands of the local retained a slight chance of further spread of cancer cells and the occurrence of metastases.This is due to the fact that some micrometastases may remain unremoved tissues and subsequently cause relapse.The risk increases considerably in the case if they were directly affected lymph nodes.Chemotherapy for preventing cancer recurrence leads to a significant increase in survival rates.
Most existing chemotherapy regimens based on the use of the drug 5-FU (5-fluorouracil), sometimes in combination with drugs such as adriamycin or cisplatin.Side effects of chemotherapy include nausea and / or vomiting (successfully controlled by antiemetic drugs), hair loss, diarrhea, stomatitis
In gastric cancer radiotherapy is not widely used because the radiation damage other organs located in the immediateproximity to the stomach.If the disease is accompanied by excruciating painful symptoms (at an advanced stage), radiotherapy effectively eases these symptoms.