A brief introduction to Stomach cancer

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Introduction

Gastric cancer is the second most common cause of cancer-related deaths in the world, the epidemiology of which has changed within last decades. A trend of steady decline in gastric cancer incidence rates is the effect of the increased standards of hygiene, conscious nutrition, and Helicobacter pylori eradication, which together constitute primary prevention. Avoidance of gastric cancer remains a priority. However, patients with higher risk should be screened for early detection and chemoprevention. Surgical resection enhanced by standardized lymphadenectomy remains the gold standard in gastric cancer therapy. This review briefly summarizes the most important aspects of gastric cancers, which include epidemiology, risk factors, classification, diagnosis, prevention, and treatment. The paper is mostly addressed to physicians who are interested in updating the state of art concerning gastric carcinoma from easily accessible and credible source.

Epidemiology

Gastric carcinoma (GC) is the fourth most common malignancy worldwide (989,600 new cases per year in 2008) and remains the second cause of death (738,000 deaths annually) of all malignancies worldwide. The disease becomes symptomatic in an advanced stage. Five-year survival rate is relatively good only in Japan, where it reaches 90%. In European countries, survival rates vary from ~10% to 30%. High survival rate in Japan is probably achieved by early diagnosis by endoscopic examinations and consecutive early tumor resection.

Symptoms

  1. Indigestion or heartburn.
  2. Pain or discomfort in the abdomen.
  3. Nausea and vomiting, particularly vomiting up solid food shortly after eating.
  4. Diarrhea or constipation.
  5. Bloating of the stomach after meals.
  6. Loss of appetite.
  7. Sensation of food getting stuck in the throat while eating.

 

Treatment

Surgery: Surgery is often the primary treatment for this type of cancer.

Chemotherapy: Chemotherapy may be used in combination with surgery and radiation therapy.

Radiation therapy: Radiation therapy may be used to kill cancer cells that may remain after surgery or shrink tumors that may be causing pain or blocking the digestive process.

Immunotherapy: Immunotherapy drugs may be an option for certain cases of advanced disease.

Targeted therapy: Targeted therapy drugs are designed to seek out specific proteins or receptors on tumor cells and kill the cells or prevent them from dividing or growing.

Gastroenterology: A gastroenterologist treats disorders of the digestive system and plays an important role in diagnosing and treating stomach cancer.

Risk Factors

Age: Stomach cancer occurs most commonly in people older than 55. Most people diagnosed with stomach cancer are in their 60s and 70s.

Gender: Men are twice as likely to develop stomach cancer as women.

Bacteria: A common bacterium called Helicobacter pylori, also called H. pylori, causes stomach inflammation and ulcers. It is also considered one of the main causes of stomach cancer. Testing for H. pylori is available and an infection can be treated with antibiotics. Testing for H. pylori is recommended if you have had a first-degree relative, such as a parent, sibling, or child, who has been diagnosed with stomach cancer or an H. pylori infection. Other family members could have it as well, and the infection should be treated if found.

Family history/genetics: People who have a parent, child, or sibling who has had stomach cancer have a higher risk of the disease. In addition, certain inherited genetic disorders, such as hereditary diffuse gastric cancer, Lynch syndrome, hereditary breast and ovarian cancer (HBOC), and familial adenomatous polyposis (FAP) may increase the risk of stomach cancer.

 

Race/ethnicity: Stomach cancer is more common in black, Hispanic, and Asian people than in white people.

Diet: Eating a diet high in salt has been linked to an increased risk of stomach cancer. This includes foods preserved by drying, smoking, salting, or pickling and foods high in added salt. Eating fresh fruits and vegetables may help lower the risk.

Previous surgery or health conditions: People who have had stomach surgery, pernicious anemia, or achlorhydria have a higher risk of stomach cancer. Pernicious anemia is a severe decrease in red blood cells caused when the stomach is not able to properly absorb vitamin B12. Achlorhydria is a lack of hydrochloric acid in the gastric juices, which help digest food.

Occupational exposure: Exposure to certain dusts and fumes may increase the risk of developing stomach cancer.

Tobacco and alcohol: Tobacco use and drinking a lot of alcohol may increase the risk of developing stomach cancer.

Obesity: Excess body weight increases a man’s risk of developing stomach cancer. It is not clear whether obesity increases a woman’s risk of stomach cancer.

Prevention

  1. You can reduce your risk for stomach cancer by doing these things:
  2. Limit the amount of alcohol you drink and do not use tobacco products.
  3. Avoid eating smoked and pickled foods and salted meats and fish.
  1. Eat fresh fruits and vegetables and plenty of whole grain foods, such as whole grain breads, cereals, pasta and rice.
  1. Maintain a healthy weight.

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Journal of Molecular Oncology Research

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