Diagnosis and Treatment of Stomach Cancer

Diagnosis and Treatment of Stomach Cancer
By Paul M Choi

The stomach is a J-shaped organ of the digestive tract that connects the esophagus to the intestinal tract. Stomach or gastric cancer is a cancerous growth that occurs in the lining of this stomach. It is an extremely common problem worldwide, with over 1 million individuals succumbing to this illness each year. Factors leading to this illness include infection by Helicobacter pylori, eating salty and smoked food, and smoking.

The diagnosis of gastric cancer often involves an upper endoscopy, an examination of the stomach using an instrument called gastroscope that enables an evaluation of the inner lining of the stomach as well as taking a biopsy or sampling of cancer tissue. Once the diagnosis is made, the initial determination of the extent of cancer is made using a radiologic examination called CT scan. In addition, routine blood tests including complete blood count (CBC), and liver function tests, as well as chest X-ray are obtained during the initial evaluation.

There are 4 stages of stomach cancer. The most important determinants in cancer staging is the extent of wall invasion and involvement of lymph node, tiny bean-shaped glands of lymphatic system. Broadly speaking, in Stage 1, the cancer is mostly confined to the lining of the stomach, with or without nearby lymph nodes. In Stage 2, the cancer tissue has invaded the additional layers of stomach wall. In Stage 3, the cancer tissue has penetrated the entire thickness of the stomach wall and may have spread to nearby organs such as the liver. In Stage 4 stomach cancer, the cancer has spread to distant organs.

The staging of stomach cancer is important since the prognosis of affected individual is highly dependent on the staging of cancer. In fact, patients with the stage 1 cancer have a 5 year survival rate of 71%, compared to only 4% for those with stage 4 cancer.

The treatment of stomach cancer depends mainly on the stage, size, and location of the tumor, as well as the overall health of the affected individual. Treatment options may include surgery, chemotherapy, and radiation therapy. Surgery is usually curative in stage 1 stomach cancer. In more advanced cancer, a combination of surgery, chemotherapy, and radiation therapy may be utilized. Commonly used chemotherapeutic agents include 5-FU, adriamycin, mitomycin, and cisplatin. In addtion, some patients may benefit from a new class of cancer therapy such as Herceptin.

Following these treatments, it is important that affected patients are carefully followed to monitor for relapses and recurrences. Thus, periodic evaluations including routine blood test, CT scan and upper endoscopy are strongly recommended.

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