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Stomach Cancer

Stomach Cancer

Stomach Cancer
Stomach (stomach) cancer occurs when cancer cells form in the stomach membrane. The wall of the stomach consists of 5 layers of tissue. From the innermost layer to the outermost layer, the layers of the stomach wall are the mucosa, submucosa, novelization, afterrosa (connective tissue), and serosa. Stomach cancer begins in the mucosa and spreads through the outer layers as it grows. Risk factors include smoking, H. infection with pylori bacteria, and some inherited conditions are found. Stomach cancer is the fourth most common cancer in the world.

RISK FACTORS
The following are risk factors for stomach cancer:

Some medical conditions
Some genetic conditions
Diet
Environmental causes
The following are protective factors that can reduce the risk of stomach cancer:
Quitting smoking
Treatment of Helicobacter pylori infection
It is not known whether the following factors reduce the risk of stomach cancer or affect the risk of stomach cancer:
Diet
Dietary supplements

DIAGNOSIS
Tests that examine the stomach and esophagus are used to detect (find) and diagnose stomach cancer. The following tests and procedures can be used:

Physical examination and family history
Suspected increase of an unusual substance in blood assay
Complete blood count
Endoscopy
X-ray imaging with barium
Computed tomography scan
Biopsy

Staging
After being diagnosed with stomach cancer, tests are carried out to find out whether the cancer cells are spreading in the stomach or in other parts of the body. Cancer can spread to other parts of the body from where it started.

The following stages are used for stomach cancer:

Stage 0
Abnormal cells are found in the mucosa of the stomach wall. These abnormal cells can develop into cancer and spread to nearby normal tissue. Stage 0 is also called in situ carcinoma.

Stage 1
It is divided into IA and IB phases.
Stage IA: cancer may have formed in the mucosa of the stomach wall and spread to the lower mucosa.
Stage IB: cancer may have formed in the mucosa of the stomach wall and spread to the lower mucosa. Cancer has spread to 1 or 2 nearby lymph nodes, or it has formed in the mucosa of the stomach wall and spread to the novelization layer.
Stage 2
It is divided into stages IIA and IIB.
Cancer in stage IIA;
It could have spread to the submucosa. It can be seen in the surrounding 3-6 lymph nodes.
It may have spread to the muscle layer of the stomach wall. Nov. It can be seen in the surrounding 1-2 lymph nodes.
It may have spread to the subserosa.
Cancer in stage IIB;
It could have spread to the submucosa. It can be seen in the surrounding 7-15 lymph nodes.
It may have spread to the muscle layer of the stomach wall. Nov. It can be seen in the surrounding 3-6 lymph nodes.
It may have spread to the subserosa. It can be seen in the surrounding 1-2 lymph nodes.
It could have spread to the serosa.

Stage 3
It is divided into stages IIIA, IIIB, and IIIC.
Cancer in Stage IIIA;
It may have spread to the muscle layer of the stomach wall. Nov. It can be seen in the surrounding 7-15 lymph nodes.
It may have spread to the subserosa. It can be seen in the surrounding 3-6 lymph nodes.
It could have spread to the serosa. It can be seen in the surrounding 1-6 lymph nodes.
It can spread to surrounding organs such as the spleen, colon, liver, diaphragm, pancreas, abdominal wall, adrenal gland, kidney, small intestine, or back abdominal wall.
Cancer in Stage IIIB;
It could have spread to the submucosa. It can be seen in 16 or more surrounding lymph nodes.
It can spread to the subserosa or serosa. It can be seen in the surrounding 7-15 lymph nodes.
It can spread to surrounding organs such as the spleen, colon, liver, diaphragm, pancreas, abdominal wall, adrenal gland, kidney, small intestine, or back abdominal wall. It can be seen in the surrounding 1-6 lymph nodes.
Cancer in stage IIIC;
It may have spread to Subserosa or serosa. It can spread to 16 or more surrounding lymph nodes.
It can spread to surrounding organs such as the spleen, colon, liver, diaphragm, pancreas, abdominal wall, adrenal gland, kidney, small intestine, or back abdominal wall. It can be seen in 7 or more surrounding lymph nodes.
Stage 4

In Stage 4, cancer has spread to other parts of the body, such as the lungs, liver, distant lymph nodes, and tissue covering the abdominal wall.

The following tests and procedures can be used in the staging process:

Endoscopic ultrasound
Computerized scanning
PET scan
MRI
Laparoscopy
TREATMENT
There are different types of treatment for patients with stomach cancer. Seven types of standard treatment are used:

Surgery
Surgery is a common treatment for all stages of stomach cancer. The following types of surgery are available:

Subtotal gastrectomy: Removal of the cancer-containing part of the stomach, nearby lymph nodes, and parts of other tissues and organs near the tumor. The spleen is removable.
Total gastrectomy: Removal of the entire stomach, nearby lymph nodes, and parts of the esophagus, small intestine, and other tissues near the tumor. The spleen is removable. The esophagus connects to the small intestine so that the patient can continue to eat and swallow.
Endoluminal stent placement: stent placement procedure to keep food passage (such as arteries or esophagus) open. For tumors that block the passage to or from the stomach, surgery can be performed to place a stent from the esophagus to the stomach or from the stomach to the small intestine to allow the patient to eat normally.
Endoluminal laser therapy: this is a procedure in which an endoscope is attached to the body with a laser. Laze rile tumor area is cleaned.
Gastrojejunostomy: this is a surgery performed to remove the part of the stomach in cancers that prevent the passage into the small intestine. The stomach is connected to the jejunum (part of the small intestine) to allow food and medicine to pass through the stomach into the small intestine.

Endoscopic mucosal resection
Endoscopic mucosal resection is a procedure that uses an endoscope to remove early-stage cancer and precancerous growths from the lining of the digestive tract without surgery.

Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either killing cells or stopping them from dividing. When chemotherapy is taken orally or injected into a vein or muscle, drugs enter the bloodstream and can reach cancer cells in the body (systemic chemotherapy) Nov. When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in these areas (regional chemotherapy). How chemotherapy is administered depends on the type and stage of the cancer being treated.

A type of regional chemotherapy studied to treat gastric cancer is intraperitoneal (IP) chemotherapy. In IP chemotherapy, anticancer drugs are transported directly to the peritoneal cavity through a thin tube.

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment method used during surgery that is being studied for stomach cancer. After the surgeon removes as much tumor tissue as possible, heated chemotherapy is sent directly to the peritoneal cavity.

Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. There are two types of radiation therapy:

External radiation therapy uses a machine outside the body to send radiation towards cancer.
Internal radiation therapy uses a radioactive substance embedded in Needles, wires, or catheters that are placed directly inside or near cancer.

How radiation therapy is administered depends on the type and stage of the cancer being treated. External radiation therapy is used to treat stomach cancer.

Chemoradiotherapy
Chemoradiation therapy combines chemotherapy and radiation therapy to enhance the effects of both. Chemoradiation given after surgery is called adjuvant therapy to reduce the risk of cancer returning. Before surgery, there are chemoradiation studies performed to reduce the tumor (neoadjuvant therapy).

Targeted therapy
Targeted therapy is a form of treatment that uses drugs or other substances to identify and attack certain cancer cells without harming normal cells. Monoclonal antibodies and multikinase inhibitors are targeted therapy types used in the treatment of stomach cancer.

Immunotherapy
Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances produced by the body or made in the laboratory are used to enhance, redirect, or restore the body's natural defenses against cancer. This type of cancer treatment is also called Biotherapy or biological therapy.

In addition, new types of treatment are being tested in clinical trials. Patients may want to consider participating in a clinical trial. Patients can undergo clinical trials before, during, or after starting cancer treatment. Follow-up tests should be administered to patients recovering from stomach cancer.

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