Stomach Cancer Treatment Information

STOMACH CANCER TREATMENT INFORMATION

How and Where does the Stomach Work?

The stomach is an expandable sack located mostly under the left lung, between the muscular "diaphragm" which pushes up the lung, and the coiled small intestine. The stomach is close-by important organs in the abdomen. To it's right is theliver, to it's lower left is the spleen, and underneath it is the pancreas . The esophagus enters the stomach at the "gastro-esophageal" junction, while the small intestine exits it at the lowermost "antrum". The front of the stomach rests on the abdominal wall, and lower parts of it also contact the upper left kidney and "transverse" colon. You can see that the stomach is in the midst of many vital organs, and infections or cancers can spread to these organs. Important areas of the stomach itself (besides the antrum and gastro-esophageal junction) are the "greater curvature" (basically the left wall of the stomach), the "lesser curvature" (the right wall), the "fundus" (main body of the stomach) and the "cardia" (uppermost portion). The stomach has a delicate inner lining, made up of "columnar epithelial cells", and acid secreting cells called "parietal cells" . This lining is protected chemicals called"prostaglandins''.

The stomach has an impressive blood supply, mainly from the "celiac artery" which comes off of the main artery, the aorta . There is also venous drainage of blood to the spleen and liver. A secondary drainage system, called the"lymph system", filters the blood in normally pea-sized lymph nodes. These are connected to lymphatics in other abdominal areas by "lymph channels" . Lymph nodes are full of white blood cells that help purify the blood serum; lymph nodes often enlarge when they detect spread of diseases.The point is that the stomach's rich blood supply and many drainage paths can act as conduits for spread of infections or cancers.

Of course, the main purpose for the stomach is digestion of foods, a process that begins with the saliva in the mouth. The stomach activates Vitamin B12 from our diet, secretes hydrochloric acid to break down food, and churns the food into pulp. It can also directly absorb substances like alcohol and caffeine. The stomach is susceptible to an increase in the concentration of hydrochloric acid brought on by stress, certain foods, and the effects of tobacco smoke. While the stomach is normally protected against it's own acid by an inner membrane, breakdown of this membrane leads to inflammation of the stomach, called "gastritis" . An area that loses it's membrane is also at risk to get an actual hole, called an "ulcer" . An ulcer may be shallow, and heal quickly, or it may be very deep and even "perforate" the outer stomach wall. Perforation is a surgical emergency. Fortunately, there are many medications now available which help reduce stomach acid concentration (i.e. Zantac, Pepcid, Tagamet), helping ulcers heal and preventing formation of new ones. Also, soothing protectants (Carafate) and even artificial prostaglandins can be given. These medications are often given preventively ("prophylactically") when the body is under great stress, such as after major surgery. While most stomach problems are minor ones, such as a mild virus or indigestion, occasionally serious disease strikes the stomach.

What is Stomach Cancer?

The stomach is composed of various "cells", which are intricately combined together into "tissues" which form the "organ" . These cells divide to produce new ones, and grow very rapidly during womb life, early childhood and puberty. In adulthood, new cells are produced only to replace those that die of old age, injury or disease. Normally, division of cells is under very tight control. This control is exerted by the "genes" inside each cell, which are housed in long clumps forming "chromosomes", which are visible under a light microscope. The genes themselves are made up of DNA, the master genetic code material. If the genes are damaged, say by chemicals or radiation, the control over cell division may be lost in one particular cell. Ultimately, cancer is considered a disease of the DNA. Stomach cancer starts in a single lung cell . That cell starts dividing haphazardly, making millions and billions of copies of itself. It takes up the nourishment needed by other cells, depriving them so the cancer can continue to grow. Quickly growing cells can clump up to form a "tumor" . A tumor simply means a swelling, it can be caused by inflammation or infection. A "benign" tumor only grows in it's local area (although it may get quite large)-- it cannot spread and is not cancer. By contrast, a tumor which can spread to other body areas is called "malignant" and this is cancer . The process of cancer spread to other areas is called "metastasis", so only malignant tumors (i.e. cancer) can metastasize. Theoretically, cancer can spread to any area of the body, and it often grows better in it's area of spread than in it's area of origin ("primary site"). It is this capacity for spread that makes cancer so dangerous. If not treated successfully, it ultimately kills by debility, anemia, infection, and compromise of normal body functions.

How Common is Stomach Cancer?

Stomach cancer is the most common cancer in the world (after skin cancer). In the U.S.A. it is much less common, with25,000 new cases per year causing14,000 deaths. This means it is about 3% of new cancers in the U.S.A. each year. Stomach cancer hasdecreased 5-fold in the U.S.A. over the past 50 years. It is more common in males, extremely rare in children, and the average patient is 55 years old.

What Causes, or Increases the Risk for Stomach Cancer?

As for any cancer, the exact reason why one person gets stomach cancer and another does not remains unknown . However, several things have been noted, when looking at groups of patients, that increase cancer risk. These "risk factors" are:

Lack of Refrigeration is seen in countries with a high level of stomach cancer, as used to be the situation in the U.S.A. prior to 1940 (when cases were very high). Preservatives like nitrates, which were commonly used before refrigerators, may be contributory.
Increased Smoked and Salted Food intake appears related to stomach cancer, and may be related to lack of refrigeration in third-world countries today.
Low Fruits and Vegetables in the diet, and high fat, is related to many "aerodigestive" (mouth, throat, lungs and gastrointestinal system) cancers, possibly by depriving the body of vitamins like"A" and "E" which appear protective for cancers. On the other hand, lots of fruits and vegetables appear to lower risk.
Chemical "Carcinogens" l ike rubber by products, coal tar and asbestos have increased cancers in industrial workers. However, Alcohol and Tobacco do not seem to increase stomach cancer risk.
Long Standing Ulcers, especially those on the lower curvature, may become malignant over time. A common bacteria, called Heliobacter Pylori, is found in many ulcers and may increase cancer risk over time. Overall, however, less than 2% of ulcers ever become cancerous.
Prior Stomach Surgery, where part of the stomach is removed ("partial gastrectomy") for bleeding ulcers, has about a 5% chance of stomach cancer after a "latent period" of as much as 40 years.
Achlorhydria means no stomach acid, this is seen in a rare syndrome called "achlorhydria-gastric polyposis"-- these patients have a 30% chance of getting stomach cancer. Any ulcer in a patient with no stomach acid has almost a 100% chance of being cancerous!
Rare Genetic Diseases such as Plummer-Vinson syndrome (10% lifetime risk)
and Peutz-Jeghers syndrome with multiple polyps have a higher risk. Any polyps in the stomach that are "villous" (as opposed to the more common harmatomatous type) have increased risk for becoming cancerous, just like for colon cancer. However, villous polyps in the stomach are quite rare. Pernicious anemia is caused by the failure of parietal cells in the stomach to secrete the "intrinsic factor" needed by the intestine to uptake vitamin B12; then cancer risk is increased.
Race-- Even after equalizing all of the above factors, Orientals, Blacks and Hispanic individuals get stomach cancer more commonly than Whites. This may be due to some pre-existing genetic susceptibility to stomach cancer.

What is the Location of Stomach Cancers?

Overall, 50% are in the lower stomach ("pyloris and antrum"), 20% are in the body of the stomach ("fundus"), 20% are in the lesser curvature, 10% at the cardia, and 3% at the greater curvature. The lower stomach ("distal") is more commonly involved in Black individuals, while the upper stomach ("proximal") is more common for Whites.

How Does Stomach Cancer Grow and Spread?

As mentioned, stomach cancer starts in a single abnormal cell. This cell divides to make millions and billions of copies of itself, forming a tumor. A malignant tumor erodes into the lining of the stomach, and into the "submucosal" and "muscular" layers. There, it sheds cells into the lymph channels which spread to local lymph nodes, causing them to swell ("lymphadenopathy"). Cancer cells shed into the tiny draining veins of the stomach, where they can travel to the spleen, liver, bone, lung and brain. The original tumor (called the "primary site") continues to grow, it can penetrate the outer wall of the stomach to erode into the liver, kidney, pancreas or intestines. The cancer can actually encase the entire bowel by spreading via the intestinal surfaces ("peritoneal spread"). The cancer may travel up the stomach to invade the esophagus, or down to invade the small intestine ("duodenum"). As it invades nerve bundles, it causes pain. While the cancer may spread to any organ, over 90% of patients succumbing to stomach cancer have disease remaining in the stomach area ("local disease") at their time of demise. Caused by exposure to asbestos, peritoneal mesothelioma is considered to be one of the rarest forms of cancer and has no known cure.

Most patients with stomach cancer do not get diagnosed until the disease is fairly advanced, due to lack of specifc symptoms for most stomach cancers. Fortunately, new developments in treatment offer more hope than ever before for the patient with this disease.

It is critical to be well-educated about stomach cancer. Making the right treatment choices can make the difference of life or death. Understanding what your choices are gives you the peace of mind of knowing you have done everything possible to fight stomach cancer successfully.

Cancer treatment centers are the perfect place to seek advice and treatment options for all forms of cancer, from stomach cancer to peritoneal mesothelioma. If you have a preventable cancer, contact a mesothelioma lawyer to see if you can receive medical compensation.

CancerAnswers's material explains, in plain English, the definition, types, frequency, risk factors, symptoms, evaluation, historic and latest effective treatment for stomach cancer. We describe surgery, radiation and chemotherapy, and their results. We tell you everything you need to know the make the right choice today to deal with a stomach cancer problem.

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