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Gastric cancer – Causes, symptoms, and management

Gastric or stomach cancer can develop in any part of the stomach. In most cases, it occurs in the central part of the stomach, known as the stomach body. In other cases, the cancer develops in the gastroesophageal junction, where the esophagus and stomach are connected. In both cases, cancer cells grow abnormally in the stomach regions. Here are some common causes, symptoms, and management options for gastric or stomach cancer.

Causes
Stomach cancer develops due to genetic mutation or changes in the DNA present in the cells of the stomach. As a result of this mutation, the cells begin to grow faster, causing a tumor to form over time. With the cancer progressing, the number of cancer cells outgrows the number of healthy cells.
As time passes, the cancerous cells in the stomach can progressively invade and harm healthy tissues. The cells penetrate deeper into the stomach and eventually break away from the abdominal area to spread to other body parts during the advanced stages. If cancerous cells migrate to another part of the body, it is known as metastasis. Researchers have yet to learn why the mutation occurs. However, conclusive studies indicate that certain factors increase the risk of gastric cancer. Here are some of the common risk factors.

Family history of stomach cancer
Autoimmune atrophic gastritis
Gastritis
Epstein-Barr virus infection
Infection of the Helicobacter pylori (H. pylori)
Gastroesophageal reflux disease or (GERD)
History of stomach polyps or stomach ulcers
Excessive consumption of foods that are fatty, salty, smoked or pickled
Consuming meals that lack fruits and vegetables
Prolonged exposure to toxic substances, including coal, rubber, and metallic particles.

In addition to the above, certain genetic conditions can increase the risk of gastric cancer. These conditions include the following.

Peutz-Jeghers syndrome
Lynch syndrome
Familial adenomatous polyposis
Hereditary diffuse gastric cancer
Common variable immunodeficiency (CVID)
Li-Fraumeni syndrome

Symptoms of gastric cancer
The symptoms are minimal at the initial stages of gastric cancer, making early diagnosis difficult. Symptoms usually start to appear when the cancer has already spread. In the rare event of early-stage stomach cancer symptoms, they usually include the following.

Frequent instances of indigestion
Feeling bloated after eating a meal
Constant heartburn
Experiencing slight nausea
Loss of appetite

Experiencing any of the signs above may indicate the possibility of having gastric cancer. However, it is important to note that these symptoms are not unique to gastric cancer and may also be caused by other digestive and gastrointestinal health issues. To obtain an accurate diagnosis, it is crucial to consult with a primary care physician and specialized doctors, who will conduct various tests and examinations. As the cancer progresses and tumors grow, additional symptoms may become apparent. Patients may experience various symptoms commonly associated with the condition during the advanced stages of gastric cancer.

Severe and chronic abdominal pain
Appearance of blood in the stool
Vomiting or nausea
Difficulty in swallowing foods, particularly dry and solid foods
Skin and eyes start to have a yellowish tint
Swelling in the stomach
Frequent instances of constipation or diarrhea
Fatigue, tiredness, and weakness
Heartburn

Management options for gastric cancer
Gastric cancer can be cured through treatments only if it is detected in the early stages. However, for advanced stages, treatment plans are devised to alleviate the effects of the symptoms and improve the quality of life. The treatment options are based on the location of the cancer, stage of progression, and overall health of the person. Generally, a team of health experts may recommend the following treatment options. In some cases, a combination of treatments is also used.

Surgery: The cancerous cells or tumors are surgically removed using several procedures. This line of treatment is usually adopted when gastric cancer has been detected in the early stages with the cancer cells still restricted to the stomach lining or the stomach and has not spread to the other parts of the body. Surgeries include endoscopic mucosal resection, subtotal gastrectomy, total gastrectomy, and lymph node removal. In the advanced stages, surgery is done to provide relief from the symptoms.
Chemotherapy: This is an intravenous procedure that kills off cancer cells. Chemotherapy is usually done in the advanced stages of gastric cancer. There are several types of chemotherapy procedures. One of the most common types is systemic chemotherapy, which travels through the whole body, killing off cancer cells. Then, hyperthermic intraperitoneal chemotherapy (HIPEC) is done right after surgery and administered directly to the stomach. In addition, neoadjuvant chemotherapy is sometimes recommended to be administered before surgical procedures to remove the cancer.
Targeted therapy: Targeted treatments attack certain chemicals found within cancerous cells. These chemicals are blockers, causing the cells to die and the tumors to shrink. This treatment option usually accompanies chemotherapy procedures in the advanced stages.
Radiation therapy: This treatment method uses high-powered energy beams to kill off cancer cells. The beams can be protons, X-rays, or other sources. This procedure is usually done in the advanced stages. During the procedure, a machine is used to direct the beams to precise points of the body where cancer has developed. In some cases, radiation therapy and chemotherapy are done simultaneously through a procedure known as chemoradiation. Radiation therapy can be done before or after surgery. When done before surgery, the goal is to shrink the size of the tumor. This is referred to as neoadjuvant radiation. When the cancer cannot be obliterated even with surgery, it is followed by a radiation therapy procedure. This is adjuvant radiation.
Immunotherapy: This treatment option involves using chemicals to support the immune system in combating cancerous cells. The immune system is made to look for these cells and kill them off. Generally, immunotherapy is administered in the advanced stages or when gastric cancer comes after remission.

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