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Stomach cancer (gastric cancer)

Stomach cancer, a malignant tumor of the stomach, is predominantly made up of cells in the gastric mucosa. Most patients are gastric cancer at diagnosis over 60 years old. According to the Robert Koch Institute, get sick around 17,000 people per year of stomach cancer, including around 9,200 men. That is around a quarter less than 20 years ago.

Advanced gastric cancer; from Original uploader was Boreali -, Gemeinfrei, Link

Causes and Risk Factors for Stomach Cancer

  • Eating habits play an important role in the development of stomach cancer. A particularly salty diet and the consumption of little fresh fruit and vegetables, but a lot of smoked and cured foods, increase the risk of illness. Experts also attribute the decline in the incidence of the disease to the fact that, thanks to the spread of refrigerators and freezers and the year-round supply of fresh fruit and vegetables, food no longer needs to be preserved by salting, curing or smoking.
  • Certain forms of chronic inflammation of the gastric mucosa also carry an increased risk of stomach cancer.
  • People with Blood group A and tight Relatives of gastric cancer patients are also slightly more likely to develop gastric cancer than the average.
  • A Helicobacter pylori infection is also considered a risk factor for the development of gastric cancer. The infection can usually be cleared with antibiotics.

Symptoms and diagnosis of gastric cancer

Many stomach cancer patients come because of earlier unspecific complaints to the doctor: You are suffering from

  • Bloating,
  • Loss of appetite,
  • Malaise,
  • they have lost weight and
  • do not feel fully efficient.

It is true that these symptoms can be quite harmless. But the hesitation of one Gastroscopy, the so-called endoscopy or gastroscopy, can early diagnosis prevent a more serious illness. Thanks to modern devices with flexible tubes, the reflection is less uncomfortable than many patients fear. A gastroscopy can remove suspicious areas immediately Tissue removed and examined become. A X-ray examination of the stomach and intestines with swallowed contrast medium can also be useful in individual cases.

If the suspicion of gastric cancer is confirmed, follow further studies to determine the spread of the disease, speak of the stage. An X-ray examination of the lungs, an ultrasound examination of the abdomen and possibly an ultrasound examination of the stomach wall with the endoscope provide information about whether tumor settlements (metastases) are present in distant body regions and how deep the tumor has penetrated into the stomach wall. Further examinations can also be useful in individual cases.

Treatment of stomach cancer

The main method of treatment is at localized gastric cancer the Surgery with the aim of completely removing the tumor tissue. This is the crucial prerequisite for healing. In most cases, it is necessary to remove the entire stomach, part of the duodenum and the lymph nodes near the stomach. If the tumor is located near the stomach entrance, it may also be necessary to remove part of the esophagus. Sometimes it makes sense to also remove the spleen. Partial removal of the stomach is only possible with small tumors in the lower third of the stomach.

At locally extensive tumors can a upstream (neoadjuvant) chemotherapy sometimes shrink the tumor so that a full operation is still possible. Since patients without or with a surgically reduced stomach experience problems with digestion, various techniques have been developed to create a kind of replacement reservoir from the small intestine.

© m. Letschert / Fotolia

Additional Treatment measures after a full operation - Chemotherapy with cell growth inhibiting drugs (cytostatics) or radiation treatment - are currently being tested for their effectiveness in certain stages of the disease.

Are already at the time of diagnosis Tumor settlements (metastases) in other organs before, the disease is not permanently curable. An operation can then be useful to avoid local complications from tumor growth and to keep the gastrointestinal passage free. Otherwise, as in the case of later occurrence of metastases, there is a chemotherapy for use. With the combinations of cytostatic agents available today, temporary tumor regression in over 60 percent of patients. In addition, chemotherapy has a good ssymptom-relieving (palliative) Effect. In the case of bone metastases, radiation is also possible.

Side effects and consequences of gastric cancer treatment

Stomach cancer poses the affliction in the first time after the operation in front significant problems. They mainly affect the nutrition. The shortening or lack of the gastric passage means that the chyme is transported too quickly into the small intestine and the nutrients are not fully utilized. Especially after a complete stomach removal, the patients need the replacement of various Vitamins and trace elementsthat are no longer adequately absorbed. By Disruption of fat digestionDiarrhea caused by g can be relieved by fat-splitting enzymes. The almost always occurring Weight loss After gastric cancer treatment, patients respond best with a diet rich in carbohydrates and protein than with more fat.

The rapid sagging of the food pulp into the small intestine can also lead to the so-called Dumping syndrome which manifests itself immediately or with a delay of a few hours in circulatory problems, nausea, sweating, palpitations, dizziness and a drop in blood pressure. The cause lies in the Strain on the intestines and in related Metabolic disorders. The best way to combat these problems is to split the food into six to ten smaller meals and not drink immediately with meals. No special diet is required. In the case of severe weight loss, so-called astronaut food can temporarily supplement the diet. One helps with long-lasting nutritional problems Tube feeding. Instead of the nasopharyngeal tube used in the past, a thin catheter is now usually inserted through the abdominal skin directly into the stomach or small intestine (PEG).

It sometimes occurs after partial stomach removal Backflow of acidic stomach contents into the esophagus. The symptoms can be relieved with acid-inhibiting drugs.

The Chemotherapy side effects - mainly nausea, vomiting and hair loss - are temporary. Nausea can now be relieved well with modern drugs.

Follow-up examinations after treatment for gastric cancer

Check-ups are used to identify undesirable consequences of treatment and relapses or to monitor the effects of chemotherapy. Will be after an operation initially every three months, carried out every six months after two years and primarily include physical exam and ultrasound, possibly also x-ray of the abdomen, after part of the stomach has been removed, the gastroscopy.

Chances of recovery in gastric cancer

Only when the cancerous tissue can be completely removed by surgery is that There is a chance of a permanent cure for gastric cancer. However, it also happens in the further course often a relapse with metastases. In a large number of gastric cancer patients, the disease is already well advanced at the time of diagnosis because it is recognized too late due to the lack of early symptoms.