2. • Stomach (gastric) cancer is an
adenocarcinoma of the stomach wall
• World wide gastric adenocarcinoma is
the second most common cancer.
3.
4. CAUSES AND RISK FACTORS
• H. pylori
• Epstein-Barr virus infection
• Smoking
• Being overweight or obese
• A diet high in smoked, pickled, or salty foods
• Stomach surgery for an ulcer
• Working in coal, metal, timber, or rubber industries
• Exposure to asbestos
5. • A diet low in fruits and vegetables
• Eating foods contaminated with aflatoxin
fungus
• Long-term stomach inflammation
• Family history of stomach cancer
6. Stages of stomach cancer
• Stage I. At this stage, the tumor is limited to
the layer of tissue that lines the inside of the
stomach. Cancer cells may also have spread to
a limited number of nearby lymph nodes.
• Stage II. The cancer at this stage has spread
deeper, growing into the muscle layer of the
stomach wall. Cancer may also have spread to
more of the lymph nodes.
7. • Stage III. At this stage, the cancer may have
grown through all the layers of the stomach
and spread to nearby structures. Or it may be
a smaller cancer that has spread more
extensively to the lymph nodes.
• Stage IV. This stage indicates that the cancer
has spread to distant areas of the body.
8. Types of stomach cancer
• Cancer that begins in the glandular cells
(adenocarcinoma).
The glandular cells that line the
inside of the stomach secrete a protective layer
of mucus to shield the lining of the stomach
from the acidic digestive juices.
Adenocarcinoma accounts for the great majority
of all stomach cancers.
9. • Cancer that begins in immune system cells
(lymphoma).
The walls of the stomach
contain a small number of immune system cells
that can develop cancer. Lymphoma in the
stomach is rare.
10. • Cancer that begins in hormone-producing
cells (carcinoid cancer).
Hormone-producing cells can
develop carcinoid cancer. Carcinoid cancer in the
stomach is rare.
11. • Cancer that begins in nervous system tissues.
A gastrointestinal stromal
tumor (GIST) begins in specific nervous system
cells found in your stomach. GIST is a rare form
of stomach cancer.
12. Symptoms
Signs and symptoms of stomach cancer may
include:
– Fatigue
– Feeling bloated after eating
– Feeling full after eating small amounts of food
– Heartburn that is severe and persistent
– Indigestion that is severe and unrelenting
13. – Nausea that is persistent and unexplained
– Stomach pain
– Vomiting that is persistent
– Weight loss that is unintentional
14. DIAGNOSIS
• endoscopy.
A thin tube containing a tiny camera
is passed down your throat and into stomach.
doctor can look for signs of cancer. If any
suspicious areas are found, a piece of tissue can
be collected for analysis (biopsy).
15. • Imaging tests.
Imaging tests used to look for
stomach cancer include computerized
tomography (CT) scan
16. • BARIUM STUDIES
drink a chalky liquid with a substance
called barium. The fluid coats in stomach and
makes it show up more clearly on X-rays.
17. TREATMENT
• ENDOSCOPIC MUCOSAL RESECTION:
Very small cancers limited to the
inside lining of the stomach may be removed using
endoscopy in a procedure called endoscopic
mucosal resection.
• The endoscope is a lighted tube with a camera
that's passed down your throat into your stomach.
The doctor uses special tools to remove the cancer
and a margin of healthy tissue from the stomach
lining.
18. • subtotal gastrectomy.
During subtotal gastrectomy, the
surgeon removes only the portion of the
stomach affected by cancer.
19. • total gastrectomy.
Total gastrectomy involves
removing the entire stomach and some
surrounding tissue.
The esophagus is then connected directly to the
small intestine to allow food to move through
digestive system.
21. Radiation therapy
• Radiation therapy uses high-powered beams
of energy, such as X-rays and protons, to kill
cancer cells.
• The energy beams come from a machine that
moves around patient who lies on a table.
• Radiation therapy to stomach can cause
diarrhea, indigestion, nausea and vomiting
22. Chemotherapy
Chemotherapy is a drug
treatment that uses chemicals to kill cancer
cells. Chemotherapy drugs travel throughout
your body, killing cancer cells that may have
spread beyond the stomach.
24. Supportive (palliative) care
• Palliative care is specialized medical care that
focuses on providing relief from pain and other
symptoms of a serious illness.
• Palliative care specialists work with patient,
family and other doctors to provide an extra layer
of support that complements for ongoing care.
• Palliative care can be used while undergoing
other aggressive treatments, such as surgery,
chemotherapy or radiation therapy.
25. NURSING MANAGEMENT
• Monitor nutritional intake and weigh patient
regularly.
• Provide comfort measures and
administer analgesics as ordered.
• Frequently turn the patient and encourage deep
breathing to prevent pulmonary complications, to
protect skin, and to promote comfort.
• Maintain nasogastric suction to remove fluids and
gas in the stomach and prevent painful distention.
• Provide oral care to prevent dryness and ulceration.
26. • Keep the patient nothing by mouth as directed to
promote gastric wound healing. Administer
parenteral nutrition, if ordered.
• When nasogastric drainage has decreased and
bowel sounds have returned, begin oral fluids and
progress slowly.
• Avoid giving the patient high-carbohydrate foods
and fluids with meals, which may trigger
dumping syndrome because of excessively rapid
emptying of gastric contents.
27. • Administer protein and vitamin supplements to
foster wound repair and tissue building.
• Eat small, frequent meals rather than three large
meals.
• Reduce fluids with meals, but take them between
meals.
• Encourage follow-up visits with the health care
provider and routine blood studies and other
testing to detect complications or recurrence.
