Stomach Cancer

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An overview of stomach cancer

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Stomach Cancer

  1. 1. Stomach cancer   ☼ An Overview Distributed under Creative Commons license
  2. 2. ☼ Introduction <ul><li>leading cause of cancer related morbidity </li></ul><ul><li>Second most common cause of cancer related deaths after Lung cancer (10.4% of all cancer related deaths).   </li></ul><ul><li>60% cases occur in the developing world </li></ul><ul><li>linked to dietary habits and unhealthy food preservation practices </li></ul>
  3. 3. ☼ Causes- <ul><li>A/S/L- </li></ul><ul><li>Elderly Male Asians and East Europeans. </li></ul><ul><li>Diet - </li></ul><ul><li>Food preserved by drying, smoking, salting and </li></ul><ul><li>pickling </li></ul><ul><li>Dietary nitrites converted to carcinogenic </li></ul><ul><li>N- nitroso compounds by bacteria in the stomach. </li></ul><ul><li>Helicobacter Pylori infection -People with H. Pylori bacteria infection of the stomach have greater risk. </li></ul>
  4. 4. Causes- contd <ul><li>Prior stomach surgery -People with a history of stomach surgery face a greater risk due to alteration in normal ph of the stomach. </li></ul><ul><li>Stomach Disorders - Pernicious anemia, achlorhydria and atrophic gastritis 6 times more prone. </li></ul><ul><li>Smoking </li></ul><ul><li>Hereditary- underlying genetic factors are poorly understood ( KRAS mutation, c-met amplification) </li></ul><ul><li>Rarely, some gastric ulcers may turn into cancer. </li></ul>
  5. 5. ☼ Types <ul><li>90% arise from the glandular cells of the stomach wall and are called Adenocarcinomas. </li></ul><ul><li>Others – </li></ul><ul><li>Gastric Lymphomas (cancer of gastric lymphatic </li></ul><ul><li>tissue) </li></ul><ul><li>Soft tissue sarcomas (e.g. Leiomyosarcomas) </li></ul><ul><li>Carcinoids </li></ul>
  6. 6. ☼ Clinical features <ul><li>Early stages asymptomatic. </li></ul><ul><li>non-specific symptoms like indigestion, nausea, vomiting and sometimes Pain. </li></ul><ul><li>bloated feeling after eating, loss of appetite, dark colored stools (due to presence of blood) and feeling of tiredness (due to anemia). </li></ul><ul><li>Late features- peritoneal and pleural effusions, Jaundice and cachexia. </li></ul><ul><li>Hepatomegaly usually occurs and presence of an enlarged left supraclavicular lymphnode (Virchow's sign) is a typical finding. </li></ul>
  7. 7. ☼ Treatment <ul><li>Surgical intervention </li></ul><ul><li>Partial/subtotal gastrectomy , </li></ul><ul><li>Total gastrectomy + making of a new stomach from S.I </li></ul><ul><li>Radiation therapy- </li></ul><ul><li>external beam radiation (5 days/week*6 to 8 weeks). </li></ul><ul><li>Tomotherapy HI-ART (Tomotherapy highly integrated adaptive radiotherapy) for specific reduced doses. </li></ul><ul><li>Chemotherapy – 5 fluorouracil, Cisplatin, Doxorubicin. </li></ul><ul><li>Immunotherapy </li></ul>
  8. 8. ☼ Prognosis <ul><li>Indicators - Stage </li></ul><ul><li>- Tumor Size </li></ul><ul><li>- Histological Type </li></ul><ul><li>- Degree of cytological atypia </li></ul><ul><li>- Lymphatic/vascular invasion </li></ul><ul><li>Generally, five year survival is a poor 30%. </li></ul><ul><li>Younger patients have more aggressive disease. </li></ul>
  9. 9. Dr. Neelesh Bhandari MBBS(A.F.M.C), MD (Path.) PGP Human Rights.

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