Adenocarcinoma is a type of cancer that originates in glandular tissue and accounts for about 90% of stomach cancers. Stomach cancer is the 5th most commonly diagnosed cancer worldwide and incidence rates are higher in developing nations and Japan where diets are high in smoked foods and low in fruits and vegetables. Risk factors include H. pylori infection, pernicious anemia, smoking, gastric ulcers, and family history. Treatment options depend on the cancer type and stage but may include surgery, chemotherapy, and radiation therapy.

1. ADENOCARCINOMA
STOMACH
Presented by Wonnila Shinglai
2nd Year GNM Nursing

2. INTRODUCTION
 ADENOCARCINOMA is responsible for about 90 percent of all cases stomach
cancer.
 ADENOCARCINOMA is a type of cancer that Orginates In glanduler tissue Specially,
it’s originates in a type of the glanduler tissue know as epithelial Tissue, which lines
the surfaces and cavities of the body’s orgain.

3. ANATOMY

5. INCIDENCE
 Overone million cases of gastric cancer are diagnosed each year around the world.
Stomach cancer is the 5th commonly diagnosed cancer in the world, and the 7th
most Prevalent (figure 1). The cumulative risk of developing gastric cancer from
birth of 74 Is 1.87% males and 0.79% in females worldwide 1
 Cancers of the stomach are frequently diagnosed develop nations. The average
incidence rate among High—middle human, developmen index (HDI) nations Is
20 Per100,000 for males while the average rate among low-middle HDI nations Is
100,000(1)

6. RISK FACTORS
It’s typecially occurs in males and people older than 40 years (Occasionally in
younger pepoles.)
 The incidence of gastric cancer is much greater in Japan. Diet appears to be a significant factor (ie,
high in smoked foods and lacking in fruits and vegetables)
 Other factors related to the incidence of stomach cancer includes chronic
inflammation of the stomach Helicobacter Pylori infection, pernicious Anemia,
smoking,achlorhydria , gastric ulcers, previous subtotal gastrectomy (more than 20
years ago) and genetics.

7. TYPES OF STOMACH CANCER
There are several types of cancers including,
 ADENOCARCINOMA OF THE STOMACH – Between 90% and 95% Of all stomach
cancers are of this type . Cancer develops from the cells that form the mucosa, the
innermost lining of the stomach
 LYMPHOMA OF THE STOMACH- Accounts of 4% of stomach cancers. Cancerous
cells form in the immune tissue (lymphoma Tissue) that is something found in the
wall of the stomach . LYMPHOMA Tissue drains away fluid and helps fight
infection.
 Grastrointestinal Stromal tumor (GIST) rare tumors that form in the mucles or
connective tissue of the stomach wall ( interstitial cells of canal ) Some of these
tumors may be bening (non cancerous ) GISTS can also be found in other Parts of
Of the digestive tracts.
 NEUROENDOCRINE TUMORS The cancerous cells Collect and form tumors in the
harmone making cells usually in the digestive tract (including the stomach) this
type of stomach cancer is rare; the most common is carcinoid tumor.
 Other type of very rare of the stomach cancer including, squamous cell carcinomo
leiomyosarcoma , and small cell carcinoma.

8. PATHOPHYSIOLOGY

9. CLINICAL MANIFESTATIONS
 Early stages: Symptoms may be absent or may resemble those of patients bening
ulcers (eg. Pain relieved with antacids).
 Progressive Disease: Symptoms include dyspepsia (Indigestion) early satiety ,
weight lose, or abdominal pain just above the umbilicus lose or decrease in
appetite bloating after meals nausea and vomiting and symptoms similar to those
of peptic ulcer diesease.
 Advanced gastric cancer may be palpable as a mass.

10. DIAGNOSTICS METHOD
 Biopsy and cytologic washing is the diagnostic study of choice.
 Barium X-ray examination Of the upper GI tract,EUS, and CT may be used.

11. SURGICAL MANAGEMENT
 Removal of gastric carcinoma, curative if tumor can be removed while still localized
to the stomach
 Effective Palliation (to prevent symptoms,such as obstruction) by resection of the
tumor,total gastrectomy, proximal subtotal gastrectomy, esoph, gastrectomy.

12. CHEMOTHERAPY & RADIATION THERAPY
 Chemotherapy for further disease control or Palliation (5- fluorouracil, cisplation,
dexorubicin, etoposide, mitomysin C)
 Radiation for Palliation
 Tumor marker assessment to determine treatment effectiveness.

13. MEDICAL MANAGEMENT
 CARBOPLATIN: CARBOPLATIN is a chemotherapy treatment for many different
types of cancer,you can have carboplatin by itself or in combination with other
chemotherapy drugs depending on the type of cancer you have.
 HOW CARBOPLATIN WORK: Carboplatin interfers with the development of the
genetic material in a cell, the DNA.This stops it from dividing into 2 new cells and
kills it.
 IRINOTECAN (CAMPTO):Irinotecan is a type of chemotherapy it is also known by
it’s brand name campto. It is a treatment for cancer that started in the bowel
(bowel cancer) this includes the colon and black passage (rectum).
 EPIRUBICIN (Pharmorubinic): Epirubicin is a chemotherapy drugs and it’s brand
name is Pharmorubinic (pronounced form-oh- roo-bis-in)it is a treatment for many
different types of cancer.
 CISPATIN: Cispatin is a chemotherapy drugs. You might have it as a treatment for a
number of different types of cancer.
 HOW CISPLATION WORK: This chemotherapy drugs destroys quickly dividing cells
such as cancer cells.

14.  OXALIPLATION (ELOXTIN): Oxaliplation is a type of chemotherapy drugs.This also
called Eloxtin.Its a treatment for bowel cancer and some other types of cancer.
 HOW IT WORKS: Oxaliplation interferes with the development of drugs in a
cell.This stop it from dividing into 2 new cells and kills it.
 FLUOROURACIL (5FU): Fluorouracil is also known as Fu or 5FU and is one of the
most commonly used drugs to treat cancer.
 HOW FLUOROURACIL WORK: Fluorouracil is a part of a group of chemotherapy
drugs known as anti metabolites.
 These differences mean that anti metabolites stop cancer cells marking
properly.They stop the cells making and repairing DNA.

15. NURSING DIAGNOSIS
 Anxiety related to physiological factors or effect of disease.
 Anxiety related to disease and anticipated treatment.
 Imbalanced nutrition,less than body requirements, related to early satiety on
anorexia .
 Pain related to tumor mass.
 Anticipatory grieving related to diagnosis of cancer.

16. NURSING MANAGEMENT
 Assessment...
 Elicit history of dietary intake.
 Identify weight loss, including time frame amount;assess appetite and eating habits
include pain assessment.
 Obtain smoking and alcohol history and family history (eg, any first or second
degree relatives with gastric or other cancer.
 Asses psychological support (marital status, coping skills, emotional and financial
resources).
 Perform complite physical examination (palpate abdomen for treatment, masses, or
ascites.

17. HEALTH EDUCATION
 Avoid foods high in simple carbohydrates(candy, cookies, cakes, fruit juice, sweetened
drinks, ice cream, canned fruits in heavy Syrup, sugar, alcohol.
 Avoid drinking liquids with meals, instead drink 30 to 45 minutes before an 1 hour after
the meal .
 Limit the use of caffeine, tea, and alcohol.these beverage can stimulate gastric motility .
Discuss the appropriate intake of alcohol with your healthcare provider.
 Eat five or six small meals a day to avoid overloading the stomach.
 Lie down for about 15 minutes after eating to help slow gastric emptying.
 Choose high fiber food to decrease the risk of late dumping.
 Eating more protein, fiber and fat,
 Eating fewere carbohydrates and choosing foods that contain complex carbohydrates
such as Whole grains , fruits, and vegetables, rather tan foods that contain simple
sugars,such as candies, cookies, sugar drinks and other foods and drinks that have
added sugar
 Avoiding milk and milk products.

18. CONCLUSION
 Significant global strides have been made in the global prevention and treatment
of gastric cancer. Never the less, the neoplasm remains the 5th most commonly
diagnosed and the 3th most deadly while H, pylori infaction is the most established
risk factor, eradicating the bacterium may actually increase the risk of a subtype of
the disease, instead, more focus is being placed on the interaction between diet,
genetics and H. Pylori diet and lifestyle modification have been revealed to be the
most effective means of preventing gastric cancer, especially in the developed
world, which advances in genetic testing are enabling earlier detection and better
survival.