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Diagnosis and Treatment of Stomach Cancer

The stomach is a  J-shaped organ that connects the esophagus to the intestinal tract. Stomach cancer is a cancerous growth that occurs in the lining of this stomach. It is an extremely common problem worldwide, with over 1 million individuals succumbing to this illness each year. Factors leading to stomach cancer include infection by Helicobacter pylori, eating salty and smoked food, and smoking.

The diagnosis of stomach cancer often involves an upper endoscopy, an examination of the stomach using an instrument called gastroscope that enables an evaluation of the inner lining of the stomach as well as taking a biopsy or sampling of cancer tissue. Once the diagnosis of stomach cancer is made, the staging of the disease is often determined using a radiologic examination called CT scan. It allows an initial assessment of the extent of spread of cancer. In addition, routine blood tests including complete blood count (CBC), and liver function tests, as well as chest X-ray are obtained during the initial evaluation.

There are 4 stages of stomach cancer. In general, the cancer stage is dependent on the depth of stomach wall invasion and lymph node involvement. In Stage 1 stomach cancer, the cancer is mostly confined to the lining of the stomach and may have spread to nearby lymph nodes. In Stage 2, the cancer tissue has invaded the additional layers of stomach and nearby lymph nodes. In Stage 3, the cancer tissue has penetrated the entire thickness of the stomach wall and may have spread to nearby organs such as the liver and distant lymph nodes. In Stage 4 stomach cancer, the cancer has spread to distant organs and lymph nodes.

The staging of stomach cancer is important since the prognosis of affected individual is highly dependent on the staging of cancer. In fact, patients with the stage 1 cancer have a 5 year survival rate of 71%, compared to only 4% for those with stage 4 cancer.

The treatment of stomach cancer depends mainly on the stage, size, and location of the tumor as well as the overall health of the affected individual. Treatment options may include surgery, chemotherapy, and radiation therapy.  Commonly utilized chemotherapeutic agents include 5-FU, adriamycin, mitomycin and cisplatin. In addtion, some patients may benefit from a new class of cancer therapy such as Herceptin.

Following these treatments, it is important that affected patients are carefully monitored for relapse and recurrence. As a result, periodic evaluations including routine blood tests, CT scan, and upper endoscopy are often recommended.