Stomach Cancer
This year, there will be 21,130 new cases of stomach cancer and 10,620 deaths from the disease, according to the American Cancer Society. The risk for developing stomach cancer is 1 in 100 for Americans. Certain populations--like Central Europeans, South Americans and Asians--are more predisposed to this type of cancer. In America, it's believed the use of antibiotics has decreased the rate of this once deadly cancer. If caught early, the five-year survival rate is 50 percent for lower stomach cancer and 10 to 15 percent for upper stomach cancer, with an average 21 percent survival rate overall.
Early Detection and Prevention
To test for stomach cancer, the doctor will take a thin tube containing a tiny camera and will pass it down the patient's throat, into her stomach, in a procedure called an "upper endoscopy." As the doctor is looking, a biopsy may be required, which is where questionable tissue is taken to be examined under a microscope. Imaging tests using Computerized Tomography, Positron Emission Tomography or "Barium Swallow" X-Rays can be used to determine the stage and severity of the stomach cancer so treatment options can be identified. Exploratory surgery performed laroscopically is a way to see where the cancer has spread and determine the severity as well.
There is no known, guaranteed way to prevent stomach cancer, but living a healthy life limits one's potential to come down with any kind of disease. Eating diets full of colorful fruits and vegetables, reducing the intake of salty and smoky foods, avoiding or quitting smoking and exercising regularly are the best protections against life-threatening trouble. Certain conditions put patients at a greater risk of stomach cancer--like anemia, gastritis and stomach polyps--so any of these prior diagnoses may warrant early screening.
Surgery
Surgery is the most common treatment used to remove stomach cancer and is the only realistic "cure" for this type of cancer. There are several types of surgery options. In an Endoscopic Mucosal Resection, a long tube is placed down the throat and some tissue is collected; this surgery is performed on early stage tumors. With a Subtotal Gastrectomy, the portion of the stomach affected by the cancer is removed, along with a portion of the esophagus, small intestine and affected lymph nodes. A Total Gastrectomy involves the removal of the entire stomach, as well as some surrounding tissue; this surgery, used for severe cancer cases, requires the esophagus to be connected directly to the small intestine, where a "new stomach" is created. During any surgical procedure, the removal of lymph nodes is very important because cancerous lymph nodes help spread the disease to other parts of the body, so most surgeons aim to remove at least 15.
There are certain risks associated with stomach surgery, although new, minimally invasive Laroscopic Surgery is believed to have fewer complications. Traditional surgery has a risk of bleeding, blood clots and infection. Total Gastrectomy carries the additional risks of diarrhea, vomiting and accumulation of undigested food in the intestine. Additionally, many patients experience heartburn, vitamin deficiency and abdominal pain. Even so, the mortality rate for people undergoing this surgery is only 1 to 2 percent (or 5 to 15 percent for more extensive surgery, with all lymph nodes removed). Following the surgery, patients are required to make dietary adjustments--eating smaller portions and more frequent meals, as well as taking vitamin supplements.
Radiation Therapy
Radiation therapy kills cancer cells using high-powered beams of energy, generated by a machine. Sometimes stomach tumors are simply shrunk by Neoadjuvant Radiation so they can be surgically removed. Other times, Adjuvant Radiation is used following surgery to kill any lingering cancer cells. Side effects from large tumors can be treated with External-Beam Radiation Therapy combined with chemotherapy. Patients report adverse symptoms like indigestion, nausea, diarrhea and vomiting following RT. According to "Clinical Hematology and Oncology," a book written by Bruce Furie, Peter A. Cassileth, Michael B. Atkins and Robert J. Mayer, there is no demonstrated survival benefit from Radiation Therapy, although it's been shown to reduce relapse rates.
Chemotherapy
Chemotherapy is a drug treatment that kills cancer cells with chemicals that travel throughout the body to reach diseased cells outside the stomach. Like Radiation Therapy, Neoadjuvant Chemotherapy is administered right before surgery to shrink a tumor and Adjuvant Chemotherapy is given right after surgery to eradicate any hanger-on cancer cells. Chemo can be given with Radiation Therapy or used on its own in patients with advanced stage stomach cancer. Success rates from chemotherapy on its own range from 0 to 30 percent, which is hardly encouraging. The most commonly prescribed chemical is 5-Fluorouracil, which exhibits a success rate of 20 to 30 percent. Cisplatin (with a clinical success rate of 18 to 20 percent) is also sometimes prescribed in combination regimens. Side effects vary, depending on the chemical, but generally include nausea, diarrhea, fatigue, hair loss, low blood counts, increased susceptibility of infections and bleeding.
