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Stomach (Gastric) Cancer

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The stomach is an organ in the upper half of the abdomen, just below the ribs, close to the left side, with developed muscle tissue that allows food to be retained and digested. Food taken from the mouth is delivered to the stomach through the esophagus. Food is digested with digestive enzymes and acid secretion secreted by the stomach. The digested food passes from the stomach to the small intestine and is moved through the digestive system. In addition to its digestive function, it is also responsible for the secretion of various hormones.  For this reason, it is also important in the formation of hunger and satiety, growth and development.

What is Stomach?

Gastric cancer is a disease caused by abnormal growth/proliferation of the cells that make up the stomach. Various types of gastric cancer have been identified, arising from different parts or layers of the stomach. The most common type of cancer is adenocarcinoma. Although the treatment is primarily surgical, there are methods to support treatment before or after surgery.

What is Stomach (Gastric) Cancer?

Stomach cancer may not show obvious symptoms, especially at the beginning of the disease. Significant symptoms include early satiety at meals, abdominal pain and fatigue. These symptoms are not directly related to stomach cancer and similar complaints can be found in different diseases. Apart from these complaints, the complaints that bring stomach cancer to mind are:

- Unexplained significant weight loss

- Severe abdominal pain

- Nausea and vomiting

- Loss of appetite

- Bloody vomiting

- Dark and sticky stool

- Pain when swallowing food

- It can be listed as difficult swallowing.

Signs and Symptoms of Stomach Cancer?

Assoc. Dr. Mutlu Ünver graduated from Ege University Faculty of Medicine. Mutlu Ünver, who completed his specialty training at Ege University Faculty of Medicine, Department of General Surgery, serves his patients in his own clinic.

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Assoc.Prof.

Mutlu Ünver

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Studies have not identified a single factor that causes stomach cancer. There are diseases and risk factors that can cause stomach cancer. These are the main ones:

 

- H. Pylori (bacteria) infection

- Atrophic gastritis

- Male gender

- Stomach polyps

- Obesity

- Cigarette smoking

- Consumption of pickled and smoked foods

- Frequent consumption of processed meat products

- Low consumption of fruits and vegetables with diet

- Family history of cancer

 can be listed in the form.

What are the Causes of Stomach Cancer?

After the patient's complaints and physical examination findings, it is appropriate to refer the patient to endoscopy. For the procedure, a thin tube with a camera at the end, whose movements are controlled by the physician, is used.  At this stage, the tissues lining the mouth, throat, esophagus and stomach are examined. With endoscopy, it is possible to take a biopsy after a possible tumor is seen.

Stomach (Gastric) Cancer Diagnosis

Once gastric cancer is diagnosed, computed tomography (CT), PET/CT or magnetic resonance imaging (MRI) is used to assess the involvement of cancer cells around the stomach, to detect metastases to other organs, and to assess the involvement of lymph nodes. As a result of this evaluation, the stage of the disease is determined, which is necessary to organize the treatment of the disease. It is very important to determine the stage of the disease correctly for an effective and correct treatment. Staging also gives us an idea about how the recovery will progress after treatment.

Staging Stomach Cancer

Treatment of gastric cancer is planned taking into account the location of cancerous cells in the stomach, the stage of the disease and metastases to surrounding tissues or organs. The main treatment consists of surgery. Additional treatment methods such as chemotherapy or radiotherapy can be applied before or after surgery to increase the effectiveness of the treatment. The application of all these treatments is determined by taking into account the general health status of the patient, the stage of the disease and the presence or absence of metastases.

Stomach Cancer Treatment

In early stage cancers, if the cancerous cells are limited to the inner layer of the stomach, mucosal or submucosal resection can be performed by endoscopy.

Endoscopic Resection:

Partial gastrectomy operation is the process of removing the cancerous area localized in the stomach together with the cancerous area and some healthy tissue around it, without removing the entire stomach. It is very important to be able to remove some healthy tissue around the cancerous cells together, especially to remove the cell-sized cancer completely from the stomach.

Partial Gastrectomy: 

Total gastrectomy operation is a method used in operations where the entire stomach must be removed. If the cancerous cells are not localized in a part of the stomach, if they have spread to the entire stomach or if the affected part of the stomach cannot be removed alone, it may be possible to remove the entire stomach to get rid of cancerous cells. With the removal of the entire stomach, the esophagus and small intestines are properly connected to each other. After this procedure, it is possible to eat normally.

All surgical procedures have their own risks during and after the operation. These risks are greatly reduced by physicians specialized in the relevant field.

Total Gastrectomy: 

Chemotherapy consists of drugs that have the capacity to recognize cancer cells. After entering the bloodstream, these drugs recognize foci outside the stomach and kill cancerous cells. Chemotherapy can also be given after the operation to reduce the size of the cancerous cell before the operation and to increase the effectiveness of surgical treatment.

Stomach Cancer Chemotherapy

Radiotherapy is the application of high-energy beams targeting cancerous cells. Similar to chemotherapy, it can be given before and after the operation. It can be used together with chemotherapy. In inoperable advanced gastric cancers, radiotherapy can also be applied to reduce pain, stop bleeding and stop the growth of cells.

Stomach Cancer Radiotherapy

The healing process after partial gastrectomy varies depending on the width of the part removed, and in general, the patient needs to be followed up in the clinic for 3 to 5 days after surgery. Patients may lose weight between 1 month and 6 weeks during the recovery period. After 3 to 6 months, the patient can eat close to his/her old diet. All these periods vary depending on the patient's health status, the part and size of the stomach where the cancerous area is located, and the application of additional treatments such as chemotherapy and radiotherapy.

After total gastrectomy, clinical follow-up is required for 5-6 days and weight loss is expected for at least 2 months. Since the entire stomach is removed, the patient's diet needs to be adjusted during the period. Transition to a new diet is important for effective recovery after surgery.  In addition to nutrition, additional vitamin and mineral support is recommended for patients.

The most important factor during recovery is the patient's compliance with the treatment and follow-up. Controls are very important in terms of monitoring the recovery after surgical treatment, monitoring whether there is any remaining cancerous tissue and monitoring new foci that may form in other organs.

The stomach is an organ located in the upper half of the abdomen, just below the ribs, close to the left side, with developed muscle tissue that allows food to be retained and digested. Food taken from the mouth is delivered to the stomach through the esophagus. Food is digested with digestive enzymes and acid secretion secreted by the stomach. The digested food passes from the stomach to the small intestine and is moved through the digestive system. In addition to its digestive function, it is also responsible for the secretion of various hormones.  For this reason, it is also important in the formation of hunger and satiety, growth and development.

Recovery Period After Gastric Cancer Surgery

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