Gastric (stomach) cancer: diagnosis, treatment options, and more
Understanding Gastric Cancer
Symptoms of gastric cancer can include things like loss of appetite, losing weight without trying, having abdominal pain, feeling full even after eating a little, heartburn, feeling sick, being tired, and having a swollen abdomen. Sometimes, though, early stomach cancer doesn't cause any signs, and doctors find it incidentally on a scan or through workup for other conditions.
Staging Gastric Cancer
Doctors use a process called "staging" to figure out the extent of spread. They look at things like how big the cancer is (T), if it's in the lymph nodes (N), and if it has spread to other parts of the body (M). They do tests like CT scans, PET/CT scans, and blood work. The stage can be from I (locally situated) to IV (tumors have left the stomach and traveled to other parts of the body).
Different Types of Gastric Cancer
The most common type of gastric cancer is called "adenocarcinoma." This means it starts in certain cells that form glands. Inside this type, there are two main kinds: "intestinal" (more common) and "diffuse" (less common). Doctors also take a small piece of the tissue to do some tests and test for biomarkers such as MSI (microsatellite instability), MMR (mismatch repair proficiency), HER2, and PDL-1. They also check for a common bacteria HPylori, which normally only leads to heartburn, but can sometimes cause stomach cancer.
Treating Gastric Cancer
Doctors often use surgery to treat gastric cancer, especially if it's caught early. There are different kinds of surgeries, like taking out the cancer with small cuts (endoscopic resection), removing part of the stomach (partial gastrectomy), or taking out the whole stomach (total gastrectomy). They will also take out lymph nodes around the stomach to check for cancer, and accurately stage disease that is not always obvious on a scan.
Most people with stomach cancer get treated with "systemic therapy.” - which refers to treatments like chemotherapy, targeted therapy, and immunotherapy. The sequencing of these therapies can vary - sometimes these treatments are used before surgery, after surgery, or both, and certainly if the cancer has spread from the stomach. Occasionally, radiation therapy is used along with other treatments if needed.
Understanding Surgery
Surgery can be done in two ways: open surgery, which needs bigger cuts and takes longer to heal, or minimally invasive surgery, which uses small cuts and helps you heal faster.
Remember to discuss your specific diagnosis and treatment options with your doctor.
