Gastric Cancer

What is a gastric cancer?

It is a growth that arises in the stomach.

Is it malignant?

A gastric tumour is most often malignant, even if it is possible to see benign growths and also borderline tumours, something between a malignant and a benign tumour.

I don’t quite understand this…

Unfortunately, several different kinds of tumours can affect the human body. Their biological behavior depends on the primary cell whose abnormality started the oncogenic process. In the stomach there are different types of cells… If a tumour arises from the cells of the mucosa, which is the most inner lining, it usually becomes an adenocarcinoma. This is the most frequent malignant tumour of the stomach. If the growth starts from the muscle layer, a malignant sarcoma or a borderline GIST (gastrointestinal stromal tumour) can result. If the malignant process affects the immunity cells of the stomach wall, here is a lymphoma. Benign tumours can arise from the same cells that give birth to malignant cancers. Obviously, this is an oversimplification, but I believe it is enough to serve as an example.

Are gastric cancers frequent?

Fortunately they are not. Gastric cancer is known to be the cancer of “poor” diets, smoked food, meat cooked on the wood fire (such as BBQ…), preservatives, smoking as a way to preserve food… Nowadays these causative factors are not common. Gastric cancer is not rare but definitely quite uncommon.

What are the symptoms of a gastric tumour?

Usually, the first symptom is anaemia, due to continuous oozing from the mass itself. If the mass is big, it can cause gastric obstruction leading to vomiting, difficulty in swallowing called dysphagia, or the feeling of a mass in the upper abdomen. An unexpected weight loss can also be a symptom of a gastric tumour. Rarely, a gastric tumour can present with an overt gastrointestinal bleeding, with blood in the vomit and in the stools.

What should I do if I get one of this symptoms?

You should be seen by your GP as soon as possible. If you fulfill the criteria for urgent investigations and treatment, you will be referred to the specialist gastrointestinal surgeon.

Is it possible to cure a tumour of the stomach?

Usually it is, depending on the nature of the tumour and its stage. Benign tumours and GISTs can be cured quite easily with a surgical operation. Big GISTs may need chemotherapy after or before surgery. Malignant tumours in their early stages can be cured with surgery or even with endoscopic resection in some very selected cases. Patients with an advanced gastric tumour removed with surgery may need further chemotherapy after surgery (sometimes even before surgery). Gastric lymphomas usually respond very well to chemotherapy alone. Unfortunately, it is not frequent to find an early gastric cancer and gastric tumours are often diagnosed quite late.

Let’s speak about gastric surgery… Do you always have to remove the whole stomach in case of cancer?

Not necessarily. Adenocarcinomas of the distal part of the stomach can usually be removed with a partial gastrectomy. Tumours of the upper and middle third need total gastrectomy. All the lymph nodes around the stomach must be removed. GISTs need only a partial resection, without lymphadenectomy.

Can we live without stomach?

Sure we can. Clearly, patients who had their stomach removed must adapt to the new situation. They will no longer be able to have a complete three-course meal, but they need to titrate their meals and do many small meals a day.

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