Gastrointestinal Cancer

Gastric cancer, or adenocarcinoma of the stomach, is a cancer of the lining of the stomach. It is the world's fourth most prevalent cancer. Early symptoms often mimic other less ominous conditions, so gastric cancers are often identified at later stages. Gastric cancers are aggressive and difficult to cure in later stages, so early detection is imperative.
Risk Factors There are many risk factors associated with gastric cancer. Male gender, African-American race, and low socioeconomic class are associated with increased risk for gastric cancer. Diets high in salt and smoked foods also increase risk, as does smoking. Helicobacter pylori, a bacterial that and live in the stomach and cause gastritis and ulcers, can also increase gastric cancer risk. Prior stomach surgery, a condition called pernicious anemia, and chronic atrophic gastritis are also associated with elevated gastric cancer risk. Finally, there are hereditary forms of gastric cancer due to genetic mutations passed along in families.
Symptoms
  • Blood per rectum
  • Obstructive bowel symptoms
  • Chronic abdominal pain plus weight loss
  • Mass in abdomen, trunk or extremity
  • Difficulty in swallowing (dysphagia)
  • Obstructive jaundice
  • Diahhrea and hot flashes (carcinoid syndrome)
  • Suspicious lesion (cyst or mass) in liver
  • Lesion, cyst or mass in the pancreas
Stages Identifying the stage of disease – how far advanced it is and whether it is has spread to nearby organs – is an important step in planning the appropriate treatment. There is no standard staging system for gastrointestinal carcinoid tumors, only three general categories.
  • Localized: found in the appendix, colon, rectum, small intestine or stomach only
  • Regional: spread to nearby tissues or lymph nodes
  • Metastatic: spread to organs and tissues throughout the body
Diagnosis The Cancer Associate Team offers a full-range of diagnostic tools, including endoscopic ultrasound, endoscopic-ultrasound-guided biopsy, endoscopic retrograde cholangiopancreatography, computed tomography angiography, interventional radiology and cytopathology. Treatment Treatment for gastric cancer involves surgery, chemotherapy, and possibly radiation therapy. Surgery is the cornerstone of treatment as the only possibility of cure is complete surgical removal of the cancer. The surgical therapy of gastric cancer involves the removal of most or all of the stomach as well as removal of the majority of lymph nodes around the stomach. The stomach is not necessary for eating and digestion; however, removal of most or all of the stomach markedly changes how a patient can eat for the rest of their lives. Surgery for gastric cancer is curative only if all of the cancer can be removed. If the cancer has spread beyond the stomach and lymph nodes, it is unlikely to be cured with surgery. Chemotherapy is used for gastric cancers that have invaded into the muscular layer of the stomach wall and/or have spread to lymph nodes. Chemotherapy can be given before surgery, after surgery, or both, depending on the size and location of the tumor and the health of the patient. Radiation therapy is generally given after surgery in selected cases. If the gastric cancer has already spread beyond the stomach and lymph nodes, surgery is usually not beneficial. Chemotherapy and radiation therapies can help prolong life, but rarely produce a cure. Occasionally surgery is needed to provide relief from symptoms, but does not aid in a cure. Other techniques that serve to prolong life and lessen symptoms include local tumor removal and placement of intestinal stents (to keep the digestive passages clear).