Stomach Cancer from Detection to Treatment
What Is Stomach Cancer?
Stomach cancer also called gastric cancer begins in the lining of the stomach.
Most cases start in the stomach's inner layer and slowly grow deeper over time.
It is often diagnosed late because early symptoms can be mild or mistaken for indigestion.
Stomach cancer also called gastric cancer begins in the lining of the stomach.
Most cases start in the stomach's inner layer and slowly grow deeper over time.
It is often diagnosed late because early symptoms can be mild or mistaken for indigestion.
1. Initial Detection / Screening
Symptoms:
Persistent indigestion or heartburn
Loss of appetite
Abdominal pain or discomfort
Nausea or vomiting
Unexplained weight loss
Fatigue
Black/tarry stools
Screening:
Upper endoscopy | gastroscopy
Symptoms:
Persistent indigestion or heartburn
Loss of appetite
Abdominal pain or discomfort
Nausea or vomiting
Unexplained weight loss
Fatigue
Black/tarry stools
Screening:
Upper endoscopy | gastroscopy
2. Diagnostic Testing
Endoscopy
Upper GI endoscopy
Biopsy
Imaging Tests
CT scan
Endoscopic ultrasound
PET-CT scan
Barium swallow
Lab Tests
Helicobacter pylori
Blood tests
• Complete blood count
• Liver function tests
• Tumor markers: CEA, CA 19-9
Endoscopy
Upper GI endoscopy
Biopsy
Imaging Tests
CT scan
Endoscopic ultrasound
PET-CT scan
Barium swallow
Lab Tests
Helicobacter pylori
Blood tests
• Complete blood count
• Liver function tests
• Tumor markers: CEA, CA 19-9
3. Staging
Based on the TNM system:
T = Tumor depth
N = Lymph node involvement
M = Metastasis
Stages:
Stage 0 | carcinoma in situ
only mucosa affected.
Stage I-III
locally advanced | deeper wall or lymph nodes.
Stage IV
metastatic | liver, lungs, peritoneum, etc.
Based on the TNM system:
T = Tumor depth
N = Lymph node involvement
M = Metastasis
Stages:
Stage 0 | carcinoma in situ
only mucosa affected.
Stage I-III
locally advanced | deeper wall or lymph nodes.
Stage IV
metastatic | liver, lungs, peritoneum, etc.
4. Treatment Plan
➛ Stage 0-I
Endoscopic mucosal resection
Endoscopic submucosal dissection
Surgery
➛ Stage II-III
Surgery
Subtotal | partial | gastrectomy
Total gastrectomy
Reconstruction: connects esophagus to small intestine.
Perioperative chemotherapy
Before and after surgery to shrink tumor and kill residual cells.
Radiation therapy
Sometimes used with chemotherapy
➛ Stage IV
Chemotherapy
Immunotherapy
Targeted therapy
• HER2-positive ➧ trastuzumab
• VEGF-targeted ➧ ramucirumab
Palliative surgery or stenting may help relieve obstruction or bleeding
➛ Stage 0-I
Endoscopic mucosal resection
Endoscopic submucosal dissection
Surgery
➛ Stage II-III
Surgery
Subtotal | partial | gastrectomy
Total gastrectomy
Reconstruction: connects esophagus to small intestine.
Perioperative chemotherapy
Before and after surgery to shrink tumor and kill residual cells.
Radiation therapy
Sometimes used with chemotherapy
➛ Stage IV
Chemotherapy
Immunotherapy
Targeted therapy
• HER2-positive ➧ trastuzumab
• VEGF-targeted ➧ ramucirumab
Palliative surgery or stenting may help relieve obstruction or bleeding
6. Post-Treatment and Follow-Up
➛ Regular checkups: Every 3-6 months for 2 years, then annually.
➛ Imaging and endoscopy to monitor recurrence.
➛ Psychological and social support for recovery and quality of life.
➛ Nutritional support:
Vitamin B12 injections | after total gastrectomy.
Small, frequent meals.
➛ Regular checkups: Every 3-6 months for 2 years, then annually.
➛ Imaging and endoscopy to monitor recurrence.
➛ Psychological and social support for recovery and quality of life.
➛ Nutritional support:
Vitamin B12 injections | after total gastrectomy.
Small, frequent meals.
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