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.


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


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


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.


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


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.