Stomach cancer is a malignant neoplasm that develops in the epithelial cells of the stomach. This disease occupies one of the leading places among oncological pathologies, having a significant impact on morbidity and mortality. Stomach cancer can be asymptomatic in the early stages, which complicates timely diagnosis and treatment. In most cases, the disease is diagnosed at a stage when it has already spread to surrounding tissues and lymph nodes, which significantly worsens the prognosis for the patient.
History of the disease and interesting historical facts
Stomach cancer has been known to mankind since ancient times. Studies of the remains of ancient burials show that the pathology may have existed more than 2,000 years ago. In ancient Egypt, cancerous tumors were described in medical texts such as the Ebers Papyrus. At that time, treatment was very primitive and consisted of surgical removal of tumors, but the results were usually disappointing. In the 17th-18th centuries, observations of patients with stomach cancer became more systematic, and the original medical works of that time contained the first attempts to classify various forms of cancer. In the 20th century, an individual grading system for the characteristics of neoplasms was developed, which contributed to more accurate diagnosis and treatment of the disease.
Epidemiology
Stomach cancer is one of the leading causes of cancer mortality in many countries. According to the World Health Organization, about 1.5 million cases of stomach cancer were registered in 2020, accounting for about 8% of the total number of cancer diagnoses. The largest number of cases is observed in East Asian countries, especially Japan and Korea. Studies also show that men are 1.5-2 times more likely to develop stomach cancer than women. It is characteristic that the incidence increases with age, especially after 50 years, and continues to increase in older age groups.
Genetic predisposition to this disease
Genetic predisposition to gastric cancer is an important aspect in its pathogenesis. Research shows that the presence of certain genetic mutations can significantly increase the risk of developing the disease. The genes involved include APC, CDH1, and TP53. Mutations in the CDH1 gene, which is responsible for encoding a protein that slows down tumor growth, can be hereditary, which increases the likelihood of developing gastric cancer in families. The presence of hereditary Lynch syndrome is also associated with a high risk of gastrointestinal cancers, including gastric cancer. It is important to consider that genetic factors play a role in conjunction with other exogenous influences, such as nutrition and the environment.
Risk factors for the development of this disease
There are numerous risk factors that contribute to the development of stomach cancer, which can be divided into physical and chemical. The main factors include:
- Chronic stomach diseases such as gastritis, peptic ulcer.
- Helicobacter pylori infection, which can cause inflammation and precancerous atrophy.
- Consumption of salt and salty foods, as well as smoked and canned foods.
- Refusal of vegetables and fruits in the diet, which can lead to a lack of antioxidants.
- Smoking and alcohol abuse.
- Poor diet, low in fiber and high in fat.
Additionally, there is a link between radiation exposure and an increased risk of stomach cancer, which requires further research to identify its mechanisms of action.
Diagnosis of this disease
Diagnosis of stomach cancer involves a variety of methods, the purpose of which is to detect the tumor at an early stage and assess its prevalence. The main symptoms of stomach cancer may include:
- Pain or discomfort in the stomach area.
- Loss of appetite and significant weight loss.
- Nausea and vomiting, especially in the presence of gastritis.
- Belching and feeling of rapid satiety.
Laboratory tests include hemoglobin levels, which may indicate anemia, and tests for infections such as H. pylori. Radiological tests such as X-rays with contrast and gastroscopy can visualize changes in the lining of the stomach. Other diagnostics include ultrasound and CT scans to determine the stage of the disease. Differential diagnoses include peptic ulcers, gastritis, and benign tumors.
Treatment
Treatment of stomach cancer depends on the stage of the disease, location and spread of the tumor. It is usually complex and may include:
- Surgery - allows the removal of the tumor and surrounding tissue, which is the main method of treatment in the early stages.
- Pharmacological treatment - includes chemotherapy to destroy cancer cells that cannot be removed surgically.
- Radiation therapy - used to shrink a tumor before surgery or to relieve symptoms in later stages.
- Immunotherapy is a relatively new direction used to activate the immune system against cancer cells.
Treatment may also be influenced by concomitant diseases and the patient's general condition.
List of medications used to treat this disease
The following groups of drugs can be used to treat stomach cancer:
- Alkylating agents (cyclophosphamide).
- Antineoplastic antibiotics (doxorubicin).
- Targeted drugs (trastuzumab).
- Chemotherapeutic drugs (paclitaxel, cisplatin).
Each of these agents is used depending on individual indications and stage of the disease.
Disease monitoring
Monitoring of stomach cancer includes regular examinations and control of the patient's condition after the main treatment. The following is carried out at the control stages:
- General examination, including blood tests to determine the level of tumor markers.
- CT and MRI to monitor potential recurrence of the disease.
- Performing gastroscopy at regular intervals to visualize the stomach.
The prognosis for stomach cancer depends on the stage at diagnosis. Complications may include recurrence of the disease, metastasis to other organs, and gastric obstruction, which may require surgery.
Age-related features of the disease
Stomach cancer exhibits age-related features, as the risk of its development increases with the patient's age. Stomach cancer is diagnosed more often in people over 50 years old, and its course may differ in older and younger patients. At a young age, tumors are usually more aggressive, while older patients may have concomitant pathology, which complicates treatment. Older patients often have concomitant diseases that affect the choice of treatment method and increase the risk of complications.
Questions and Answers
- What are the main symptoms of stomach cancer? Main symptoms may include stomach pain, loss of appetite, significant weight loss, nausea and vomiting.
- How is stomach cancer diagnosed? Diagnosis includes laboratory tests, radiological studies such as ultrasound and gastroscopy, and biopsy.
- What are the risk factors associated with developing stomach cancer? The main risk factors include H. pylori infection, poor diet, smoking and chronic gastritis.
- How is stomach cancer treated? Treatment includes surgery, chemotherapy, radiotherapy and immunotherapy depending on the stage of the disease.
- What is the prognosis for stomach cancer? The prognosis depends on the stage of the disease, the conditions of its diagnosis, the nature of the tumor; the best outcomes are observed with early diagnosis and timely treatment.
