LOVE. TRUTH. LIGHT: Stomach Cancer

An Introduction to Stomach Cancer: What It Is and Everything You Need to Know

Introduction

Six years ago, I came in terms with reality that I was about to lose one of the most important people in my life, my beloved mom; Shirley Savitree. For two-year years, I watched my dear mother battle against an ailment that drained her piece by piece, and no matter how much she tried, the pain and suffering didn’t go away. On February 6th, 2018, my mother went to be with God as she lost her battle with stomach cancer.

Over the years, I have sought to understand as much as possible about stomach cancer, it’s nature and things that can be done to combat it. I have labouredly read through articles, books, report, and many more to gain full insight on stomach cancer. Stomach cancer is the 5th most common cancer in the world, and accounts for 1.3% of new cancer cases worldwide. It’s of little surprise, that attention is given to disseminate information on what one can look out for when it comes to stomach cancer.

While, gastric cancer –like most cancers–isn’t exactly a death sentence, but a person’s survival rate declines the more time the cancer spends undiscovered. This article will touch on several key aspects of the discourse about stomach cancer. The objective of this article is to ensure that by the time you get to the last word of this article, you will have a good example of what stomach cancer is, the types of stomach cancer, how to recognize the signs early enough, what options are available to you if you are battling with stomach cancer, and things that can put you at risk for stomach cancer.

It’s time to introduce to the wonderful thing that is “An Introduction to Stomach Cancer: What is It and Everything You Need to Know.”

Anatomy of The Stomach

To fully understand stomach cancer and its effects, one would will need to understand the anatomy of the organ it affects. To achieve this, we will take a look at the anatomy of the stomach in the first part of this article.

The stomach is a J-shaped muscular organ that digests food. This is achieved by a mix of enzymes and acids which are produced in the stomach, which then act on the food you eat to break them down before passage to the small intestine.

The stomach is part of the gastrointestinal tract (GI tract). The GI tract is a long tube which begins at the mouth and terminates at the anus. This tract is considered a very important part of the digestive system.

The stomach sits in the upper abdominal region by the left of the body. The top of the stomach connects to a valve known as esophageal sphincter, and the bottom connects with the small intestine.

The stomach is divided into five parts, namely:

The Cardia: This is the top part of the stomach. It contains the cardiac sphincter, whose main function is to prevent food from travelling back into esophagus.
The Fundus: The fundus is the rounded section next to the Cardia. It’s located right below the diaphragm.
The Corpus: Also known as the body, is the largest section of the stomach. This section of the stomach contracts, and this is where mixing of the food takes place.
The Antrum: This lies below the Corpus. It acts as a temporary storage place for food until the small intestine is ready to receive the food.
The Pylorus: This is bottom part of the stomach. It contains the pyloric sphincter, which controls how and when the content of your stomach enters the small intestine.

To further understand the stomach, we will also examine the structure of the stomach. The stomach is made of four layers of muscles and tissues. These include;

Serosa: The Serosa is a fatty membrane that acts as a cover over the stomach, and offer some sort of protection to it.
Muscularis External: This is the primary and most external muscle of the stomach. It is in itself made up of three layers, which contracts and relaxes rhythmically to break down food in the stomach.
Submucosa: This layer of the stomach contains blood vessels, connective tissues, and nerve cells. It also offers protection to the innermost layer of the stomach, the Mucosa.
Mucosa: The Mucosa is the innermost lining of the stomach. The structure of the mucosa varies depending on whether your stomach is full or empathy. When empty, the mucosa has small ridges called “rugae”, but when full the stomach expands and these ridges flatten.

The last aspect of the stomach you should understand are the functions of the stomach. The functions of the stomach include;

Temporarily store for food
Contraction and relaxation to break down food
Production of enzymes and acids to digest food.

Now, we have fully explored what the stomach looks like and its function, it’s time to take the next step and explore what stomach cancer is. If you have read up till this point, then it’s obvious you are curious for more, and that is exactly what I’m offering in the next section.

What is Stomach Cancer?

If you were to conduct a survey and ask people if they have had of stomach cancer or gastric cancer, a great number of them will respond in positive, but when narrowed down and asked if they are, that number decreases significantly. Many people have poor knowledge of cancer, and more specifically, gastric cancer, and aside from knowing it’s a depleting ailment, they know very much little else about stomach cancer. So, the question is; what is stomach cancer?

Stomach cancer, also known as gastric cancer, is a cancer that affects the lining of the stomach. It’s basically the uncontrollable growth of cells originating from the stomach. It commonly affects he Corpus (body) of the stomach. However, in some countries, it can originate mainly from other sections of the stomach. For example, in the United States, cases of stomach cancer mainly arise from the gastrophageal junction, that is the part where the esophagus meets with stomach.

Primarily, stomach cancer starts from the inner linings of T stomach before extending outward. Its progress is slow, but if left unchecked can become a mass tumour and affect nearby organs such as the liver and pancreas.

Types of Stomach Cancer

Just “knowing” about stomach cancer or stomach carcinoma, can keep you on alert to seek out help when you sense something. However, just knowing what stomach cancer is, isn’t enough. To help on our quest to know more about stomach cancer, the types of stomach cancer have been outlined for you below.

The type of stomach cancer include;

Adenocarcinoma of the stomach: This type of stomach cancer begins in the mucus-producing cells in the innermost linings of the stomach. It’s important to note that nearly all cases of stomach cancers are adenocarcinomas. This type of stomach cancer is further classified into two, namely; Gastric cardia cancer (begins at the top notch of the stomach, where the stomach meets the oesophagus) and non-gastric cardia cancer (begins in all other sections of the stomach). They can be also defined as intestinal or diffuse, depending on how the cancerous cells look under a microscope
Gastrointestinal neuroendocrine tumour: This type of cancer begins in the neuroendocrine cells that line the GIT. Neuroendocrine cells are cells that function as both a nerve cells and hormone-producing cell.
Gastrointestinal stromal tumours (GIST): This cancer is found in the stomach and other parts of the digestive system. It’s classified as a form of soft-tissue sarcoma.
Primary gastric lymphoma: This type of cancer is a non-Hodgkin lymphoma (a form of cancer where cancer cells form in the lymph system). The most common cases are mucosa-associated lymphoid tissue (MALT), gastric lymphoma or diffuse B-cell lymphoma of the stomach

Having knowledge of the types of stomach cancer will help you know what to expect with each one. If you are still interested till this point, there’s every reason to believe that you will be interested in the next part.

Symptoms of Stomach Cancer

Before we start and you get to see the symptoms of stomach gastric cancer, it’s important to state that having one or two symptoms of stomach cancer isn’t a definitive reason to conclude that one can have stomach cancer. For every disease condition, symptoms are quite similar and if one isn’t sure about them, they could start feeling agitated for no reason. A bulk of stomach cancer symptoms are common symptoms associated with other non-life-threatening diseases, and it’s wise to note how long the symptoms have lasted and the combination of the symptoms before suspecting a thing. If you feel you could have stomach cancer, see your doctor immediately.

Let’s get right into it. Symptoms of stomach cancer include, but are not limited to;

Difficulty in swallowing
Black stool
Blood in vomit
Stomach pain, often above the umbilical region
Feeling full especially after eating very little
Bloating after eating
Fatigue or weakness
Unexplained weight loss
Heartburn

It’s important to note if you notice a symptom and don’t feel comfortable with it, see your doctor as soon as possible. Early detection of gastric cancer improves the chances of survival of anyone significantly. You should also note that stomach cancer doesn’t present with symptoms until it’s quite advanced, so as soon you notice any symptoms that you feel might be stomach cancer report to your doctor, immediately.

Causes of Stomach Cancer

Researchers believe that gastric cancer is caused by a mutation in DNA, however, they aren’t certain on what causes this mutation. The process suggested by researchers is that stomach cancer begins when the inner linings of the stomach are hurt by something, (My mother suffered brutal punches to the stomach by her cruel abuser). As a result of this damage to that area of the stomach, it causes the cells to alter their DNA structure. This alteration triggers rapid and uncontrollable growth of the cells in the stomach. These cells keep on living even when healthy cells have died off in accordance with your natural lifecycle. This causes a lot of extra cells to exist in the area, giving rise to a tumour.

These cancer cells might become invasive and start attacking nearby tissues. With time, these cancer cells eat deeper into the wall of the stomach and spreads. If left unchecked, they break away from the stomach wall and spread to other organs of the body. When this happens, it’s called metastasis.

Although, there are no definite cause of stomach cancer, there are risk factors that can predispose you to developing stomach cancer. These risk factors will be explored in the next heading.

Risk Factors Associated with Stomach Cancer

There are several risk factors that can cause one to develop stomach cancer. Different risk factors can increase the risk of stomach cancer at different areas of the stomach. For example, Heobacter Pylori (H.Pylori) increases the risk in the lower and middle part of the stomach. Obesity increases the risk of stomach cancer in the upper part of the stomach.

Risk factors associated with stomach cancer, include;

Pylori: Chronic H.pylori infection can lead to development of atrophic gastritis, this could lead to severe changes in the lining of the stomach which subsequently results to stomach cancer or gastric MALT lymphoma.
Chronic atrophic gastritis
Atrophic gastritis with intestinal metaplasia
Epstein-Barr virus infection
Pernicious anaemia
Obesity
Gastrophageal reflux disease
A history of stomach cancer in a first-degree family member such as mother, father, siblings, or child.
A family cancer syndrome such as; familial intestinal gastric cancer (FIGC), gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS), hereditary diffuse gastric cancer (HDGC), juvenile polyposis syndrome, Li-Fraumeni syndrome, Lynch syndrome, and, Peutz-Jeughers syndrome.
Type A blood
A diet of low vegetables and fruits while being high in salt and smoked food
Poorly preserved food
Smoking
Working in a rubber or coal industry
Exposure to high level of radiation

Being among individuals at risk of stomach cancer doesn’t mean you will eventually develop stomach carcinoma. Plenty of people while being at risk of stomach cancer don’t develop one, and many people who are at risk of stomach cancer end up with one.

Diagnosis of Stomach Cancer

When it comes to diagnosing gastric cancer, two goals are hoped to be achieved. The first is to diagnose the presence of a stomach cancer, and the second is the staging of the gastric cancer (diagnosis carried out to know which stage the cancer is at). Before a full diagnosis is carried out, your doctor might ask you a couple of questions and carry out some examinations to know if your symptoms are specific to stomach cancer. These questions might include;

Your personal and family risk
Carry out a physical examination
Run some tests to check for anaemia
Check your stool for occult blood

The results of your doctor’s prior results will determine which tests he might recommend for the diagnosis. These tests include;

Upper endoscopy with biopsy: This is a procedure used to view inside the esophagus, stomach, and duodenum, with the help of a thin lighted tube. It is carried to search for abnormalities in these areas that may suggest the presence of a carcinoma. A tissue sample might be collected from the area for further testing.
Barium swallow: In barium swallow, the patient swallows a small amount of liquid containing barium, which coats the inside of esophagus and stomach which makes it visible during X-rays.
CT scan
Biomarker testing: Biomarker testing is designed to test for genes, proteins, and other substances (also called biomarkers, or tumour markers) that can provide information about cancer. These biomarkers can affect how cancer grows and how cancer treatments are carried out. They will serve as a key measure for you and your doctor when it comes to picking the right cancer treatment for you. These biomarkers include; HER2, PD-L1, Microsatellite instability, Mismatch repair deficiency, Tumour mutational burden, NTRK

These tests are carried to confirm a diagnosis of gastric cancer. After a diagnosis of stomach cancer, the next step is staging the cancer. These tests are carried out to stage stomach cancer;

Endoscopic sounding: In this procedure, an endoscope is passed through the mouth of anus, and high-energy sound waves off internal organs and tissues. The echoes form a picture of the body tissue called sonography
PET-CT scan: This is a combination positron emission tomography (PET) scan and a computed tomography (CT) scan. Both scans are carried out and on the same machine, and offers a more detailed image than either scan can offer alone.
Magnetic resonance imaging (MRI) with gadolinium: Gadolinium is injected through the vein, and they collect around the cancer cells. They subsequently appear brighter in the imaging.

It is important to note that proper diagnosis and staging is important to ensure proper treatment. It should be carried as thorough as possible, and early enough.

Stages of Stomach Cancer

Stomach cancer is broken into four stages. These stages determine the extent of the cancer in your body, such as the size of the growth, if the cancer has spread, and how far the cancer has spread. The stages include;

Stage 0 (Carcinoma in-situ):
Stage 1, further divided into stage 1A and stage 1B
Stage 2, further divided into stage 2A and stage 2B
Stage 3, further divided into stage 3A, 3B, and 3C.
Stage 4

In some cases, a last stage is added. This stage is added if the cancer returns after it has been treated. The stage is called recurrent stomach cancer. Although, the cancer returns anywhere in the body, not primarily in the stomach.

Treatment

Different treatment modules are available for treatment if stomach cancer. It’s up to you and your care team to sit and decide on the best option for you. A treatment plan might include more than one type of treatment type. Before deciding on a treatment, several factors such as stage of cancer, your overall health, and preferences will be considered. Also, your treatment plan will carry information about your cancer, goals of treatment, treatment duration, treatment options, and possible side effects.

Treatments for stomach cancer include;

Endoscopic mucosal resection
Surgery
Radiation therapy
Chemotherapy
Targeted therapy
Immunotherapy
Hyperthermic intraperitoneal chemotherapy (HIPEC)
Clinical trials

Prognosis of Stomach Cancer

The survival rate of stomach is measured using the 5-years relative scale. To explain in simple terms, it means the likelihood of a person suffering from stomach cancer to be alive in 5 years compared to someone without stomach cancer. The 5-year relative survival rate for different forms of cancers are;

75% for localized stomach cancer
35% for regional stomach cancer
7% for metastatic stomach cancer.

Survival rates doesn’t mean that everyone suffering from stomach cancer will have the same survival chance. Yours might be higher, and full recovery can even be made from advanced stages. Individuals differ, and it’s best you keep in touch with your healthcare team throughout the course of treatment?

How To Cope with Stomach Cancer.

Getting diagnosed with stomach carcinoma can be life altering moment. It is bound to cause significant physical and emotional side effects. Your first thought might be how to cope with the sudden change in your life. The first step is trusting your care team and talking extensively to them about the problem. I have also outlined ways that might help you cope better with stomach cancer. These methods include;

A change in eating habits and nutrition, as you might cut down on the amount of food you eat, and the type of food you eat. Also, you might be advised to sit upright for a while after meals.
You have to understand that you aren’t alone, and try not to allow the sudden changes in your appearance as a result of the cancer and treatment affect your body image.
Planning and scheduling your meetings will help you cope better with follow-up care.
The rising cost of treatment might be a huge burden. You can seek out resources and grans to help you fund these treatments.

Conclusion

My precious mother had an unsuccessful battle with stomach cancer. She went through a lot of pain, suffering and abuse in her life before exiting this world as a result of an cruel, abusive, narcissistic psychopath and her stomach carcinoma. It doesn’t have to be that way for you. This article was written to make sure you have a full picture of what you are going through, or your loved ones are. It’s best to surround yourself with those who love and care for you at such difficult moments. Stomach cancer is not a death sentence, and proper treatment will have back on your feet in no time.

References

Gastric cancer (adult). Mayo Clinic; 2020.
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Gastric cancer treatment (PDQ). National Cancer Institute. https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq. Accessed July 22, 2022.
Gastric (stomach) cancer prevention (PDQ). National Cancer Institute. https://www.cancer.gov/types/stomach/patient/stomach-prevention-pdq. Accessed July 22, 2022.
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National Cancer Institute. Gastric Cancer Treatment (PDQ®)–Patient Version. (https://www.cancer.gov/types/stomach/hp/stomach-treatment-pdq#_163_toc) Accessed 5/17/2022.
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