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Encyclopedia > Stomach cancer
Stomach cancer
Classification & external resources
ICD-10 C16.
ICD-9 151

Stomach cancer (also called gastric cancer) can develop in any part of the stomach and may spread throughout the stomach and to other organs; particularly the esophagus and the small intestine. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... The esophagus (also spelled oesophagus/Å“sophagus, Greek ), or gullet is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ... In biology the small intestine is the part of the gastrointestinal tract (gut) between the stomach and the large intestine. ...

Diagram of the stomach

Contents

Image File history File links Stomach_diagram. ... Image File history File links Stomach_diagram. ...

Epidemiology

Stomach cancer represents roughly 2% (25,500) cases of all new cancer cases yearly in the United States, but it is much more common in Korea, Japan, Great Britain, South America, and Iceland. It is associated with high salt in the diet, smoking, and low intake of fruits and vegetables. Infection with H. pylori is the main risk factor in about 80% or more of gastric cancers. It is more common in men. Edible salt is mostly sodium chloride (NaCl). ... Look up Smoking in Wiktionary, the free dictionary. ... Helicobacter pylori is a bacterium that infects the mucus lining of the human stomach. ...


Gastric or stomach cancer, has very high incidence in Korea and Japan. Gastric cancer is the leading cancer type in Korea with 20.8% of malignant neoplasms, the second leading cause of cancer deaths. It is suspected several risk factors are involved including diet, gastritis, intestinal metaplasia and Helicobacter pylori infection. A Korean diet, high in salted, stewed and broiled foods, is thought to be a contributing factor. Ten percent of cases show a genetic component.[1] In Japan and other countries bracken consumption and spores are correlated to stomach cancer incidence.[2] Epidemiologists have yet to fully account for the high rates of gastric cancer as compared to other countries. Gastritis is inflammation of the gastric mucosa. ... Binomial name Helicobacter pylori ((Marshall 1985) Goodwin 1989) Helicobacter pylori is a bacterium that infects the mucus lining of the stomach and duodenum. ... Species Pteridium aquilinum Pteridium caudatum Pteridium esculentum Pteridium latiusculum and about 6-7 other species For the Irish television soap opera, see Bracken (TV). ...


A very small percentage of diffuse-type gastric cancers (see Histopathology below) are thought to be genetic. Hereditary Diffuse Gastric Cancer (HDGC) has recently been identified and research is ongoing. However, genetic testing and treatment options are already available for families at risk (Brooks-Wilson et al., 2004).


Metastasis occurs in 80-90% of individuals with stomach cancer, with a five year survival rate of 75% in those diagnosed in early stages and less than 30% of those diagnosed in late stages. The death rate is 12,400 a year in the United States. Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ...


Symptoms

Endoscopic image of linitis plastica, a type of stomach cancer where the entire stomach is invaded, leading to a leather bottle-like appearance.

Stomach cancer is often asymptomatic or causes only nonspecific symptoms in its early stages. By the time symptoms occur, the cancer has generally metastasized to other parts of the body, one of the main reasons for its poor prognosis. Stomach cancer can cause the following signs and symptoms: Image File history File links Linitis_plastica_2. ... Image File history File links Linitis_plastica_2. ... Linitis plastica is seen in diffuse gastric carcinoma. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ...


Early

Late Indigestion is a condition that is frequently caused by eating too fast, especially by eating high-fat foods quickly. ... Anorexia (deriving from the Greek όρεξη (orexe) = appetite) is the decreased sensation of appetite. ...

These can be symptoms of other health problems, such as a stomach virus or gastric ulcer, and diagnosis should be done by a gastroenterologist or an oncologist. Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... For the Beck song, see Nausea (song). ... Vomiting (also throwing up or emesis) is the forceful expulsion of the contents of ones stomach through the mouth and sometimes the nose. ... Types 5-7 on the Bristol Stool Chart are often associated with diarrhea Diarrhea (in American English) or diarrhoea (in British English) is a generally unpleasant condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... Bloating is any abnormal general swelling, or increase in diameter of the abdominal area. ... Weight loss, in the context of medicine or health, is a reduction of the total body weight, which can mean loss of fluid, muscle, bone mass, or fat. ... Weakness can mean: The opposite of strength Weakness (medical) This is a disambiguation page — a navigational aid which lists pages that might otherwise share the same title. ... The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... Blood from a finger Bleeding is the loss of blood from the body. ... Hematemesis (American English) or haematemesis (International English) is the vomiting of fresh red blood. ... In medicine, when refering to human feces, Blood in stool can refer to several distinct conditions: Melena Fecal occult blood Hematochezia In infants, the Apt test can be used to distinguish Fetal hemoglobin from maternal blood. ... Anemia (AmE) or anaemia (BrE), from the Greek () meaning without blood, refers to a deficiency of red blood cells (RBCs) and/or hemoglobin. ... Gastroenterology or Gastrology might be better described as the field of digestive diseases, which are traditionally separated by anatomic or functional category. ... Please refer to cancer for the biology of malignant disease, as well as a list of malignant diseases. ...


Diagnosis

To find the cause of symptoms, the doctor asks about the patient's medical history, does a physical exam, and may order laboratory studies. The patient may also have one or all of the following exams:

  • Gastroscopic exam is the diagnostic method of choice
  • Upper GI series (may be called barium roentgenogram)
  • Fecal occult blood test is obsolete except possibly as a screening test; a negative test proves nothing and a positive result may result from a large number of other conditions beside gastric carcinoma.

Abnormal tissue seen in a gastroscope examination will be biopsied by the surgeon or gastroenterologist. This tissue is then sent to a pathologist for histological examination under a microscope to check for the presence of cancerous cells. A biopsy, with subsequent histological analysis, is the only sure way to confirm the presence of cancer cells. In medicine, a gastroscopic exam is an endoscopic exam of the esophagus and stomach using a thin, lighted tube called a gastroscope, which is passed through the mouth and esophagus to the stomach. ... Upper GI series (barium swallow) of the esophagus, showing abnormalities associated with eosinophilic esophagitis. ... Fecal occult blood is a term for blood present in the feces that is not visibly apparent. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ... Gastroenterology or Gastrology might be better described as the field of digestive diseases, which are traditionally separated by anatomic or functional category. ... Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. ... A thin section of lung tissue stained with hematoxylin and eosin. ...


Histopathology

Image:Adenocarcinoma low differentiated (stomachy) H&E magn 400x.jpg
Low differentiated Adenocarcinoma of the stomach.
  • Gastric adenocarcinoma is a malignant epithelial tumor, originating from glandular epithelium of the gastric mucosa. It invades the gastric wall, infiltrating the muscularis mucosae, the submucosa and thence the muscularis propria. Histologically, there are two major types of gastric cancer (Lauren classification): intestinal type and diffuse type.
  • Intestinal type adenocarcinoma: tumor cells describe irregular tubular structures, harboring pluristratification, multiple lumens, reduced stroma ("back to back" aspect). Often, it associates intestinal metaplasia in neighboring mucosa. Depending on glandular architecture, cellular pleomorphism and mucosecretion, adenocarcinoma may present 3 degrees of differentiation: well, moderate and poorly differentiate.
  • Diffuse type adenocarcinoma (mucinous, colloid): Tumor cells are discohesive and secrete mucus which is delivered in the interstitium producing large pools of mucus/colloid (optically "empty" spaces). It is poorly differentiated. If the mucus remains inside the tumor cell, it pushes the nucleus at the periphery - "signet-ring cell". [1]

Adenocarcinoma is a form of carcinoma that originates in glandular tissue. ... Section of mucous membrane of human rectum. ...

Staging

If cancer cells are found in the tissue sample, the next step is to stage, or find out the extent of the disease. Various tests determine whether the cancer has spread and, if so, what parts of the body are affected. Because stomach cancer can spread to the liver, the pancreas, and other organs near the stomach as well as to the lungs, the doctor may order a CT scan, an ultrasound exam, or other tests to check these areas. Blood tests for tumor markers, such as carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) may be ordered, as their levels correlate to extent of metastasis, especially to the liver, and the cure rate. The stage of a cancer is a descriptor (usually numbers I to IV) of how much the cancer has spread. ... CAT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... Tumor markers are substances found in the blood, urine or body tissues that can be elevated in cancer. ... Carcinoembryonic antigen (CEA) is a glycoprotein involved in cell adhesion. ...


Staging may not be complete until after surgery. The surgeon removes nearby lymph nodes and possibly samples of tissue from other areas in the abdomen for examination by a pathologist.


Treatment

Like any cancer, treatment is adapted to fit each person's individual needs and depends on the size, location, and extent of the tumor, the stage of the disease, and general health. Cancer of the stomach is difficult to cure unless it is found in an early stage (before it has begun to spread). Unfortunately, because early stomach cancer causes few symptoms, the disease is usually advanced when the diagnosis is made. Treatment for stomach cancer may include surgery, chemotherapy, and/or radiation therapy. New treatment approaches such as biological therapy and improved ways of using current methods are being studied in clinical trials. Chemotherapy is the use of chemical substances to treat disease. ... Clinac 2100 C100 accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...


Surgery

Surgery is the most common treatment for stomach cancer. The surgeon removes part (subtotal or partial gastrectomy) or all (total gastrectomy) of the stomach, as well as some of the tissue around the stomach, with the basic goal of removing all cancer and a margin of normal tissue. Depending on the extent of invasion and the location of the tumor, surgery may also include removal of part of the esophagus, spleen, ovaries, or intestines. Tumors in the lower parts of the stomach may call for a Billroth I or Billroth II procedure. Endoscopic mucosal resection is a treatment for early gastric cancer that has been pioneered in Japan, but is available in the United States at some centers. In this procedure, the tumor is removed from the wall of the stomach using an endoscope, with the advantage in that it is a smaller operation than removing the stomach. Surgical interventions are currently curative in less than 40% of cases, and, in cases of metastasis, may only be palliative. Diagram of the stomach, showing the different regions. ... The esophagus (also spelled oesophagus/Å“sophagus, Greek ), or gullet is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ... A splenectomy is a procedure that involves the removal of the spleen by operative means. ... Oophorectomy is the surgical removal of the ovaries of a female animal. ... Palliative care is any form of medical care or treatment that concentrates on reducing the severity of the symptoms of a disease or slows its progress rather than providing a cure. ...


Chemotherapy

Chemotherapy is the use of systemic drugs to fight the stomach cancer. Unfortunately, gastric cancer has not been especially sensitive to these drugs until recently, and historically served to palliatively reduce the size of the tumor and increase survival time. Some drugs used in stomach cancer treatment include: 5-FU (fluorouracil), BCNU (carmustine), methyl-CCNU (Semustine), and doxorubicin (Adriamycin), as well as Mitomycin C, and more recently cisplatin and taxotere in various combinations. Scientists are exploring the benefits of giving chemotherapy before surgery to shrink the tumor, or as adjuvant therapy after surgery to destroy remaining cancer cells. Combination treatment with chemotherapy and radiation therapy is also under study. Doctors are testing a treatment in which anticancer drugs are put directly into the abdomen (intraperitoneal hyperthermic chemoperfusion). Chemotherapy also is being studied as a treatment for cancer that has spread, and as a way to relieve symptoms of the disease. The side effects of chemotherapy depend mainly on the drugs the patient receives. Chemotherapy is the use of chemical substances to treat disease. ... Fluorouracil (5-FU) is a drug that is used in the treatment of cancer. ... Doxorubicin or Adriamycin® or hydroxyldaunorubicin is a DNA-interacting drug widely used in chemotherapy. ... Cisplatin, cisplatinum or cis-diamminedichloroplatinum(II) (CDDP) is a platinum-based chemotherapy drug used to treat various types of cancers, including sarcomas, some carcinomas (e. ... Docetaxel is a clinically well established anti-neoplastic medication used mainly for the treatment of breast, ovarian, and non-small cell lung cancer. ... A procedure in which a warmed solution containing anticancer drugs is used to bathe, or is passed through the blood vessels of, the tissue or organ containing the tumor. ...


Radiation therapy

Radiation therapy (also called radiotherapy) is the use of high-energy rays to damage cancer cells and stop them from growing. When used, it is generally in combination with surgery and chemotherapy, or used only with chemotherapy in cases where the individual is unable to undergo surgery. Radiation therapy may be used to relieve pain or blockage by shrinking the tumor for palliation of incurable disease Clinac 2100 C100 accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...


Multimodality Therapy

While previous studies of multimodality therapy (combinations of surgery, chemotherapy and radiation therapy) gave mixed results, the Intergroup 0116 (SWOG 9008) study (NEJM study abstract) showed a survival benefit to the combination of chemotherapy and radiation therapy in patients with nonmetastatic, completely resected gastric cancer. Patients were randomized after surgery to the standard group of observation alone, or the study arm of combination chemotherapy and radiation therapy. Those in the study arm receiving chemotherapy and radiation therapy survived on average 36 months, compared to 27 months with observation.


Biological therapy

Biologic therapy is still in the testing stages for stomach cancer. The side effects of biological therapy vary with the type of treatment. Some cause flu-like symptoms, such as chills, fever, weakness, nausea, vomiting, and diarrhea. Patients sometimes get a rash, and they may bruise or bleed easily. These problems may be severe, and patients may need to stay in the hospital during treatment.


External links

  • stomach cancer may originate from bone marrow cell
  • Photos at: Atlas of Pathology
  • Article on Hereditary Diffuse Gastric Cancer
  • National Cancer Institute Gastric cancer treatment guidelines
  • National Comprehensive Cancer Network Gastric cancer treatment guidelines

References

  1. ^ AHyuk-Joon Lee, Han-Kwang Yang, Yoon-Ok Ahn, Gastric cancer in Korea Gastric Cancer, Volume 5, Number 3 / September, 2002. DOI:10.1007/s101200200031]
  2. ^ Alonso-Amelot ME, Avendano M., Human Carcinogenesis and Bracken Fern: A Review of the Evidence, Curr Med Chem. 2002 Mar;9(6):675-86

Lewis, S.M., Heitkemper, M.M., & Dirksen, S.R. Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 6th ed. St. Louis: Mosby, 2004.


McCance, K., & Huether, S. Pathophysiology: The Biologic Basis for Disease in Adults & Children, 4th ed. St. Louis: Mosby, 2002.


  Results from FactBites:
 
Stomach cancer, gastric cancer (686 words)
Stomach cancer (also called gastric cancer) is a disease in which normal cells in the stomach tissues become cancerous and grow out of control.
The most common type of stomach cancer is adenocarcinoma, which starts in the glandular tissue of the stomach, and accounts for 95% of all stomach cancers.
Stomach cancer also may extend through the stomach wall and spread to nearby lymph nodes and to organs such as the liver, pancreas, and colon.
BWH General and Gastrointestinal Surgery Stomach Cancer Information (896 words)
Stomach cancer has decreased as the most common cause of cancer deaths in males in 1930 to one of the less common causes of cancer death today.
The prognosis or likelihood of cure is related to the degree of invasion of the wall of the stomach and the presence or absence of lymph node metastases.
Cancers involving the outlet end of the stomach can be removed with a "distal sub-total gastrectomy" leaving one-quarter to one-third of the upper end of the stomach which is connected to the small intestine.
  More results at FactBites »

 
 

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