Understanding Stomach Cancer: Causes, Symptoms, Types, Diagnosis & Treatments

Stomach cancer, also known as gastric cancer, originates when the cells lining the lining of the stomach begin multiplying abnormally and uncontrollably. These cancerous cells can develop into tumors that expand deeper into the stomach wall. Eventually, they can spread to other organs or parts of the body located far more distant.

As early stomach cancer usually causes minor or uncertain symptoms, it is commonly diagnosed at an advanced stage, which causes worse outcomes. The stomach is necessary for digestion, therefore any damage to its lining or structure may disrupt normal digestion and can cause pain, and reduce the absorption of nutrients.

In short, stomach cancer is an abnormal growth developing from the stomach's inner lining (usually glandular cells), which can enter tissue and spread to other organs in later stages. It usually shows up late due to mild early symptoms.

Causes and Risk Factors

These are the main causes and risk factors of stomach cancer:
• The Prolonged Helicobacter pylori infection is a major risk factor for stomach lining as it can cause long-term inflammation.
• High intake of salty, grilled, or processed food items may increase risk.
• Improper consumption of fruits and vegetables may increase the risk of developing cancer.
• Cigarette smoking is believed to enhance the risk of stomach cancer.
• Chronic gastritis, atrophic gastritis, or intestinal metaplasia: long term inflammation or changes in the stomach lining may raise the risk of cancer.
• Some benign growths, like gastric polyps and adenomas, may develop into cancerous over time.
• A family history with stomach cancer or genetic disorders, like a CDH1 gene mutation, may increase risk.
• The incidence increases with age (normally after 50-60) and seems more common in men than in women.
• Obesity and GERD, or gastroesophageal reflux disease, have been linked with cancers that can occur near the esophagus-stomach junction.
• Heavy smoking and alcohol intake: Smoking is well known, but high alcohol use may contribute indirectly through mucosal harm.
• Additional factors to consider include previous stomach surgery, Epstein-Barr virus infection, and occupational exposure to nitrosamines.
These risk factors are not a certainty; many people with risk factors do not develop stomach cancer, while others who are diagnosed have none of the usual risk factors.

Early Signs and Common Symptoms

Stomach cancer can sometimes be silent in its early stages, but as cancer grows more advanced, the following signs and symptoms may develop:
• Chronic indigestion or heartburn: Constant pain or feeling of burning in the upper abdomen.
• Bloating after meals or early feeling of fullness: Feeling full quickly particularly with small meals.
• Occasional nausea & vomiting: usually after eating.
• Loss of appetite or weight loss: Unintentional weight loss and reduced appetite.
• Upper abdomen pain or discomfort: mainly in the the epigastric (upper central) area.
• Heartburn or reflux: especially with malignancies that occur at the gastroesophageal junction
• Anemia or fatigue: Chronic tumor bleeding can cause anemia, tiredness, and low blood counts in body.
• Vomiting blood (hematemesis) or dark tarry stools (melena): indicate severe internal bleeding.
• Dysphagia: A tumor located at the esophagus-stomach junction may result in difficulty while swallowing.
• Jaundice : occurs if cancer spreads to the liver or bile ducts.
• Advanced condition may result in swelling, buildup of fluid (ascites), or a palpable malignancy.
Many of these symptoms are similar to normal gastrointestinal disorders (gas, ulcers, and GERD), thus consistent or increasing symptoms should be investigated by a doctor.

Types of Stomach Cancer

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Stomach (gastric) cancer has been divided into multiple pathological and anatomical types. Key types include:
1. Adenocarcinoma (Gastric Adenocarcinoma)
- It covers 90-95% of stomach cancers.
- It originates in the stomach lining's glandular cells, that secrete mucus.
Subclassified by location:
- Gastric cardia (upper stomach around the esophagus)
- Non cardia gastric cancer (all additional areas)
further histologic subtypes (Lauren classification):
- Intestinal type: develops glandular structures, mostly affected by environmental conditions.
- Diffuse type: It involves small cohesive cells, like as signet ring cells, infiltrating the stomach wall and resulting in thickening (e.g. linitis plastica).
2. Gastrointestinal Stromal Tumors (GISTs)
- Cajal cells (pacemaker cells) develop interstitial spaces in the stomach wall that cause it..
- Represent a soft tissue sarcoma.
- Behavior depends on the size, mitotic rate, and mutations in the genome.
3. Lymphoma of the stomach
It occurs when lymphatic cells in the stomach grow wrongly.
Most non-Hodgkin's lymphomas originate from mucosa-associated lymphoid tissue (MALT) in the stomach wall.
4. Neuroendocrine (Carcinoid) Tumors
- Carcinoid tumors originate by neuroendocrine cells in the stomach lining, that make hormones.
- While commonly slow-growing, some specific cancers can spread.
5. Mixed/other Rare Types
- Squamous cell cancer (rare)
- Small cell carcinoma
- Signet ring cell carcinoma (a subtype of diffuse adenocarcinoma)
- Linitis plastica: It is a morphological pattern that characterized by major widespread infiltration and stiffening of the stomach wall, sometimes known as "leather-bottle stomach".
Every type has a different pathological behavior, development pattern, and outcome, which decides therapy options. For example, adenocarcinomas are often treated with surgery and systemic treatments, but GISTs may benefit from targeted kinase inhibitors.

Stages of Stomach Cancer

Understanding the stages of stomach cancer allows doctors to determine the best treatment option and provides patients a greater awareness of what's going on within their bodies. Stomach cancer, also known as gastric cancer, can be divided into five stages (0 to IV) according to the extent and depth of the spread of the cancer.

Stage 0 – Early Stage
•At this stage, cancerous cells are only recognized in the stomach's inner lining.
•The cancer has not spread to nearby tissues or lymph nodes.
•Surgery to remove the affected stomach area is commonly used as treatment.
•Early detection is the most effective way to treat this stage.

Stage I – Localized Stomach Cancer
•In this stage, cancer has start to spread into the stomach wall's inner layers
•It may have spread to nearby lymph nodes, but not to distant organs.
•Surgery is the basic treatment, supported by chemotherapy to prevent recurrence.

Stage II – Regional Stomach Cancer
•The cancer has spread to the stomach wall and lymph nodes.
•Possibly affecting nearby organs involving the pancreas, spleen, or esophagus.
•Treatment options include surgery, chemotherapy, and targeted treatment combined to remove and control the disease.

Stage III – Locally Advanced Stomach Cancer
•This is the most advanced stage. The cancer has spread to distant organs, such as the liver, lungs, even bones.
•While complete cure is challenging & difficult, therapy works to slow down cancer progression, relieve symptoms, and improve quality of life.
•Chemotherapy, targeted treatment, and immunotherapy can help extend lifespan.

Stage IV – Metastatic Stomach Cancer
•This is considered to be The most advanced stage. The cancer has spread to distant organs such as the liver, lungs, and bones.
• As Complete cure is totally impossible at this stage, treatment options can help to slow down cancer spread, decrease symptoms, and increase quality of life.
•Treatment options like chemotherapy, targeted therapy, & immunotherapy may improve survival and comfort.

In Short:

• Stage 0-I: Early and curable with surgery.
• Stages II-III: Need combination therapies because of their advanced condition.
• At Stage IV, the focus revolves around managing symptoms and extending life as the cancer has spread to other organs.
Early identification is crucial to improving stomach cancer survival rates. Also, regular health checkups along with awareness of symptoms can make a huge impact.

How Stomach Cancer is Diagnosed

There are so many methods, including clinical checkup, imaging, and pathology are used for detecting stomach cancer.
1. Medical history & physical examination.
- Doctor examines symptoms like pain, weight loss, vomiting, bleeding, etc.
- Carefully observe any signs of abdominal discomfort, palpable mass, or anemia.
2.Endoscopy (upper GI endoscopy/esophagogastroduodenoscopy (EGD))
- An endoscope is inserted through the mouth to observe the stomach lining.
- A biopsy is used for examining unusual or suspicious lesions or ulcers under a microscope.
- This is the accepted standard for diagnosis.
3. Biopsy & Pathology
- Pathologists examine biopsy samples to confirm malignancy and subtype (e.g., adenocarcinoma, lymphoma) of the cancer.
- They also evaluate HER2 expression for possible targeted therapies.
4. Imaging Studies
- CT scans of abdomen, chest, and pelvis are used to differentiate between local & distant spread.
- Endoscopic ultrasonography (EUS) may determine the level of invasion and lymph node involvement.
- PET-CT can be used in some cases to detect metastasis.
5. Staging laparoscopy
- It is a form of minimally invasive surgery used to identify peritoneal spread or tiny metastasis that can't be detected on imaging.
- It may also entail cytology.
6. Laboratory tests
- Complete blood count (for anemia), liver and kidney function tests
- Tumor markers (e.g., CEA, CA 19-9) but not conclusive.
7. Molecular testing
- For HER2 status (using immunohistochemistry or FISH) is crucial for targeted treatment options.
- Further genetic or molecular profiling done as per the requirement of procedure.
Altogether, the combination of endoscopic biopsy, imaging, and other procedures help doctors to determination of stage & type of cancer help doctors to, confirm the diagnosis, and plan appropriate treatment options.

Treatment Options for Stomach Cancer

Treatment of stomach cancer is determined according to the cancer's stage, patient's overall health, tumor's location, and molecular features such as HER2 status etc. The most common treatment options are surgery, systemic therapy like chemotherapy and targeted/immunotherapy and radiation therapy. Sometimes these combine within an approach that is multidisciplinary.

Surgery

• Gastrectomy (partial or total): It is the primary treatment used in limited conditions which involves removing both the tumor and a zone of healthy tissue. In many situations, an area of the stomach (subtotal gastrectomy) or the entire stomach (total gastrectomy) is surgically eliminated.
• Lymph node dissection: Elimination of regional lymph nodes to prevent disease spread and reduce ongoing symptoms.
• Palliative surgery: It may reduce symptoms such as blockage, bleeding, or perforation in severe cases, even if cure is not possible.

Chemotherapy
• Neoadjuvant chemotherapy: It is done before surgery to reduce tumors size, improve outcomes, and prevent tumor growth.
• Adjuvant chemotherapy: Used after surgery to eliminate the remaining cancer cells and decrease recurrence risk.
• Systemic chemotherapy in metastatic cancer: It usually involves multi-drug regimens, like platinum & fluoropyrimidine combinations.
• Targeted therapy (HER2-targeted): For HER2-positive gastric tumors, Trasturel 440 mg injection (trastuzumab) can be combined with chemotherapy for enhanced results. Trasturel is a monoclonal antibody that targets the HER2 receptor and inhibits cancer cells from multiplying.

Radiation Therapy
• Adjuvant radiotherapy: Adjuvant radiation is commonly used after surgery (sometimes with chemotherapy) to prevent local recurrence, especially if margins are nearby or positive.
• Definitive radiotherapy (rare): Rarely used therapy that can control symptoms for persistent tumors, whether alone or with chemotherapy.
• Palliative radiotherapy: It improves symptoms like pain, bleeding, and blockages. Immunotherapy / Novel Therapies

• Immune checkpoint inhibitors: Drugs targeting PD-1/PD-L1 have shown potential effects in advanced or metastatic gastric cancer, particularly in tumors with high microsatellite instability (MSI)
• Additional monoclonal antibodies & antibody-drug conjugates are currently investigated.
• Clinical studies and molecularly targeted medicines may serve patients based on tumor genetics.
Many patients with locally advanced cancer get multidisciplinary treatment, that involves neoadjuvant chemo-radiation, surgery, & adjuvant chemotherapy or targeted therapy. Systemic therapy like chemotherapy with targeted/immunotherapy is the main therapy for metastatic cancer to improve survival rate and quality of life.
Routine examination, additional support such as nutrition & symptom management and imaging follow-up are all necessary throughout therapy.

Prevention Tips and Lifestyle Changes

Here are some of the easy strategies to reduce the risk of stomach cancer while keeping good gastric health:
• Treat H. pylori infections if identified with proper antibiotics course as prescribed by your doctor.
• Eat a balanced diet rich in fruits, vegetables, fiber, and antioxidants. Reduce your intake of salty, smoked, pickled, and processed foods.
• Limit salt and processed meats.
• Stopping smoking significantly decreases the chance of developing stomach cancer.
• Maintain moderate alcohol consumption by avoiding too much drinking.
• Maintain a healthy weight with involving in regular exercise to minimize the risk of obesity along with maintaining healthy BMI.
• Regular medical checkups are crucial if you have risk factors such as family history, constant gastritis, past stomach polyps and others. Regular examinations or observation endoscopy may be helpful.
• Use NSAIDs with precaution and under medical supervision to minimize stomach lining damage.
• Prioritize food hygiene and safety during storage, cooking, and handling to prevent contamination and carcinogen production.
• Always seek medical attention in case of constant reflux to prevent harm to the upper stomach-lower esophagus junction.
While not all circumstances can be avoided, these steps help to reduce risk and enhance early detection.

Living with Stomach Cancer

Living with stomach cancer entails many physical, emotional, and lifestyle challenges. Below are important considerations and strategies:
● Nutrition and eating adjustments
● Symptom management
● Emotional and psychological support
● Regular monitoring and follow-up
● Medication adherence
● Lifestyle modifications
● Managing treatment side-effects
● Palliative care and comfort
● Family involvement and support network
● Planning for survivorship or progression
Overall, a complete treatment that combines medical therapy with nutritional, psychological, and supporting strategies helps patients to live their lives to the fully and most comfortably.

Conclusion

Stomach cancer is a life threatening yet often silent condition which requires immediate attention, early detection, and a specific & multidisciplinary treatment approach. Recent Innovations in targeted therapy, like Trasturel 440 mg injection (a trastuzumab formulation), give hope to patients through enhancing the efficacy of treatment.
When choosing pharmaceuticals, patients must search for trusted pharmaceutical companies. For example Magicine Pharma is providing high-quality cancer therapies at online platform.
Trasturel 440 mg Injection prices vary by geographical region, supplier, and whether the medication is original or bio-similar. Always buy from approved pharmacies with prescription to ensure safety and authenticity.

FAQs

1.Can stomach cancer be curable completely?
Yes, stomach cancer can be cured if diagnosed in early stages. As it can be treated with surgical removal combined with chemotherapy or targeted therapy method and result in cure or long-term remission.

2. How common is HER2-positive gastric cancer?
Approximately 10–20 % of gastric adenocarcinomas overexpress HER2, making them eligible for HER2-targeted treatments like Trasturel (trastuzumab).

3. Is Trasturel 440 mg injection safe?
This is a generally safe injection under medical supervision. Though side effects such as cardiac toxicity, infusion reactions, and blood count changes may occur during the treatment.

4. How long does treatment last in case of stomach cancer?
Treatment duration determined by the doctor according to stage & type of cancer and method of treatment.

5. Should asymptomatic people get screened for stomach cancer?
In regions with high incidence such as East Asia, screening endoscopy is more common. In lower-risk regions, screening is considered only for high-risk individuals (family history, gastric atrophy, H. pylori).​

References

● American Cancer Society / Cancer.org — what is stomach cancer and types. Wikipedia+3American Cancer Society+3Cancer Australia+3
● Medline / PubMed / NCBI reviews on gastric cancer epidemiology and treatment. PMC+2NCBI+2
● Mayo Clinic on stomach cancer symptoms and causes. Mayo Clinic
● Axon, A. (2006). Symptoms and diagnosis of gastric cancer at early curable stage. Best practice & research Clinical gastroenterology, 20(4), 697-708.
● Paterson, H. J. (1910). The Early Diagnosis and Treatment of Cancer of the Stomach. The British Medical Journal, 953-955.