Importance of early diagnosis and screening to treat stomach cancer

By Dr. Santosh B Chikaraddi, Senior Consultant Medical Oncology, HCG NMR Cancer Centre, Hubli
Almost everyone has experienced stomach pain at some point of time or the other. Stomach is an important part of the human body and is significantly linked to overall health and disease. Stomach pain could be a sign of a wide range of health issues, and this could also be due to multiple reasons and can be the cause of concern if it continues. As a result, preventive measures that people take in the case of other cancers are ignored when it comes to stomach cancer. The reason for this is not far to seek. Due to several misconceptions about stomach cancer, people fail to identify and interpret the symptoms early enough. Thus, there are delayed diagnoses of the cancers which often happens only in their terminal stages.
Beginning with the abnormal growth of the cells lining the inner layer, it slowly, but surely spreads outwards and then onto other organs around it. Hence, right at the outset when the symptoms such as abdominal pain is dismissed as mere a case of indigestion, thus increasing the risk of stomach cancer. It’s an onerous task to regulate the triggers of the cancer as the symptoms include indigestion, fatigue, or unexplained weight loss. They get interpreted as other common gastric diseases. For instance, the repeated instances of indigestion could result from a bacterial infection in the stomach. 

The cancers
The most common stomach cancer is adenocarcinoma, a cancer of the glands that produces the mucus, digestive juices, and other fluids. This accounts for 90% of stomach cancers. This form of cancer originates in the tissue lining the cavities and surfaces of the organs. The other form of stomach cancers includes the Gastric lymphomas i.e. the cancers of the immune system, and the rare one called the Carcinoid (cancerous) tumours which originate in the nervous system and endocrine system. Yet another is the Gastrointestinal stromal tumours or GIST that form in the stomach wall.
The treatments of these cancers depend on the stage at which it has been diagnosed, and the current stage. The removal of a part or the whole stomach is often the most common form of treatment. But, chemotherapy, radiation therapy and medications are administered to kill the cancer cells and prevent them from recurring.

Identifying the Symptoms
It’s no mean task to diagnose stomach cancer at the initial stages as most of the symptoms are very similar to many other more common infections, particularly those of the gastro-intestinal tract. As there are few or no symptoms, they are difficult to identify. But it starts to show signs that cannot be ignored. These would include abdominal pain near the belly button, unintentional weight loss, heartburn and chronic indigestion, blood in vomit and feeling full after eating small meals, fatigue, and loss of appetite. The doctor must be consulted if these symptoms persist to initiate treatment after the diagnosis.
Once the stomach cancer begins to spread to the liver and the colon, it can create a blockage and lead to ascites i.e., enlarged liver with fluid and jaundice.

Causes
Among the major causes of the cancer include lifestyle and diet choices, genetics, and a family history. While the risk factors emanating from lifestyle choices can be mitigated by making healthier changes, for others, it is important to seek immediate medical attention and get diagnosed.
•    Role of Diet, Lifestyle
Diet and lifestyle choices are integral to our good health or sickness. Preserved foods, including cured meats, salty, smoked, or pickled foods could contain carcinogens. Consuming fresh fruits and vegetables and less processed foods help to keep the stomach healthy. Experts suggest the method of preserving food through refrigeration also contributes towards the rise in stomach cancer cases. Quitting smoking and tobacco consumption can prove vital for one’s health and cut the risk factors of many organs in the gastro-intestinal tract and keep them safe.
Other than poor lifestyles and diets, there are several health conditions of the stomach that can up stomach cancer risk. Factors that increase the risk of stomach cancers include conditions like stomach polyps, stomach surgeries to excise ulcers, megaloblastic anaemia which is characterised by the presence of non-absorbing cells of Vitamin-B12. 
●       Genetics
Stomach cancer, just as any other, can be genetic. Understanding genetics, the family history of diseases and cancers can determine if stomach cancer has been passed on from generation to generation. These offspring are also at higher risk of developing colorectal cancer, the familial adenomatous polyposis, or polyps in the large intestine, BRCA1 and BRCA2 gene mutations. Counselling by experts on the risk factors can help to take necessary actions to prevent the cancer from spreading and recurring.

Treatment
Stomach cancer may be treated using methods like surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy to cure a cancer, shrink a cancer or stop the progression of a cancer. Depending on the situation and the extent of the spread, patients may receive one treatment, or may receive a combination of treatments.

Prevention
Cancer is curable and if diagnosed in the early stages and if the right treatment is given on time, it can prevent the spread of the cancer that is affecting other parts of the body. In case of any symptom or doubts about the occurrence, one needs to seek immediate medical attention to rule out the worse.