Stomach Cancer

Stomach cancer, also known as gastric cancer, occurs due to uncontrolled growth of cells in the stomach's inner lining. It is common for this uncontrolled cell growth to start from a gastric ulcer, so prevention begins with thorough examination of these types of lesions.

The stages of stomach cancer, which classify the disease according to its severity, are:

• Stage 0: Known as carcinoma in situ, this is the initial phase of the cancer. In these cases, the tumor is only found on the superficial part of the mucosa, which is the inner layer.
• Stage I: Affects the mucosa and the middle layer of muscle tissue, without reaching the serosa, which is the deepest layer.
• Stage II: In addition to affecting the two inner layers of the stomach, cancerous cells spread to nearby lymph nodes.
• Stage III: The cancer extends to the serosa and nearby lymph nodes. Sometimes, it spreads to adjacent organs such as the liver, colon, or spleen.
• Stage IV or metastatic: This is the most advanced and worst prognosis stage, as it affects all layers of the stomach, distant lymph nodes, and more distant organs such as the lungs.

Despite its higher incidence in other countries, stomach cancer is one of the least common cancers in Spain, with about 7,865 cases per year according to data from the Spanish Association Against Cancer.

The prognosis varies depending on when it is detected. Currently, stomach cancer is often diagnosed when it has already spread to other nearby organs because it does not show early symptoms. Therefore, the 5-year survival rate is 31% (5% if metastasis reaches distant organs). When discovered before spreading, this percentage increases to 67%.

Symptoms

Gastric cancer, especially in its early stages, does not present symptoms or, at least, they are not specific and can be attributed to other conditions. The most notable symptoms are:

• Stomach pain
• Feeling of fullness (even when not overeating)
• Unexplained weight loss
• Nausea and vomiting
• Fatigue
• Anemia
• Blood loss, causing darker stools

Causes

Although the exact causes are unknown, stomach cancer occurs when the tissue lining its interior deteriorates, either due to infection or injury, such as an ulcer. Depending on the affected cells, gastric cancer is divided into:

• Stomach Adenocarcinoma: Affects the mucous tissue. It is the most common type.
• Gastrointestinal Stromal Tumor (GIST): A soft tissue sarcoma that damages the nerve cells of the stomach wall.
• Stomach Carcinoid Tumor: Damages the neuroendocrine cells that produce hormones controlling gastric juice and the movement of digestive tract muscles.
• Stomach Lymphoma or LTAM: Originates in mucosal cells that produce antibodies. Most gastric lymphomas are non-Hodgkin's.

Risk Factors

Stomach cancer can affect anyone, but the risk increases in the following cases:

• People over 60 years old
• Men
• Family history
• Benign stomach conditions (ulcers, Crohn's disease, diverticulitis, inflammatory bowel disease, gastric polyps, gastritis)
• Helicobacter pylori infection
• Alcohol
• Smoking
• Obesity
• Poor diet: diet rich in salt or smoked foods and low in fruits and vegetables

Complications

When stomach cancer is not treated in time or does not respond adequately to treatments, it can metastasize to other organs in the body and lead to death.

Prevention

Some advice to prevent stomach cancer includes:

• Quit smoking. Avoid tobacco and alcohol.
• Exercise regularly.
• Increase the consumption of fruits and vegetables.
• Reduce the intake of smoked or salted foods.
• Participate in routine screenings when there is a family history of stomach cancer.

Which doctor treats stomach cancer?

Stomach cancer is usually diagnosed by a gastroenterologist, and it requires a multidisciplinary approach involving medical oncologists, radiotherapy oncologists, general surgeons, digestive system surgeons, and palliative care specialists.