In Surgery for Stomach Cancer A new stomach is made out of tissues from intestine

The Stomach has five layers:-

  • Serosa or Outer Layer
  • Sub Serosa or Support Tissues for the Outer Layer
  • Muscles Layer
  • Sub Mucosa or Support Tissues for the Inner Layer
  • Mucosa or Inner Layer
Stomach Cancer normally begins in the Inner Layer of the Stomach. Stomach Cancer will spread through the stomach’s outer layer, into the nearby organs such as pancreas, esophagus and intestines. Also Stomach Cancer will spread through the blood stream to the liver, lungs, and other organs. Stomach Cancer spread to other organs will be still called Stomach Cancer or Metastatic Stomach Cancer.

The Causes of Stomach Cancer are unknown and the following are the Risk Factors for Stomach Cancer:-

  • Age: Mostly people above 72years get it
  • Sex: Men are more likely to get it
  • Race: It is common in Asian, Pacific Islander, Hispanic, and African Americans
  • Diet: Eating diet smoked, salted or pickled get it. Eating Fresh fruits and vegetables
  • Helicobacter Pylori infection
  • Smoking
  • Chronic Gastritis or Long Term Inflammation in stomach
  • Inflammation due to surgery
  • Pernicious Anemia
  • Family History
Symptoms of Stomach Cancer:-
There will not be any symptom in the initial stages of Stomach Cancer. The common symptoms of growing disease are:-
  • Discomfort in stomach
  • Feeling Stomachful or bloated even after a small intake of food
  • Nausea or Vomiting
  • Undue Weight Loss
Diagnosis of Stomach Cancer:-
The above symptoms need not be because of Stomach Cancer only. Other problems such as Ulcer and Infection also will have the same symptoms. In case of having the above symptoms, doctor must be consulted for diagnosis, whether it is Stomach Cancer or Ulcer or any other Infection. A Gastro-enterologist, the Specialist in diagnosing Digestive and other Stomach Problems will try to find out the disease, will do a Physical Examination and by the following Laboratory Tests:-
  • X Rays of Esophagus and Stomach with Barium taken in
  • Endoscopy of the stomach
  • Biopsy of the Tissues of the Stomach taken by endoscopy
After the Physical Examinations by the Doctor and the Laboratory Tests, if the disease is diagnosed as Stomach Cancer, to plan the best treatment, the r doctor needs to know the extent (stage) of the disease. The stage is based on whether the Cancer has invaded nearby tissues, whether the cancer has spread, and if so, to what parts of the body. Stomach cancer can spread to the lymph nodes, liver, pancreas, and other organs.

Stage 0: The cancer is found only in the inner layer of the stomach

Stage I is one of the following:-

  • The Cancer has invaded only the submucosa
  • Cancer cells may be found in up to 6 lymph nodes
  • The Cancer has invaded the muscle layer or subserosa. Cancer cells have not spread to lymph nodes or other organs.
Stage II is one of the following:-
  • The Cancer has invaded only the Submucosa. Cancer cells have spread to 7 to 15 lymph nodes
  • Cancer has invaded the muscle layer or Subserosa. Cancer cells have spread to 1 to 6 lymph nodes
  • The Cancer has penetrated the outer layer of the stomach. Cancer cells have not spread to lymph nodes or other organs
Stage III is one of the following:-
  • The tumor has invaded the muscle layer or subserosa. Cancer cells have spread to 7 to 15 lymph nodes.
  • The tumor has penetrated the outer layer. Cancer cells have spread to 1 to 15 lymph nodes.
  • The tumor has invaded nearby organs, such as the liver or spleen. Cancer cells have not spread to lymph nodes or to distant organs
Stage IV is one of the following:-
  • The Cancer cells have spread to more than 15 lymph nodes
  • The Cancer has invaded nearby organs and at least 1 lymph node
  • The Cancer cells have spread to distant organs
Recurrent cancer:- The cancer has come back (recurred) after a period of time when it could not be detected. It may recur in the stomach or in another part of the body.

If it is confirmed that the disease is Stomach Cancer the next step is Treatment for Cancer. The Patient must have a detailed discussion on the treatment for the Stomach Cancer and it is advisable to have the close relatives of the patient, in the discussions and planning for the treatment.

It is advisable to get a Second Opinion on the Diagnosis and the Plan for the Treatment of Stomach Cancer.

The Method of Treatment for Stomach Cancer depends on the size and the place of Cancer, the Stage of Cancer and your General Health. Treatment for stomach cancer will involve one of the following, depending on individual cases:-

  • Surgery
  • Chemotherapy
  • Radiation therapy
The doctor will explain in detail the treatment choices and the expected results. The Patient and the doctor should work together to develop a treatment plan that meets the patient’s needs.
Cancer treatment will be either local therapy or systemic therapy.

Local therapy:- Surgery and radiation therapy are local therapies. They remove or destroy cancer in or near the stomach. When stomach cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.

Systemic therapy:- Chemotherapy is systemic therapy. The drug enters the bloodstream and destroys or controls cancer throughout the body.

Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each person, and they may change from one treatment session to the next.

Before treatment starts, the health care team will explain possible side effects and suggest ways to help the patient to you manage them. National Cancer Institute (NCI) provides helpful booklets about cancer treatments and coping with side effects. These include “Chemotherapy and You”, “Radiation Therapy and You”, and “Eating Hints for Cancer Patients”.

At any stage of the disease, supportive care is available to relieve the side effects of the treatment, to control pain and other symptoms, and to ease emotional concerns.

Surgery is the most common treatment for stomach cancer. The type of surgery depends on the extent of the cancer. There are two main types of stomach cancer surgery:-

  • Partial (subtotal) gastrectomy:- The surgeon removes the part of the stomach with cancer. The surgeon also may remove part of the esophagus or part of the small intestine. Nearby lymph nodes and other tissues may be removed.
  • Total gastrectomy:- The doctor removes the entire stomach, nearby lymph nodes, parts of the esophagus and small intestine, and other tissues near the tumor. The spleen also may be removed. The surgeon then connects the esophagus directly to the small intestine. The surgeon makes a new “stomach” out of tissue from the intestine.
It is but natural to be concerned about eating after surgery for stomach cancer. During surgery, the surgeon may place a feeding tube into the small intestine. This tube helps the patient to get enough nutrition while healing.

The time it takes to heal after surgery is different for each person. The patient may be uncomfortable for the first few days. Medicine can help control the pain. Before surgery, the patient should discuss the plan for pain relief with the doctor. After surgery, the doctor will adjust the plan if the patient needs more pain relief.

Many people who have stomach surgery feel tired or weak for sometime. The surgery also can cause constipation or diarrhea. These symptoms can be controlled with diet changes and medicines. The health care team will watch for signs of bleeding, infection, or other problems that may require treatment.

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