Stages and treatment of stomach cancer

by Irshad KK Digital Marketing

The treatment of stomach cancer depends on two main factors. These are the

Type of cancer
Stage of cancer

Types of stomach cancer

There are four common types of stomach cancer:

Adenocarcinomas: These develop in the cells in the lining of the stomach. Adenocarcinomas are the most common type of stomach cancer, making up almost 85 % of all stomach cancer.

Lymphomas: Lymphomas begin in the immune system tissues of the body and can develop in the lymph tissues of the stomach. It is an extremely rare form of stomach cancer.

Gastrointestinal stromal tumors: It is a very rare form of cancer that develops in the interstitial cells of Cajal (ICCs). ICCs are special cells found in the lining of the stomach.

Carcinoid tumors: These tumors develop in the stomach's hormone-producing cells. These are of three types – Type I ECL, Type II ECL, Type III ECL (this is an extremely aggressive form). Again, this is a rare form of stomach cancer.

Stages of stomach cancer:

Stage 0- also called carcinoma in situ. The cancer cells are limited to the superficial layer of the stomach lining

Stage 1-the cancer has spread to deeper layers with the involvement of 1 or 2 lymph nodes

Stage 2- cancer has spread into deeper layers with the involvement of lymph nodes

Stage 3- cancer has gone deep and may involve lymph nodes and adjacent organs.

Stage 4- cancer has spread to other parts of the body like lungs, liver, brain, etc.

Treatment for stomach cancer

Stomach cancer treatment includes surgery, chemotherapy, radiation therapy, medications, and targeted therapy.

Surgery- Surgery is the most preferred treatment for stomach cancer. Early-stage to stage 3 stomach cancers respond well to surgery. There may be chemotherapy or radiation treatment before and after the surgery. There are various types of surgery for stomach cancer depends on the stage of the disease.

The most common surgical techniques practiced for stomach cancer are:

Endoscopic mucosal resection: This is an option for early-stage cancer that is non-invasive. In this procedure, the doctor will insert an endoscope through the mouth into the stomach. They will then remove the mucosal lining affected by cancer. The benefits are an early recovery and fewer side effects.

Subtotal (partial) gastrectomy: It is a procedure to remove a part or whole of the stomach. In subtotal gastrectomy, the surgeon will remove the part of the stomach and the adjacent lymph nodes affected by cancer.

Total gastrectomy: In this technique, the surgeon will remove the entire stomach and nearby lymph nodes. Sometimes, they will remove the spleen, parts of the esophagus, intestines, pancreas, and other organs where cancer has spread.

The surgeon will then connect the oesophagus to the small intestine. A part of the intestine is modeled into the form of a stomach to allow one to eat.

At times surgery cannot completely remove an obstructive stomach tumor. The options in such cases are Endoluminal stent placement and Endoluminal laser therapy.

Chemotherapy- Chemotherapy can be given either before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy). Neoadjuvant chemotherapy helps to shrink the tumor and helps make surgery easier. Adjuvant chemotherapy aims to kill any cancer cells that may have been left behind but too small.

Chemoradiation, a combination of chemotherapy and radiation, is done for cancers that could not be removed completely by surgery.

Chemotherapy is the primary treatment for stomach cancer that has spread to distant organs. It will help shrink the cancerous cells or slow their growth. It thus helps in relieving symptoms for few patients and helps them live longer. Each cycle of chemotherapy typically lasts for a few weeks. With each period of treatment, there will be a rest period to allow the body to recover.

Radiation therapy - Radiation therapy uses very high energy rays or particles to kill cancer cells. Radiation may be done along with chemotherapy to try to shrink the tumor before. Radiation therapy destroys very small remnants of cancer that cannot be seen and removed during surgery.

Radiation therapy is also a palliative procedure in advanced stage stomach cancer. The aim is to slow the growth of tumors and ease the symptoms like pain, bleeding, and eating problems.

Other treatments for stomach cancer:

Targeted therapy tries to destroy cancer cells by inhibiting the formation of certain proteins that help them grow.

Immunotherapy tries to improve the body's immunity through the administration of certain drugs. This improved immunity helps the body to fight the cancer cells.