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Stomach Cancer Causes

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<h3>
Types of Stomach Cancer</h3>
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The cells that form the tumor determine the type of stomach cancer. The type of cells in your <a href="http://cancer-666.blogspot.com/search/label/Stomach%20Cancer" rel="nofollow" target="_blank">stomach cancer</a> helps determine your treatment options. Types of stomach cancer include: Stomach Cancer Causes 
<ul>
<li>Cancer that begins in hormone-producing cells (carcinoid cancer) 
Hormone-producing cells can develop carcinoid cancer. Carcinoid cancer in the stomach is rare.</li>
<li>Cancer that begins in immune system cells (lymphoma) 
The walls of the stomach contain a small number of immune system cells that can develop cancer. Lymphoma in the stomach is rare.</li>
<li>Cancer that begins in nervous system tissues 
A gastrointestinal stromal tumor (GIST) begins in specific nervous system cells found in your stomach. GIST is a rare form of stomach cancer.</li>
<li>Cancer that begins in the glandular cells (adenocarcinoma) 
The glandular cells that line the inside of the stomach secrete a protective layer of mucus to shield the lining of the stomach from the acidic digestive juices. Adenocarcinoma accounts for the great majority of all stomach cancers.</li>
</ul>
Because the other types of stomach cancer are rare, when people use the term "stomach cancer" they generally are referring to adenocarcinoma. 
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<h3>
Do we know what causes stomach cancer?</h3>
There are many known <a href="http://cancer-666.blogspot.com/2014/07/stomach-cancer-risk-factors.html" target="_blank">risk factors for stomach cancer</a>, but it is not known exactly how these factors cause cells of the stomach lining to become cancerous. This is the subject of ongoing research. Several changes thought to be pre-cancerous can occur in the stomach lining. 
 
In chronic atrophic gastritis, the normal glands of the stomach are either decreased or absent. There is also some degree of inflammation (the stomach cells are damaged by cells of the immune system). Atrophic gastritis is often caused by H pylori infection. It can also be caused by an autoimmune reaction, in which a person’s immune system attacks the cells lining the stomach. Some people with this condition go on to develop pernicious anemia or other stomach problems, including cancer. It is not known exactly how this condition might progress to cancer. Stomach Cancer Causes 
 
Another possible pre-cancerous change is intestinal metaplasia. In this condition, the normal lining of the stomach is replaced with cells that closely resemble the cells that usually line the intestine. People with this condition usually have chronic atrophic gastritis as well. How and why this change occurs and progresses to stomach cancer is not well understood. This might also be related to H pylori infection. 
 
Recent research has provided clues on how some stomach cancers form. For instance, H pylori bacteria, particularly certain subtypes, can convert substances in some foods into chemicals that cause mutations (changes) in the DNA of the cells in the stomach lining. This may also explain why certain foods such as preserved meats increase a person’s risk for stomach cancer. On the other hand, some of the foods that might lower stomach cancer risk, such as fruits and vegetables, contain antioxidants that can block substances that damage a cell’s DNA. 
<h3>
 
</h3>
<h3>
How stomach cancer spreads?</h3>
There are three ways stomach cancer can spread: 
<ul>
<li>Directly 
The cancer can spread from the stomach into nearby tissues and organs, such as the pancreas, colon, small intestine and peritoneum (the lining of the inside of the abdominal cavity). </li>
<li>Through the lymphatic system 
The lymphatic system is a series of glands (nodes) located throughout your body, similar to the blood circulatory system; glands produce many specialised cells needed by your immune system to fight infection.</li>
<li>Through the blood 
Which can cause the cancer to spread from the stomach to other parts of the body, most commonly the liver.</li>
</ul>
Stomach cancer that spreads to another part of the body is known as metastatic stomach cancer. Stomach Cancer Causes</div>
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Stomach Cancer Causes

Types of Stomach Cancer The cells that form the tumor determine the type of stomach cancer. The type of cells in your stomach cancer ...

Stomach Cancer Risk Factors

ancorez Stomach Cancer 7:29 PM

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A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed. But risk factors don’t tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. And many people who get the disease may have few or no known risk factors. Stomach Cancer Risk Factors. 
 
Scientists have found several risk factors that make a person more likely to get stomach cancer. Some of these can be controlled, but others cannot. The following factors may raise a person’s risk of developing stomach cancer: 
 
 • A Family History of Stomach Cancer 
 
Family history is being looked at as a risk factor for stomach cancer. Brothers, sisters, and children, of people with stomach cancer have an increased risk of getting it themselves. We're not sure whether this is genetic, or because they share other risk factors, such as Helicobacter pylori infection. 
 
• Age 
 
Stomach cancer occurs most commonly in people older than 55. Most people diagnosed with stomach cancer are in their 60s and 70s. 
 
• Anti Inflammatory Drugs 
 
An overview of published studies showed that people who regularly take non steroidal anti inflammatory drugs appear to have a slightly lower risk of stomach cancer. These drugs are called NSAIDs. Examples are aspirin, ibuprofen or Nurofen. Researchers in 2010 reviewed the trials looking at whether daily aspirin can protect against health conditions. They found that taking daily aspirin may reduce the risk of dying from stomach cancer. This needs more research though, and regular use of NSAIDs can increase the risk of developing stomach or duodenal ulcers. 
 
• Being Overweight or Obesity 
 
Excess body weight increases a man’s risk of developing stomach cancer. It is not clear whether obesity increases a woman’s risk of stomach cancer. 
 
• Certain Occupations 
 
Workers in the coal, metal, and rubber industries seem to have a higher risk of getting stomach cancer. 
 
• Common Variable Immune Deficiency (CVID) 
 
People with CVID have an increased risk of stomach cancer. The immune system of someone with CVID can’t make enough antibodies in response to germs. People with CVID have frequent infections as well as other problems, including atrophic gastritis and pernicious anemia. They are also more likely to get gastric lymphoma and stomach cancer. 
 
• Diet 
 
The incidence of stomach cancer in the UK has fallen a great deal since the 1970s. This is probably partly due to better diet. Incidence varies from country to country around the world. This may be explained to some extent by differences in diet. A diet high in very salty foods increases the risk of stomach cancer. Stomach cancer levels are very high in Japan where very salty pickled foods are popular. But these foods are not typically eaten in the UK and stomach cancer rates here are lower than in Japan. 
 
A diet high in certain preserved foods may also increase your risk. Several studies and a large ongoing research study called EPIC have found a small increase in the risk of stomach cancer in people who eat a lot of preserved meat. Preserved meat includes bacon, sausages and ham. These meats contain chemicals called nitrosamines, which have been linked to stomach cancer. A Canadian study found that the increased risk was greatest in people infected with Helicobacter pylori bacteria. Eating a lot of pickled foods may also increase the risk. 
 
A recent study showed that vegetarians may have a lower risk of stomach cancer than meat eaters. And the EPIC study showed an increased risk of stomach cancer for people who eat a lot of red meat. But we need more studies to confirm this. 
 
A diet high in fresh fruit and vegetables seems to reduce the risk of stomach cancer. This may be because these foods contain high levels of antioxidant vitamins. Vitamin C in particular, together with other substances in these fresh foods, may help to prevent damage to the stomach lining that can lead to cancer. Vitamin A has been shown to protect against stomach cancer. One study has also suggested that vitamin B6 may have a protective effect. Research studies have shown that antioxidant vitamins may have the greatest protective effect in people who are under nourished. Antioxident vitamins help in well nourished people too, but their effects are likely to be less. This may explain why some recent studies in America and Europe found no association between fruit and vegetable intake and stomach cancer risk. 
 
• Epstein-Barr Virus (EBV) Infection 
 
Epstein-Barr virus causes infectious mononucleosis (also called mono). Almost all adults have been infected with this virus at some time in their lives, usually as children or teens. EBV has been linked to some forms of lymphoma. It is also found in the cancer cells of about 5% to 10% of people with stomach cancer. These people tend to have a slower growing, less aggressive cancer with a lower tendency to spread. EBV has been found in some stomach cancer cells, but it isn’t yet clear if this virus actually causes stomach cancer. 
 
• Ethnicity/Race 
 
Black people are more likely than white people to develop stomach cancer. 
 
• Gender 
 
Men have twice the risk of developing stomach cancer, compared with women. 
 
• Geography 
 
Worldwide, stomach cancer is more common in Japan, China, Southern and Eastern Europe, and South and Central America. This disease is less common in Northern and Western Africa, South Central Asia, and North America. 
 
• Helicobacter Pylori Infection 
 
Helicobacter pylori is a bacterial infection that has been investigated a lot in the past few years. Infection with this type of bacteria increases the risk of stomach cancer in the lower part of the stomach by around 6 times. Infection with a particular type of HP called cagA positive helicobacter pylori may increase the risk even more. Stomach Cancer Risk Factors. 
 
Millions of people are infected with these bacteria and most of those do not get stomach cancer so other factors must also be at work. Diet and smoking may interact with HP to cause stomach cancer. The bacteria can cause an inflammatory condition called severe chronic atrophic gastritis (SCAG) and this can lead to stomach cancer. People with SCAG have an increased risk of stomach cancer in both the upper and lower parts of the stomach. 
 
Helicobacter infection can be shown on a blood test or a breath test. It can usually be cured fairly easily with a course of antibiotic treatment. But we're not really sure yet how much benefit we get from getting rid of it. HP may protect against a particular type of cancer of the food pipe (oesophagus) called adenocarcinoma of the oesophagus. A meta analysis of studies looking at HP treatment showed that it lowered the risk of stomach cancer a little bit but it may be most effective in people with peptic ulcer or pre cancerous changes. Even if you do have it treated, there is a chance that you will get re infected because it is so common. So your doctor may not treat HP unless you have stomach pains (a symptom of peptic ulcer). 
 
• Hormone Replacement Therapy (HRT) 
 
Women who take hormone replacement therapy (HRT) have a reduced risk of stomach cancer. But HRT increases the risk of some other types of cancer, including breast cancer. 
 
• Inherited Cancer Syndromes 
 
Some inherited conditions may raise a person’s risk of stomach cancer. 
<ul>
<li>BRCA1 and BRCA2 
People who carry mutations of the inherited breast cancer genes BRCA1 or BRCA2 may also have a higher rate of stomach cancer.</li>
<li>Familial adenomatous polyposis (FAP) 
In FAP syndrome, people get many polyps in the colon, and sometimes in the stomach and intestines as well. People with this syndrome are at greatly increased risk of getting colorectal cancer and have a slightly increased risk of getting stomach cancer. It is caused by mutations in the APC gene.</li>
<li>Hereditary diffuse gastric cancer 
This inherited syndrome greatly increases the risk of developing stomach cancer. This condition is rare, but the lifetime stomach cancer risk among affected people is about 70% to 80%. Women with this syndrome also have an increased risk of getting a certain type of breast cancer. This condition is caused by mutations (defects) in the CDH1 gene. </li>
<li>Hereditary non-polyposis colorectal cancer (HNPCC) 
HNPCC, also known as Lynch syndrome, is an inherited genetic disorder that increases the risk of colorectal cancer. People with this syndrome also have an increased risk of getting stomach cancer (as well as some other cancers). In most cases, this disorder is caused by a defect in either the MLH1 or MSH2 gene, but other genes can cause HNPCC, including MLH3, MSH6, TGFBR2, PMS1, and PMS2.</li>
<li>Li-Fraumeni syndrome 
People with this syndrome have an increased risk of several types of cancer, including developing stomach cancer at a relatively young age. Li-Fraumeni syndrome is caused by a mutation in the TP53 gene.</li>
<li>Peutz-Jeghers syndrome (PJS) 
People with this condition develop polyps in the stomach and intestines, as well as in other areas including the nose, the airways of the lungs, and the bladder. The polyps in the stomach and intestines are a special type called hamartomas. They can cause problems like bleeding or blockage of the intestines. PJS can also cause dark freckle-like spots on the lips, inner cheeks and other areas. People with PJS have an increased risk of cancers of the breast, colon, pancreas, stomach, and several other organs. This syndrome is caused by mutations in the gene STK1.</li>
</ul>
 
• Menetrier Disease (Hypertrophic Gastropathy) 
 
In this condition, excess growth of the stomach lining causes large folds in the lining and leads to low levels of stomach acid. Because this disease is very rare, it is not known exactly how much this increases the risk of stomach cancer. 
 
• Pernicious Anemia 
 
Certain cells in the stomach lining normally make a substance called intrinsic factor (IF) that we need to absorb vitamin B12 from foods. People without enough IF may end up with a vitamin B12 deficiency, which affects the body’s ability to make new red blood cells and can cause other problems as well. This condition is called pernicious anemia. Along with anemia (too few red blood cells), people with this disease have an increased risk of stomach cancer. 
 
• Previous Stomach Surgery 
 
Stomach cancers are more likely to develop in people who have had part of their stomach removed to treat non-cancerous diseases such as ulcers. This might be because the stomach makes less acid, which allows more nitrite-producing bacteria to be present. Reflux (backup) of bile from the small intestine into the stomach after surgery might also add to the increased risk. These cancers typically develop many years after the surgery. 
 
 • Radiation Exposure 
 
Atomic bomb survivors in the 2nd World War were more likely to get stomach cancer because of the radiation they were exposed to. And we've known for many years that people who have had radiotherapy to the spine for a condition called ankylosing spondylitis have an increased risk. 
 
Stomach cancer has also been linked to medical X-ray exposure in the past. These days, the amount of radiation used in a regular X-ray is much lower than it used to be. But some other medical tests, such as CT scans, use a significant amount of radiation. This is not harmful to you if you have scans only when you need them. But it explains why doctors are reluctant to use scans for routine screening. 
 
• Some Types of Stomach Polyps 
 
Polyps are non-cancerous growths on the lining of the stomach. Most types of polyps (such as hyperplastic polyps or inflammatory polyps) do not seem to increase a person’s risk of stomach cancer, but adenomatous polyps – also called adenomas – can sometimes develop into cancer. 
 
• Stomach Lymphoma 
 
People who have had a certain type of lymphoma of the stomach known as mucosa-associated lymphoid tissue (MALT) lymphoma have an increased risk of getting adenocarcinoma of the stomach. This is probably because MALT lymphoma of the stomach is caused by infection with H pylori bacteria. 
 
• Tobacco and Alcohol Use 
 
Cigarette smoke contains many cancer causing chemicals. When you breathe in cigarette smoke, you will always swallow some of it without meaning to. In that way, smoking can increase the risk of stomach cancer. About 1 in 5 stomach cancers (20%) in the UK is thought to be caused by smoking. 
 
People who smoke have around twice the risk of stomach cancer compared to non smokers. The risk falls if you stop smoking. If smokers have HP infection, they may have more than 10 times the risk of non smokers without HP infection. A Swedish study showed that non smokers who use a type of chewing tobacco called snus increase their risk of stomach cancer by up to a half. From recent research it seems unlikely that drinking alcohol increases the risk of stomach cancer. 
 
• Type A Blood 
 
Blood type groups refer to certain substances that are normally present on the surface of red blood cells and some other types of cells. These groups are important in matching blood for transfusions. For unknown reasons, people with type A blood have a higher risk of getting stomach cancer. Stomach Cancer Risk Factors. 
 </div>
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Stomach Cancer Risk Factors

A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. S...

The Stages of Stomach Cancer

ancorez Stomach Cancer 6:41 PM

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Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery. The Stages of Stomach Cancer. 
 
There are different stage descriptions for different types of cancer. This section covers staging of adenocarcinoma, the most common type of stomach cancer. Staging is different for gastric lymphoma, sarcoma, and carcinoid tumors. 
 
<h3>
TNM Stages of Stomach Cancer</h3>
The system most often used to stage stomach cancer in the United States is the American Joint Commission on Cancer (AJCC) TNM system. The TNM system for staging contains 3 key pieces of information: 
<ul>
<li>T describes the extent of the primary tumor (how far it has grown into the wall of the stomach and into nearby organs).</li>
<li>N describes the spread to nearby (regional) lymph nodes.</li>
<li>M indicates whether the cancer has metastasized (spread) to distant parts of the body. The most common sites of distant spread of stomach cancer are the liver, the peritoneum (the lining of the space around the digestive organs), and distant lymph nodes. Less common sites of spread include the lungs and brain.</li>
</ul>
Numbers or letters appear after T, N, and M to provide more details about each of these factors: 
<ul>
<li>The numbers 0 through 4 indicate increasing severity.</li>
<li>The letter X means “cannot be assessed” because the information is not available.</li>
<li>The letters “is” refer to carcinoma in situ, which means the tumor is only in the top layer of mucosa cells and has not yet invaded deeper layers of tissue.</li>
</ul>
This system is for staging all stomach cancers except those starting in either the gastroesophageal junction (where the stomach and the esophagus meet) or in the cardia (the first part of the stomach) and growing into the gastroesophageal junction. Those cancers are staged (and often treated) like cancers of the esophagus. 
 
• T categories of stomach cancer 
 
Using the TNM system, the “T” plus a letter or number (0 to 4) is used to describe the how far the tumor has grown into the stomach. Some stages are also divided into smaller groups that help describe the tumor in even more detail. The T category describes how far through the stomach’s 5 layers the cancer has invaded. 
<ul>
<li>The innermost layer is the mucosa. The mucosa has 3 parts: epithelial cells, which lie on top of a layer of connective tissue (the lamina propria), which is on top of a thin layer of muscle (the muscularis mucosa).</li>
<li>Under the mucosa is a supporting layer called the submucosa.</li>
<li>Below this is the muscularis propria, a thick layer of muscle that moves and mixes the stomach contents.</li>
<li>The next 2 layers, the subserosa and the outermost serosa, act as wrapping layers for the stomach.</li>
</ul>
Specific tumor stage information is listed below: 
<ul>
<li>TX: The primary tumor cannot be evaluated.</li>
<li>T0 (T plus zero): There is no evidence of a primary tumor in the stomach.</li>
<li>Tis: This stage describes a condition called carcinoma (cancer) in situ. The cancer is found only in cells on the surface of the inner lining of the stomach called the epithelium and has not spread to any other layers of the stomach.</li>
<li>T1: The tumor has grown into the lamina propria, muscularis mucosae, or the submucosa, which are the inner layers of the wall of the stomach. 
<ul>
<li> T1a: The tumor is growing into the lamina propria or muscularis mucosa.</li>
<li> T1b: The tumor has grown through the lamina propria and muscularis mucosa and into the submucosa.</li>
</ul>
</li>
<li>T2: The tumor has grown into the muscularis propria, the muscle layer of the stomach.</li>
<li>T3: The tumor has grown through all of the layers of the muscle into the connective tissue outside the stomach, but it has not grown into the lining of the abdomen, called the peritoneal lining, or into the serosa, which is the outer layer of the stomach.</li>
<li>T4: The tumor has grown through all of the layers of the muscle into the connective tissue outside the stomach and has grown into the peritoneal lining or serosa or the organs surrounding the stomach 
<ul>
<li> T4a: The tumor has grown through the stomach wall into the serosa, but the cancer hasn’t grown into any of the nearby organs or structures.</li>
<li> T4b: The tumor has grown through the stomach wall and into nearby organs or structures.</li>
</ul>
</li>
</ul>
 
• N categories of stomach cancer 
 
The “N” in the TNM staging system is for lymph nodes, the tiny, bean-shaped organs that help fight infection. Lymph nodes inside the abdomen are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes. The overall prognosis for patients with stomach cancer is based on how many regional lymph nodes show signs of cancer. If six lymph nodes or fewer have cancer, the prognosis is better than if more than 15 lymph nodes contain cancer cells. 
<ul>
<li>NX: Nearby (regional) lymph nodes cannot be assessed.</li>
<li>N0: No spread to nearby lymph nodes.</li>
<li>N1: The cancer has spread to 1 to 2 nearby lymph nodes.</li>
<li>N2: The cancer has spread to 3 to 6 nearby lymph nodes.</li>
<li>N3: The cancer has spread 7 or more nearby lymph nodes. 
<ul>
<li> N3a: The cancer has spread to seven to 15 regional lymph nodes.</li>
<li> N3b: The cancer has spread to 16 or more regional lymph nodes.</li>
</ul>
</li>
</ul>
 
• M categories of stomach cancer 
 
The “M” in the TNM system indicates whether the cancer has spread to other parts of the body. 
<ul>
<li>MX: Distant metastasis cannot be evaluated.</li>
<li>M0 (M plus zero): No distant metastasis (the cancer has not spread to distant organs or sites, such as the liver, lungs, or brain).</li>
<li>M1: The cancer has spread to another part or parts of the body.</li>
</ul>
 
<h3>
Stomach Cancer Stage Grouping</h3>
Once the T, N, and M categories have been determined, this information is combined and expressed as a stage, using the number 0 (zero) and the Roman numerals I through IV. This is known as stage grouping. Some stages are split into substages, indicated by letters. The Stages of Stomach Cancer. 
 
• Stage 0: This is also called carcinoma in situ. The cancer is found only on the surface of the epithelium. The cancer has not grown into any other layers of the stomach and is considered an early cancer (Tis, N0, M0). 
 
• Stage IA: The cancer has grown into the inner layer of the wall of the stomach, but it has not spread to any lymph nodes or other organs (T1, N0, M0). 
 
• Stage IB: Stomach cancer is called stage IB in either of these two conditions: 
<ul>
<li>T1, N1, M0: The cancer has grown into the layer of connective tissue (lamina propria), and may have grown into the thin layer of muscle beneath it (muscularis mucosa) or deeper into the submucosa (T1). Cancer has also spread to 1 or 2 lymph nodes near the stomach (N1), but not to any distant tissues or organs (M0).</li>
<li>T2, N0, M0: The cancer has grown into the main muscle layer of the stomach wall, called the muscularis propria (T2). It has not spread to nearby lymph nodes (N0) or to any distant tissues or organs (M0).</li>
</ul>
• Stage IIA: Stomach cancer is called stage IIA for any one of these conditions: 
<ul>
<li>T1, N2, M0: The cancer has grown beneath the top layer of cells of the mucosa into the layer of connective tissue (lamina propria), thin muscle layer (muscularis mucosa), or the submucosa (T1). It has spread to 3 to 6 nearby lymph nodes (N2). It has not spread to distant sites (M0).</li>
<li>T2, N1, M0: The cancer has grown into the main muscle layer of the stomach called the muscularis propria (T2). It has spread to 1 or 2 nearby lymph nodes (N1), but has not spread to distant sites (M0).</li>
<li>T3, N0, M0: The cancer has grown through the main muscle layer into the subserosa, but has not grown through all the layers to the outside the stomach (T3). It has not spread to any nearby lymph nodes (N0) or to distant tissues or organs (M0).</li>
</ul>
• Stage IIB: Stomach cancer is called stage IIB for any one of these conditions: 
<ul>
<li>T1, N3, M0: The cancer has grown beneath the top layer of cells of the mucosa into the layer of connective tissue (lamina propria), the thin muscle layer, or the submucosa (T1). It has spread to 7 or more nearby lymph nodes (N3). It has not spread to distant tissues or organs (M0).</li>
<li>T2, N2, M0: The cancer has grown into the main muscle layer, called the muscularis propria (T2). It has spread to 3 to 6 nearby lymph nodes (N2), but it has not spread to distant tissues or organs (M0).</li>
<li>T3, N1, M0: The cancer has grown into the subserosa layer, but not through all the layers to the outside of the stomach (T3). It has spread to 1 or 2 nearby lymph nodes (N1), but has not spread to distant tissues or organs (M0).</li>
<li>T4a, N0, M0: The cancer has grown completely through all the layers of stomach wall into the outer covering of the stomach (the serosa), but it has not grown into nearby organs or tissues, such as the spleen, intestines, kidneys, or pancreas (T4a). It has not spread to any nearby lymph nodes (N0) or distant sites (M0).</li>
</ul>
• Stage IIIA: Stomach cancer is called stage IIIA for any one of these conditions: 
<ul>
<li>T2, N3, M0: The cancer has grown into the main muscle layer, called the muscularis propria (T2). It has spread to 7 or more nearby lymph nodes (N3), but has not spread to distant tissues or organs (M0).</li>
<li>T3, N2, M0: The cancer has grown into the subserosa layer, but not through all the layers to the outside of the stomach (T3). It has spread to 3 to 6 nearby lymph nodes (N2), but it has not spread to distant tissues or organs (M0).</li>
<li>T4a, N1, M0: The cancer has grown completely through all the layers of the stomach wall into the outer covering of the stomach (the serosa), but it has not grown into nearby organs or tissues (T4a). It has spread to 1 or 2 nearby lymph nodes (N1), but it has not spread to distant sites (M0).</li>
</ul>
• Stage IIIB: Stomach cancer is called stage IIIB for any of these conditions: 
<ul>
<li>T3, N3, M0: The cancer has grown into the subserosa layer, but not through all the layers to the outside of the stomach (T3). It has spread to 7 or more nearby lymph nodes (N2), but it has not spread to distant sites (M0).</li>
<li>T4a, N2, M0: The cancer has grown completely through all the layers of the stomach wall into the serosa (the outer covering of the stomach), but it has not grown into nearby organs or tissues (T4a). It has spread to 3 to 6 nearby lymph nodes (N2), but it has not spread to distant sites (M0).</li>
<li>T4b, N0 or N1, M0: The cancer has grown through the stomach wall and into nearby organs or structures such as the spleen, intestines, liver, pancreas, or major blood vessels (T4b). It may also have spread to up to 2 nearby lymph nodes (N0 or N1). It has not spread to distant sites (M0).</li>
</ul>
• Stage IIIC: Stomach cancer is called stage IIIC for any of these conditions: 
<ul>
<li>T4a, N3, M0: The cancer has grown completely through all the layers of the stomach wall into the serosa, but it has not grown into nearby organs or tissues (T4a). It has spread to 7 or more nearby lymph nodes (N3), but it has not spread to distant sites (M0).</li>
<li>T4b, N2 or N3, M0: The cancer has grown through the stomach wall and into nearby organs or structures such as the spleen, intestines, liver, pancreas, or major blood vessels (T4b). It has spread to 3 or more nearby lymph nodes (N2 or N3). It has not spread to distant sites (M0).</li>
</ul>
• Stage IV: Stage IV stomach cancer describes a cancer of any size that has spread to distant parts of the body in addition to the area around the stomach (any T, any N, M1). 
 
If you have any questions about the stage of your disease, ask your doctor to explain this to you. The stage of a stomach cancer is an important factor, but it is not the only factor in considering treatment options and in predicting outlook for survival. The Stages of Stomach Cancer.</div>
</div>

The Stages of Stomach Cancer

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the bo...

Diagnosing Stomach Cancer

ancorez Stomach Cancer 4:58 PM

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Stomach cancers are usually found when a person goes to the doctor because of signs or symptoms they are having. The doctor will take a history and examine the patient. If stomach cancer is suspected, tests will be needed to confirm the diagnosis. Tests and procedures used to diagnose stomach cancer include: 
 
Biopsy 
 
A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed during the biopsy is analyzed by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. Diagnosing Stomach Cancer. 
 
<hr />
 
Imaging Tests 
 
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests may be done for a number of reasons, including: 
<ul>
<li>To help find out whether a suspicious area might be cancerous</li>
<li>To learn how far cancer may have spread</li>
<li>To help determine if treatment has been effective</li>
</ul>
• Chest X-ray 
This test can help find out if the cancer has spread to the lungs. It might also determine if there are any serious lung or heart diseases present. This test is not needed if a CT scan of the chest has been done. 
 
• Barium Meal 
A barium meal is a type of X-ray investigation. This test is not commonly used now for stomach cancer. You can have it as an outpatient. You won't be able to eat or drink anything for 6 hours before you have your test. When you get to the X-ray department, the nurse will ask you to change into a hospital gown. When the test is about to begin, you will have: 
<ul>
<li>An injection to relax the muscles of your digestive system</li>
<li>A white liquid to drink</li>
</ul>
The white liquid is the barium meal. It is this chalky liquid that shows up on the X-rays. After you've drunk the barium, you lie down on the X-ray couch. Your doctor will watch on an X-ray screen as the barium passes through your stomach and duodenum. Any growths or ulcers will show up on the screen. The couch will be tipped into different positions during the test to make the barium flow where the doctor wants it to go. 
 
The whole test takes about an hour. You should be able to go home straight after the test. You can eat and drink normally as soon as the test is over. But some people feel sick for a while afterwards. You may find the barium makes you constipated. Your bowel motions will be white for a day or so as your body gets rid of the barium. 
 
• Computed Tomography (CT or CAT) Scan 
A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye is usually given as a solution to swallow. 
 
CT-guided needle biopsy: CT scans can also be used to guide a biopsy needle into a suspected area of cancer spread. The patient remains on the CT scanning table while a doctor moves a biopsy needle through the skin toward the mass. CT scans are repeated until the needle is within the mass. A fine-needle biopsy sample (tiny fragment of tissue) or a core-needle biopsy sample (a thin cylinder of tissue) is then removed and looked at under a microscope. 
 
• Magnetic Resonance Imaging (MRI) Scan 
An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye is usually injected into a patient’s vein. 
 
• Positron Emission Tomography (PET) Scan 
In this test, radioactive substance (usually a type of sugar related to glucose, known as FDG) is injected into a vein. (The amount of radioactivity used is very low and will pass out of the body over the next day or so.) Because cancer cells are growing faster than normal cells, they use sugar much faster, so they take up the radioactive material. After about an hour, you are moved onto a table in the PET scanner. You lie on the table for about 30 minutes while a special camera creates a picture of areas of radioactivity in the body. 
 
PET is sometimes useful if your doctor thinks the cancer might have spread but doesn’t know where. The picture is not finely detailed like a CT or MRI scan, but it provides helpful information about the whole body. Although PET scans can be useful for finding areas of cancer spread, they aren’t always helpful in certain kinds of stomach cancer because these types don’t take up glucose very much. 
 
Some machines can do both a PET and CT scan at the same time (PET/CT scan). This lets the doctor compare areas of higher radioactivity on the PET with the more detailed appearance of that area on the CT. PET/CT may be more helpful than PET alone for stomach cancer. This can help show if the cancer has spread beyond the stomach to other parts of the body, in which case surgery might not be a good treatment. 
 
• Upper Gastrointestinal (GI) Series 
This is an x-ray test to look at the inner lining of the esophagus, stomach, and first part of the small intestine. This test is used less often than endoscopy to look for stomach cancer or other stomach problems, as it may miss some abnormal areas and does not allow the doctor to take biopsy samples. But it is less invasive than endoscopy, and it might be useful in some situations. Diagnosing Stomach Cancer 
 
For this test, the patient drinks a white chalky solution containing a substance called barium. The barium coats the lining of the esophagus, stomach, and small intestine. Several x-ray pictures are then taken. Because x-rays can’t pass through the coating of barium, this will outline any abnormalities of the lining of these organs. A double-contrast technique may be used to look for early stomach cancer. With this technique, after the barium solution is swallowed, a thin tube is passed into the stomach and air is pumped in. This makes the barium coating very thin, so even small abnormalities will show up. 
 
<hr />
 
Medical History and Physical Exam 
 
When taking your medical history, the doctor will ask you questions about your symptoms (eating problems, pain, bloating, etc.) and possible risk factors to see if they might suggest stomach cancer or another cause. The physical exam gives your doctor information about your general health, possible signs of stomach cancer, and other health problems. In particular, the doctor will feel your abdomen for any abnormal changes. 
 
If your doctor thinks you might have stomach cancer or another type of stomach problem, he or she will refer you to a gastroenterologist, a doctor who specializes in diseases of the digestive tract, who will examine you and do further testing. 
 
<hr />
 
Upper Endoscopy 
 
Upper endoscopy (also called esophagogastroduodenoscopy or EGD) is the main test used to find stomach cancer. It may be used when someone has certain risk factors or when signs and symptoms suggest this disease may be present. During this test, the doctor passes an endoscope, which is a thin, flexible, lighted tube with a small video camera on the end, down your throat. This lets the doctor see the lining of your esophagus, stomach, and first part of the small intestine. If abnormal areas are seen, biopsies (tissue samples) can be taken using instruments passed through the endoscope. The tissue samples are sent to a lab, where they are looked at under a microscope to see if cancer is present. 
 
When seen through an endoscope, stomach cancer can look like an ulcer, a mushroom-shaped or protruding mass, or diffuse, flat, thickened areas of mucosa known as linitis plastica. Unfortunately, the stomach cancers in hereditary diffuse gastric cancer syndrome often cannot be seen during endoscopy. 
 
Endoscopy can also be used as part of a special imaging test known as endoscopic ultrasound, which is described below. This test is usually done after you are given medication to make you sleepy (sedation). If sedation is used, you will need someone to take you home (not just a cab). 
 
• Endoscopic Ultrasound 
This test is similar to an endoscopy, but the gastroscope has a small ultrasound probe on the end that produces a detailed image of the stomach wall. An ultrasound uses sound waves to create a picture of the internal organs. The ultrasound image helps doctors determine how far the cancer has spread into the stomach and nearby lymph nodes, tissue, and organs, such as the liver. 
 
<hr />
 
Other Tests 
 
• Lab Tests 
When looking for signs of stomach cancer, a doctor may order a blood test called a complete blood count (CBC) to look for anemia (which could be caused by the cancer bleeding into the stomach). A fecal occult blood test may be done to look for blood in stool (feces) that isn’t visible to the naked eye. 
 
The doctor might recommend other tests if cancer is found, especially if you are going to have surgery. For instance, blood tests will be done to make sure your liver and kidney functions are normal and that your blood clots normally. If surgery is planned or you are going to get medicines that can affect the heart, you may also have an electrocardiogram (EKG) and echocardiogram (an ultrasound of the heart) to make sure your heart is functioning well. 
 
• Laparoscopy 
If this procedure is done, it is usually only after stomach cancer has already been found. Although CT or MRI scans can create detailed pictures of the inside of the body, they can miss some tumors, especially if they are very small. Doctors might do a laparoscopy before any other surgery to help confirm a stomach cancer is still only in the stomach and can be removed completely with surgery. It may also be done before chemotherapy and/or radiation if these are planned before surgery. 
 
This procedure is done in an operating room with the patient under general anesthesia (in a deep sleep). A laparoscope (a thin, flexible tube) is inserted through a small surgical opening in the patient’s side. The laparoscope has a small video camera on its end, which sends pictures of the inside of the abdomen to a TV screen. Doctors can look closely at the surfaces of the organs and nearby lymph nodes, or even take small samples of tissue. If it doesn’t look like the cancer has spread, sometimes the doctor will “wash” the abdomen with saline (salt water). The fluid (called peritoneal washings) is then removed and checked to see if it contains cancer cells. If it does, the cancer has spread, even if the spread couldn’t be seen. 
 
<hr />
 
After The Tests 
 
Your specialist will give you an appointment to come back to the hospital when your test results have come through. The results may take a little time and you are bound to feel anxious. It may help if you ask your specialist how long the results are likely to take so that you have some idea of how long you will have to wait. 
 
While you are waiting for results it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience. Diagnosing Stomach Cancer</div>
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Diagnosing Stomach Cancer

Stomach cancers are usually found when a person goes to the doctor because of signs or symptoms they are having. The doctor will take a ...

Signs and Symptoms of Stomach Cancer

ancorez Stomach Cancer 2:46 PM

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People with stomach cancer may experience the following symptoms or signs. Sometimes, people with stomach cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. Stomach cancer is usually not found at an early stage because it often does not cause specific symptoms. When symptoms do occur, they may be vague and can include: Signs and Symptoms of Stomach Cancer 
<ul>
<li>A sense of fullness in the upper abdomen after eating a small meal</li>
<li>Abdominal (belly) pain</li>
<li>Fatigue </li>
<li>Feeling bloated after eating</li>
<li>Feeling full after eating small amounts of food</li>
<li>Heartburn or indigestion</li>
<li>Indigestion that is severe and unrelenting</li>
<li>Low red blood cell count (anemia)</li>
<li>Nausea that is persistent and unexplained</li>
<li>Poor appetite</li>
<li>Stomach pain</li>
<li>Swelling or fluid build-up in the abdomen</li>
<li>Vague discomfort in the abdomen, usually above the navel</li>
<li>Vomiting, with or without blood</li>
<li>Weight loss (without trying)</li>
</ul>
Most of these symptoms are more likely to be caused by things other than cancer, such as a stomach virus or an ulcer. They may also occur with other types of cancer. But people who have any of these problems, especially if they don’t go away or get worse, should check with their doctor so the cause can be found and treated. Since symptoms of stomach cancer often do not appear until the disease is advanced, only about 1 in 5 stomach cancers in the United States is found at an early stage, before it has spread to other areas of the body. Signs and Symptoms of Stomach Cancer.</div>
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Signs and Symptoms of Stomach Cancer

People with stomach cancer may experience the following symptoms or signs. Sometimes, people with stomach cancer do not show any of thes...

Esophagus Cancer Treatment

ancorez Esophageal cancer 1:50 PM

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Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Take time to learn about your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Esophagus Cancer Treatment. 
 
After the cancer is found and staged, your cancer care team will discuss treatment options with you. It is important that you take time to think about your choices. You will want to weigh the benefits of each treatment option against the possible risks and side effects. In choosing a treatment plan, 2 of the main factors to consider are your overall health and the stage (extent) of the cancer. The main options for treatment of cancer of the esophagus include: 
 
• Chemotherapy 
Chemotherapy is the use of drugs to kill cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time. 
 
As explained above, chemotherapy and radiation therapy are often given at the same time to treat esophageal cancer, called chemoradiotherapy. Recent studies also show that chemotherapy without radiation therapy may work as well, but more research is needed to understand any benefits of chemotherapy without radiation therapy compared with chemoradiotherapy. 
 
The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished. 
 
• Cryotherapy 
This is a type of palliative treatment that uses an endoscope with a probe attached that can freeze and remove tumor tissue. It can be used to reduce the size of a tumor to help a patient swallow better. 
 
• Electrocoagulation 
This type of palliative treatment helps kill cancer cells by heating them with an electric current. This is sometimes used to help relieve symptoms by removing a blockage caused by the tumor. 
 
• Photodynamic therapy 
Photodynamic therapy is a palliative or supportive option used to make swallowing easier, especially for people who cannot or choose not to have surgery, radiation therapy, or chemotherapy. In photodynamic therapy, a light-sensitive substance is injected into the tumor and stays longer in cancer cells than in healthy cells. A laser is then aimed at the tumor, destroying the cancer cells. Although photodynamic therapy may relieve swallowing problems for a short period of time, it does not cure esophageal cancer. Esophagus Cancer Treatment. 
 
• Radiation therapy 
Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation therapy given from a machine outside the body. When radiation treatment is given directly inside the body, it is called internal radiation therapy or brachytherapy. For esophageal cancer, this involves temporarily inserting a radioactive wire into the esophagus using an endoscope. 
 
Side effects from radiation therapy may include fatigue, mild skin reactions, soreness in the throat and esophagus, difficulty or pain with swallowing, upset stomach, nausea, and loose bowel movements. Most side effects go away soon after treatment is finished. 
 
• Surgery 
Surgery is the removal of the tumor and surrounding tissue during an operation. A surgical oncologist is a doctor who specializes in treating cancer using surgery. Surgery has traditionally been the most common treatment for esophageal cancer. However, currently, surgery is used as the primary (first) treatment only for patients with early-stage esophageal cancer. 
 
For patients with locally-advanced esophageal cancer, a combination of chemotherapy and radiation therapy, or only chemotherapy in some situations, may be used before surgery to shrink the tumor. For people who cannot have surgery, the best treatment option is often a combination of chemotherapy and radiation therapy. 
 
The most common surgery to treat esophageal cancer is called an esophagectomy, where the doctor removes the esophagus and then connects the remaining healthy part of the esophagus to the stomach so that the patient can swallow normally. The stomach or part of the intestine may sometimes be used to make the connection. The surgeon also removes lymph nodes around the esophagus. 
 
• Targeted therapy 
Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to normal cells. 
 
Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. As a result, doctors can better match each patient with the most effective treatment whenever possible. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them. 
 
Some of these treatments can also be used as palliative treatment when all the cancer cannot be removed. Palliative treatment is meant to relieve symptoms, such as pain and trouble swallowing, but it is not expected to cure the cancer. 
 
Depending on the stage of the cancer and your general health, different treatment options may be used alone or in combination. Based on these options, you might have different types of doctors on your treatment team. These doctors could include: 
<ul>
<li>A gastroenterologist: a doctor who specializes in treatment of diseases of the digestive system</li>
<li>A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy</li>
<li>A radiation oncologist: a doctor who treats cancer with radiation therapy</li>
<li>A thoracic surgeon: a doctor who treats diseases of the chest with surgery</li>
</ul>
Many other specialists might be part of your treatment team as well, including physician assistants, nurse practitioners, nurses, nutrition specialists, social workers, and other health professionals. Esophagus Cancer Treatment.</div>
</div>

Esophagus Cancer Treatment

Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the ...