Introduction: Needless to say, gastric cancer is still one of the leading cause of deaths all around the globe. A good prognosis follows an early diagnosis, which is uncommon when it comes to gastric cancer. Awareness and education are hence, crucial, at this point.
Stomach cancer or gastric cancer is mainly of 3 types depending on its origin, namely, carcinoma, sarcoma and lymphoma while gastric carcinoma being the most common of all. Gastric carcinoma has various subtypes as in adenocarcinoma, basal cell carcinoma, squamous cell carcinoma and so on. The most common site of occurrence is the gastric canal.
Talking about carcinomas, they are of epithelial origin and most common. They develop on tissue surfaces and are capable of metastasizing or spreading to the nearby sites through blood vessels or lymph nodes. Gastric carcinoma first develops on the gastric mucosal layer and can grow into the submucosal layer. The diagnosis made at this stage is Early Gastric Carcinoma (EGC). On the other hand, Advanced Gastric Carcinoma is when the cancer cells have already grown into muscularis propria or beyond. The metastasis usually starts from the sub-mucosal layer. It can invade organs like pancreas, lung, liver or esophagus, generally.
Gastric carcinomas remain undiagnosed until late when some unavoidable symptoms appear. As a result, most patients are in the stage of Advanced Gastric Cancer at the time of their diagnosis. This is associated with greater complications and higher mortality rate. The prognosis remains pitiful and survival rate is low.
ETIOLOGY: We might not be able to establish a strong opinion for why gastric cancer develops but we can identify the various risk factors.
• Many malignancies are related to infections by the gram-positive bacteria, Helicobacter pylori. The role of viruses in gastric cancer is significant as well. Epstein-Barr virus(EPV) is also found to be associated with number of cases.
• E-cadherin protein in humans is translated by the CDH1 gene, a tumor suppression gene. The protein acts as a Cell Adhesion Molecule(CAM) and keeps the normal cells attached to each other. Loss or inactivation of this protein is seen in carcinomas as a result of mutation or so.
• Tobacco, alcohol, tobacco smoke, some industrial chemicals often lead to cancer.
• Food compounds that undergo nitrosylation to form nitrosamine and nitrosamide, processed food items and excessive consumption of red meat are major risk factors for gastric carcinoma.
• Chronic gastric ulcers or recurrent gastritis can also lead to malignancy.
CLINICAL FEATURES: Gastric carcinoma presents itself in a diversified manner and can sometimes, be asymptomatic.
However, the more common features seen are-
• Gastritis, acute or chronic
• Abdominal pain
• Heartburn
• Anaemia
• Undefinable weakness
• Weight loss
• Dysphagia or difficulty in swallowing food
• Troisier’s sign, in cases of malignancy
• Frequent incidents of indigestion
• Melena or dark/black coloured stool
TREATMENT: All of us need to know that cancer can be treated only when the diagnosis is made early. For early diagnosis, we need to stop ignoring the symptoms and present them to a medical practitioner as soon as it is possible.
Treatment includes-
• Surgical removal of benign tumors
• Endoscopic resection
• Chemotherapy
• Radiation therapy
• Immunotherapy
• Chemoradiation therapy
• Gastrectomy
While the research is still on, cancer screening has been introduced that will help identify the signs even before the symptoms develop.
Precision oncology is a powerful shield against cancer where the genetic and molecular characteristics of patients are identified and the treatment is individualized accordingly, lessening the adverse side effects of chemotherapy and radiation therapy.
Technology in the form of Artificial Intelligence(AI) has claimed that it can lead to early diagnosis, better prognosis and even predict the course of disease.
CONCLUSION: Gastric Carcinoma will be defeated when awareness, knowledge, screening and early diagnosis come together. Besides, possible prevention is always better than cure. It’s never too late to take the first step of spreading awareness among people around us about this silent killer.
Cancer is not something that just destroys your physical health. It destroys your mental health and the lives of your loved ones as well. It kills you from within with each passing day and inflicts un-definable pain.
It remains immortal as a trauma to the family of people who fought and lost their life to cancer. I guess, life is too precious to be taken away by cancer.
Contributor- Medico Nikita Mishra
Nice one