Stomach Cancer

Overview

Gastric cancer is the fifth most common cancer in the world and the third leading cause of cancer death in both sexes worldwide
It is a difficult disease to cure mainly because most patients present with advanced disease

What are the signs and symptoms?
Early symptoms are usually ignored by patients and presentation is usually delayed.

• Nonspecific with dyspepsia,
• Rapid weight loss and loss of appetite
• Vomiting, difficulty in eating , blood in vomit or blackish stools
• Anaemia and easy fatigue
• 70% of patients with early gastric cancer only have symptoms of uncomplicated dyspepsia
• All at-risk patients with dyspepsia should be considered for endoscopy.
• The majority of patients present with advanced disease and symptoms such as weight loss, vomiting, anorexia, abdominal pain and anaemia.

Treatment options
Being an aggressive disease, patients require multimodality management including surgery, chemotherapy, radiotherapy and targeted therapy and combination of these.

• Surgery: Surgery is the treatment of choice for gastric cancer. The most important indicator for resectability and survival after surgery is early diagnosis and therefore early stage of disease at operation.
• Adjuvant and perioperative chemotherapy
• Perioperative combination chemotherapy has become the standard of care for localised gastric cancer
• Adjuvant chemotherapy and radiotherapy are used in advanced gastric cancers.
• Targeted therapy is useful in metastatic cancers.