Stomach cancer, also referred to as gastric cancer, begins in the mucus-producing cells on the inside lining of the stomach (adenocarcinoma). Adenocarcinoma is the most common type of stomach cancer. Gastric cancer is the third most common cause of cancer-related death in the world.

Stomach Cancer Treatment In Malaysia



 

Types of stomach cancer

There are different types of stomach cancer and the frequency of these cancer subtypes are as follows.

Adenocarcinoma

90-95%

Lymphomas

1-5%

Gastrointestinal stromal tumors

2%

Carcinoids

1%

Adenoacanthomas

1%

Squamous cell carcinomas

1%

Risk Factors

Gender
Stomach cancer is more common in men than in women.
Earlier stomach surgery
People who have had part of their stomach removed to treat other problems like ulcers have a higher risk of stomach cancer.
Age
Risk increases with age.
Pernicious anemia
Where a person lives
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.
Menetrier disease
A rare disease that involves changes in the stomach lining.
Infection
With the bacterium called Helicobacter pylori.
Type A blood
MALT lymphoma of the stomach
Which is also caused by infection with pylori.
Diet
An increased risk of stomach cancer is seen in people with diets high in smoked foods, salted fish and meats, and pickled vegetables. The risk of stomach cancer seems to be lowered by eating lots of fresh fruits and vegetables.
Family history
People with close family members (parents, siblings, and children) who have had stomach cancer are more likely to get this disease.
Tobacco use
A type of stomach polyp
Called adenomatous or adenoma sometimes change into stomach cancer.
Being overweight or obese
Certain types of work
Workers in the coal, metal, and rubber industries seem to have a higher risk of getting stomach cancer.

 

Prevention of gastric cancer

There is no sure way to prevent stomach cancer, but there are things you can do that might lower your risk.

Diet, body weight, and exercise
To help reduce your risk, avoid a diet that is high in smoked and pickled foods and salted meats and fish. The American Cancer Society recommends an emphasis on plant foods and whole grains. Being overweight or obese may add to the risk of stomach cancer. On the other hand, being physically active may help lower your risk. Aside from possible effects on the risk of stomach cancer, losing weight may also have an impact on the risk of some other cancers and health problems.
Inherited stomach cancers
A small percentage of stomach cancers are caused by an inherited genetic condition called hereditary diffuse gastric cancer syndrome. Most people who have inherited the gene for this condition will get stomach cancer at some point in their lives. If you have a strong family history of stomach cancer, our oncologists at Onco Life Centre can help you get genetic counseling and testing to see if you have the gene that causes it.
H. pylori infection
It is not yet clear whether everyone with on-going (chronic) infection with H. pylori bacteria should be treated to prevent stomach cancer. Some studies have suggested that giving antibiotics to people with H. pylori infection might lower their rate of getting stomach cancer. But more research needs to be done.
Stay away from tobacco
Tobacco use can increase the risk of stomach cancer, as well as other cancers.

 

Treatment overview

Talk to our oncologists at Onco Life Centre about your treatment options. Treatment recommendations by our oncologists at Onco Life Centre are tailored and personalized and depends on stage of stomach cancer, genetic changes in the tumor, and the patient’s preferences and overall health. The landscape of drug treatment in stomach cancer has evolved over the last 5 years.

 

Surgery

Surgery is often part of the treatment for stomach cancer if it can be done. Depending on the type and stage of your cancer, surgery might be used to remove the cancer and part or all of your stomach. Surgery (often along with other treatments) offers the only real chance to cure stomach cancer. Even if the cancer is too widespread to be completely removed, an operation could help prevent bleeding from the tumor or keep the stomach from being blocked. This type of surgery is known as palliative surgery.

The 3 main types of surgery for stomach cancer.

Endoscopic resection

In this operation, the cancer is removed through an endoscope and can be done only for some very early cancers where the chance of spread is very low.

Partial gastrectomy

With this approach only part of the stomach is removed, sometimes along with part of the esophagus or the first part of the small intestine. This may be an option if the cancer is only in the lower part of the stomach close to the intestines.

Total gastrectomy

In this operation, the surgeon removes all of the stomach, nearby lymph nodes and sometimes the spleen, parts of the esophagus, intestines, pancreas, and other nearby organs. This may be an option if the cancer is only in the upper part of the stomach or if the cancer has spread throughout the stomach.

Chemotherapy

Chemotherapy can be given before surgery to shrink the tumor and make it easier to completely remove it. Chemo may also be given, often along with radiation, after surgery to kill any groups of cancer cells that may have been left behind but are too small to be seen. The goal is to keep the cancer from coming back.

Chemo may also be used as the main treatment for stomach cancer that has spread to distant organs, to relieve cancer related symptons as well as to prolong patient survival.

Targeted Therapy

Targeted therapy 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 healthy cells. To find the most effective treatment, our oncologist will run tests to identify the genes, proteins, and other factors in your tumor.

HER2-targeted therapy

Some cancers may make too much of a protein called human epidermal growth factor receptor 2 (HER2). If your stomach cancer cells overexpress HER2 protein, HER2-targeted therapy with chemo can prolong the lives of patients with advanced stomach cancer.

Anti-angiogenesis therapy

Anti-angiogenesis therapy is focused on stopping angiogenesis, which is the process of making new blood vessels. Because a tumor needs the nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor.

Immunotherapy

Immunotherapy is designed to boost your body's natural defenses to fight the cancer. The PD-1 pathway is critical in the immune system’s ability to control cancer growth. PD-1 and PD-L1 antibodies block this pathway and can stop the growth of stomach cancer. For patients with advanced stomach cancer that has PD-L1 or is MSI-H disease, immunotherapy may be an option for patients when chemotherapy does not work.

Radiation Treatment

Before surgery, radiation can be used along with chemo to try to shrink some tumors to make surgery easier. After surgery, radiation can be used to kill very small areas of cancer that cannot be seen and removed during surgery. Radiation, especially when combined with chemotherapy (chemo), might delay or prevent the cancer from coming back after surgery and may help people to live longer. Radiation can also be used to slow the growth and ease symptoms of advanced stomach cancer such as pain, bleeding, and trouble eating.

Patients and their families have opportunities to talk about the way they are feeling with our oncologists, nurses, counselors, or join our psychosocial program and support group at Onco Life Centre.

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