Gastric cancer was first successfully operated by Billroth in Austria at the end of the 18th century. Over the past century and a half, therapeutic approaches to most malignant neoplasms have changed, many anticancer drugs have appeared, but only surgery gives hope for a cure of gastric cancer.
Principles for choice of gastric cancer therapy
In gastric cancer, the treatment tactics is determined by the extent of the malignant tumor. According to the treatment strategy focused on the highest life expectancy with acceptable quality, all patients are divided into three groups:
- The first group can hope for a long life, nine out of ten will live more than five years, because they had been diagnosed with initial cancer that can be cured only by surgery, in some cases even saving the stomach.
- The second group is the largest, including patients with a rather extensive tumor localized only in the stomach with lesion of the nearest lymph nodes, able to be removed with the loss of part or all of the organ.
- The third group consists of patients whose existing neoplasms cannot be radically and entirely removed, or whose general condition is so weak that it does not allow for surgery.
Surgical treatment of gastric cancer
Only surgical tumor removal gives hope for a cure. The range of interventions recommended by the standards includes resection, removal of a part of the stomach, and gastrectomy, its complete removal. With a minimal mucosal lesion, innovative endoscopic operations are used that preserve the organ, and with it, a good quality of long life.
With a small cancer, the common and most often used tactics is stomach resection, and with an advanced tumor, gastrectomy.
Metastases exclude radical treatment, during this period cancer cells are spread throughout the body by blood and lymph, this process is called dissemination. Surgery is absolutely contraindicated with several metastases of gastric cancer in the pulmonary and hepatic tissue. With single and slowly growing tumor nodes, the case conference should discuss whether the part of the lung or the liver affected by metastases should be removed, only if it is possible to completely «clear out» the cancer from the body, as even not a single neoplasm may remain.
It is not possible to remove the lymph nodes affected by cancer outside the abdominal cavity, or tumor seedings on the peritoneum, therefore surgery is contraindicated.
Causes of gastric cancer are more suggested than accurately confirmed, which is typical for most malignant neoplasms. Science knows all the stages of transformation of a normal cell into a cancer cell, but it cannot answer the question «why this happened».
Gastric cancer cause
Helicobacter infection is believed to contribute to cancerous transformation. It is known for sure that the Helicobacter pylori bacterium causes peptic ulcer, with ulcer and malignant transformation, the same process occurs, namely proliferation or increased cell reproduction in response to chronic inflammation.
In the process of such increased cell reproduction, a failure and a structural defect occurs in the cell, turning it into the progenitor of the malignant cell pool.
An interesting fact is that the Helicobacter pylori content in the peoples of the Russian North is very high, yet ulcer or cancer occur very rarely, because their mucous membrane has genetically adapted to process hard food.
It turns out that bacteria prepare development of a malignant neoplasm, but what becomes the main cause of cancer development still remains unknown.
Heredity as a cause for gastric cancer development
Genetic predisposition is confirmed by an increase by one fifth of the likelihood to develop a malignant neoplasm in the stomach, when a close relative suffers from gastric cancer.
Apparently, some genes are responsible for the development of the condition, because it is common for entire nations, such as Japanese, Chileans and Icelanders. It is characteristic of
Gastric cancer risk factors
- A certain harmful product was not found, but nutrition is also regarded as a cause contributing to tumor development. This, nutritional pattern change of the Japanese who migrated to the U.S. leads to a decrease in the condition incidence.
- It is believed that the culprit is chronic vitamin B12 deficiency occurring due to mucous membrane deficiency. It is possible that disruption of vitamin absorption and malignant growth are due to the initial morbidity of the mucous membrane, and are not related to each other in any way.
- It has been observed that in patients with gastric surgery the frequency of a malignant tumor increases threefold.
- Working with asbestos and nickel can lead to a process, as well as a high content of nitrates, nitrites and preservatives in food.
- Chronic and severe immunity deficiencies contribute to this; therefore, malignant tumors often develop with immunodeficient against the background of HIV infection.
- The abuse of alcohol and smoking damages the mucous membrane, which causes its proliferative changes, but these factors do not increase the risk
In most cases, the condition occurs with a combination of several risk factors, but quite often the patient does not reveal a single cause that could lead to a malignant process.