Stomach cancer

Diagnosis

The following tests may be performed to diagnose stomach cancer:

• Upper endoscopy (known as esophagogastroduodenoscopy or EGD). An investigation consisting of a flexible thin tube connected to a tiny camera which will be inserted into a patient’s mouth, passing through the esophagus to evaluate the stomach to check for any signs of cancer.
• Biopsy. This is a process of taking a sample of the stomach’s tissue for examination under a microscope to check for cancer, which is commonly done during an upper endoscopy.
• Imaging tests. Computed Tomography (CT) Scan and barium swallow may be used to detect stomach cancer. 

Staging stomach cancer

Stomach cancer stage may be determined using the following tests: 

• Blood tests. Blood test can be used to check the organ function if they are damaged by cancer such as liver.
• Endoscopic ultrasound (EUS). A tiny tube with camera is inserted into the throat down to the stomach and then a special ultrasound is utilized to view images of its structures inside. This test indicates if the cancer has penetrated the wall of the stomach.
• Imaging tests. A CT Scan and Positron Emission Tomography (PET) may be recommended. 
• Exploratory surgery. This surgery may be done laparoscopically (minimally invasive) using a special camera inserted in the abdominal area. The scope will then explore the chest and abdomen are to check if the cancer has spread and transmit images to a monitor during surgery.

Stomach cancer may be staged from 0 to IV. The lowest number indicates that the cancer is small and localized only in the inner layers of the stomach. If it has reached stage IV, it means that the cancer has become advanced and has spread to other parts of the body.

Treatment

Surgery 

The surgery entails removing not only the cancer in the stomach but also a few of the healthy tissues surrounding it. The following techniques may be done:

• Endoscopic mucosal resection (EMR). An endoscopy (e.g. endoscopic submucosal resection) may be used to insert surgical instruments and remove small-sized cancer limited to the inside lining of the stomach in its early stage.
• Subtotal gastrectomy. This procedure only removes some parts of the stomach that is damaged. It is commonly done if the part of the stomach affected by cancer is near the small intestine.
• Total gastrectomy. This procedure is done if the stomach is fully affected by cancer and some parts of the gastroesophageal junction. It removes the whole stomach and some tissues around it. Then, the esophagus will be stitched to the small intestine to allow the passage of food.
• Removing lymph nodes to check for cancer. The lymph nodes may be removed to find cancer.
• Surgery to relieve signs and symptoms. In advanced stomach cancer, surgery may be done to remove some parts of the stomach to alleviate the signs and symptoms.

Chemotherapy

Chemotherapy medications are taken orally or intravenously to kill cancer cells. It is an option for cancers that has metastasized (spread to other parts of the body).

Radiation therapy 

This treatment uses high power beams such as X-rays and protons or by the placement of radioactive material inside the body nearby the cancerous area in order to kill the cells.

Targeted drug therapy 

Targeted Therapy is a medication for cancer that has been developed to be exceptionally precise. Meaning, it specifically targets tumor cells that have a mutated receptor or targets the receptor that has the primary mechanism of developing cancer. This leads to obtaining a good result of the treatment and a positive response to medications. Targeted drugs are combined with chemotherapy for advanced stomach cancers or cancer that recurs after treatment.

Immunotherapy

Immunotherapy is a type of cancer treatment that relies on the function of the patient’s immune system. Typically, the immune system keeps monitoring and destroying all of the foreign substances, such as germs or cancer cells. However, it sometimes cannot detect cancer cells. Immunotherapy helps boost the effectiveness of the immune system to detect and fight against the cancer. Immunotherapy might be used when the stomach cancer is advanced.