Stomach Cancer

Stomach cancer is a malignant condition in which a tumor forms in the stomach, usually in the stomach lining. The stomach plays a crucial role in digesting food, and a tumor can severely disrupt this function. Stomach cancer often develops slowly and can spread in its early stages without obvious symptoms, which is why it is often not detected until it has reached an advanced stage.

Symptoms of stomach cancer can vary, but usually include a combination of loss of appetite, weight loss, persistent stomach pain, a feeling of fullness after small meals, nausea, vomiting (sometimes with blood), and black, tarry stools due to internal bleeding. However, these symptoms can also occur with other, less serious stomach problems, which makes early diagnosis difficult.

The exact cause of stomach cancer is often unknown, but there are several risk factors. These include infection with the bacterium *Helicobacter pylori*, chronic gastritis, smoking, a diet high in salt and smoked foods, genetic predisposition, and age (it is more common in people over 50). Early detection of stomach cancer is important, as treatment options and prognosis depend heavily on how far the disease has progressed at the time of diagnosis.

Treatment for stomach cancer varies and may include surgery, chemotherapy, radiation therapy, or a combination of these methods. The choice of treatment depends on the stage of the cancer, the location of the tumor, and the patient's overall health.

In the
early stages, most stomach tumors do not cause any symptoms. Symptoms such as discomfort in the stomach area (pain, heartburn, or a feeling of unease), nausea and vomiting, feeling full quickly during a meal, difficulty swallowing (dysphagia), and unexplained weight loss. 
Anemia can develop if the tumor starts to bleed. As a result, you may sometimes notice jet-black stools (melena) or vomit small amounts of blood.

The cause is not entirely clear, but environmental factors are thought to play a major role. 

The bacterium Helicobacter pylori, which can cause chronic inflammation of the stomach lining, is the most significant risk factor. This bacterium is common, but fortunately it is easily treated with a combination of two or three types of antibiotics. As a result, it rarely leads to cancer. 

In addition, frequent consumption of highly salted and smoked foods (barbecue), genetic factors (3–5% of all stomach cancers), partial gastrectomy, smoking, excessive alcohol consumption, and occupational exposure to certain fumes are associated with an increased risk of stomach cancer.

Your doctor may suspect a stomach tumor based on your symptoms, but to confirm the diagnosis, further evaluation by a gastroenterologist is always necessary. 

The doctor will perform an endoscopic examination of the stomach (gastroscopy) and remove a small sample of tissue from the tumor for microscopic examination (biopsy). 

Metastases are detected using ultrasound and CT scans, possibly supplemented by exploratory surgery, an MRI scan, or a PET scan. 

Once the diagnosis is confirmed, further diagnostic tests (including a CT scan) will determine whether the cancer has spread. Treatment will be selected based on those results. 

A blood test can detect anemia.

If there are no metastases, the recommended course of action is to surgically remove the tumor after first performing exploratory surgery. The lymph nodes near the stomach are also removed and examined for cancer cells. This is often combined with chemotherapy, which may be started before the surgery to shrink the tumor and make the procedure easier. Chemotherapy is continued afterward.

In 75% of cases, the cancer has metastasized. In such cases, the decision is often made to administer chemotherapy alone and to limit further treatment to symptomatic, palliative care. The emphasis here is on quality of life rather than a cure.

During and after treatment, the patient will be closely monitored to detect and treat any recurrence, tumor progression, or potential deficiencies (such as vitamin B12) resulting from the removal of the stomach. 

Surgical intervention is now reserved only for complications such as a complete blockage of the food passage (obstruction). A tumor marker can be measured in the blood; this can be useful for monitoring the treatment.