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Transcript of GASTRIC CANCER - · PDF file GASTRIC CANCER What patients need to know about gastric cancer...

  • What patients need to know about gastric cancer This medical guide is designed to provide the background and necessary information for gastric cancer management. Discussions with your healthcare provider will help you further understand symptoms, risks, and overall health.

    GASTRIC CANCER

  • GASTRIC CANCER What patients need to know about gastric cancer

    How does a healthy stomach work?

    Fundus

    Middle

    Pylorus

    Cardiac sphincter

    Pyloric sphincter

    Bowel

    Esophagus

    The stomach is a part of the digestive system. It is a muscular bag that digests your food by churning it with the acidic juices and pepsin produced in the walls of the stomach. The thick liquid mixture moves down to the bowel where the body absorbs it. To protect its lining from the acid and pepsin when it is empty, the stomach produces a thick mucus.1

    Esophagus: The food pipe that carries the food from your mouth to your stomach. Cardiac sphincter: The valve at the top of the stomach that joins with the esophagus. Fundus: The upper part of the stomach. Pylorus: The end part of the stomach which marks the end of the stomach and the beginning of the small intestine. Pyloric sphincter: The valve at the bottom of the stomach that joins with the small intestine.

    What patients need to know about gastric cancer

    CONTENTS • How does a healthy stomach work?

    • What is gastric cancer?

    • What are the different types of gastric cancer?

    • What causes gastric cancer?

    • What are the symptoms of gastric cancer?

    • How is gastric cancer diagnosed?

    • How is gastric cancer treated?

    • Living with gastric cancer

    • Frequently asked questions

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  • GASTRIC CANCER What patients need to know about gastric cancer

    04 05

    Normal Gastric Cancer

    What is gastric cancer?

    Stages of Gastric Cancer

    Stage 0 Stage IVStage I Stage II Stage III

    Mucosa Submucosa

    Muscle

    Outer layer (serosa)

    Gastric cancer commonly begins in the inner lining of the upper part of the stomach. It can spread through the walls of the stomach and invade other organs or spread to the lymph vessels and nodes.2-4

    Gastric cancer can be staged from 0 to IV. Stage 0 is when the tumour is found only in the inner layer of the stomach. As the stage number increases, the bigger the cancer has grown and the further the cancer has spread.5

    Gastric cancer, also called stomach cancer, begins when stomach cells grow excessively and build up to form a tumour. These tumours are harmful if they are malignant or cancerous. 2-4

    Tumour Healthy mucosa

    Tumour

  • GASTRIC CANCER What patients need to know about gastric cancer

    06 07

    Adenocarcinoma Gastroesophageal cancer

    Gastroesophageal junction cancer

    Esophagus

    Gastroesophageal junction

    Gastric cancer

    What are the different types of gastric cancer? Stomach cancer may include other rare cancers that develop inside the stomach. They include:7

    A type of skin cancer that begins in the squamous cells (cells of the middle and outer layer of the skin)12

    Squamous Cell Cancer

    Cancer that starts in the lymph nodes of the lymphatic system8Lymphoma

    A common type of soft tissue sarcoma that develop in smooth muscle cells11

    Leiomyoarcoma

    Rare tumours that develop in nerve or gland cells of the neuroendocrine system10

    Neuroendocrine Tumours

    A rare type of sarcoma found in the wall of the stomach9

    Gastrointestinal Stromal Tumour

    (GIST)

    The most common type of cancer is adenocarcinoma. This type of cancer forms in the gland cells that line the stomach.6

    Recently, the rates of cancer in the stomach body have been decreasing while the number of cancer in the gastroesophageal junction (where the lower end of the esophagus and the top part of the stomach meet) has been increasing.6

    This type of cancer is called gastroesophageal cancer.6

  • GASTRIC CANCER What patients need to know about gastric cancer

    Gender

    Gastric cancer occurs more often in males than in females.

    Family History

    Those who have a family history of stomach cancer have a higher risk of getting the disease.

    Infection with Helicobacter pylori Bacteria

    Long term infection with Helicobacter pylori, a type of bacteria that lives in the mucus of the stomach’s lining, increases the risk of gastric cancer.

    Lifestyle Factors

    Smoking and a poor diet that is high in pickled, smoked, processed, and salted foods and low in fresh fruits and vegetables are highly linked with gastric cancer.

    Age

    The risk of gastric cancer increases with age like many other types of cancer. Most men who are diagnosed with gastric cancer are above 50 years old and around half of gastric cancers develop in people aged 75 or over.

    08 09

    What causes gastric cancer? Although the exact cause of how cells in the stomach lining become cancerous is still unknown, there are several risk factors that are associated with gastric cancer including:13-15

  • GASTRIC CANCER What patients need to know about gastric cancer

    What are the symptoms of gastric cancer? Many symptoms of gastric cancer can be easily mistaken for symptoms of other health problems, such as ulcer.

    However, it is very important for you not to leave them unnoticed. If you have any of these symptoms, it is highly recommended that you consult with your doctor.16

    Nausea and vomiting Stomach pain

    Unintended weight loss

    Having blood in vomit or stool

    Difficulty in swallowing or

    digesting

    Feeling full or bloated after eating a small

    amount of food

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    Symptoms of Gastric Cancer

  • GASTRIC CANCER What patients need to know about gastric cancer

    Endoscopy Ultrasound

    x-rayBiopsy

    Endoscopy Ultrasound

    x-rayBiopsy

    Endoscopy Ultrasound

    x-rayBiopsy

    MRI PET

    MRI PET

    MRI PET

    MRI PET

    Endoscopy Ultrasound

    x-rayBiopsy

    How is gastric cancer diagnosed?

    Diag nosis of gastri c cancer

    Upper endoscopy The main test used to find stomach cancer

    Endoscopic ultrasound An ultrasound procedure that uses a small transducer placed on the tip of the endoscope

    Biopsy The removal of a sample of stomach cells through endoscopy for analysis

    Upper gastrointestinal (GI) series An x-ray that is used to look at the inner lining of the esophagus, stomach, and first part of the small intestine

    If gastric cancer is suspected, the doctor will review your medical history and examine you to confirm the diagnosis.

    Endoscopy: A procedure that uses a thin, flexible tube with a small video camera on the end (endoscope) and passes it down the throat to see the linings of the esophagus and the stomach. Endoscopic ultrasound: Ultrasound procedure that has the transducer rest directly on the wall of the stomach where the cancer is located. Upper gastrointestinal (GI) series: An x-ray procedure that requires the patient to drink a substance called barium that coats the lining of the esophagus, stomach, and small intestine prior to imaging.

    CT (computerized tomography) scan: a type of scan that uses series of X-rays that build up a 3D picture of inside the body. MRI (magnetic resonance imaging) scan: a type of scan that uses strong magnetic fields and radio waves to produce detailed images of inside the body. PET (positron emission tomography) scan: a type of scan that creates a picture using a radioactive substance that is injected into the vein.

    Tests and procedures used to diagnose both adenocarcinoma and gastroesophageal cancer include:17

    CT/CAT scan To check the spread of cancer through detailed cross–sectional images of the body

    MRI scan A scan that uses radio waves and strong magnetic fields instead of x-rays

    PET scan To find out whether the cancer has spread to other areas of the body

    Chest X-ray To find out if the cancer has spread to the lungs

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    Diagnosis of Gastric Cancer

  • GASTRIC CANCER What patients need to know about gastric cancer

    Hormone theraphy

    Radiation theraphy Surgery

    chemotheraphy

    Targeted theraphy

    How is gastric cancer treated? Depending on the location, size, type, and stage of your gastric cancer, there are various ways to treat the disease. The main treatments include:18, 19

    Hormone theraphy

    Radiation theraphy Surgery

    chemotheraphy

    Targeted theraphy

    Obesity Alcohol Radiation therapy

    Hormone Therapy Birth control

    Hormone theraphy

    Radiation theraphy Surgery

    chemotheraphy

    Targeted theraphy

    Targeted Therapy

    Targeted therapy is a drug-treatment that attacks specific cell irregularities or directs the immune system to kill cancer cells. Some targeted drugs used to treat stomach cancer include trastuzumab, ramucirumab, imatinib, sunitinib, and regorafenib.

    Chemotherapy

    Chemotherapy is a cancer-killing drug treatment given by injection or by mouth. It is often combined with radiation therapy. Chemotherapy regimens that are useful in treating gastric cancer include capecit