GASTRIC CANCER

Epidemiology:

Gastric cancer occurs all over the world however in some regions it is more common.

Incidence of gastric cancer among men in age of 50-70 is higher then among women. (M / F – 2/1), risk increases also in people with low socioeconomic status, pernicious anemia, blood group A. or case of gastric cancer in family story.

In the etiology of gastric cancer very important are environmental factors.

Studies have shown that migrant populations from high-risk areas show a marked reduction in risk when they move to low-incidence regions

Etiology:

(Factors which increases and reduces the risk of gastric cancer)

Factors increasing risk:

-Gastric cancer in family story

-Diet (excessive nitrate, oil, salt intake)

-Familial polyposis

-Gastric adenoma

-Hereditary nonpolyposis colorectal cancer

-The infection of Helicobact Pylori

-Atrophic gastritis, intestinal metaplasia, dysplasia

-Gastrectomy or gastrojejunostomy (> 10 years)

-Tobacco use

-Menetrier's Disease

Factors reducing risk:

-Aspirin use

-Diet (Fresh fruit and vegetable intake)

-Vitamin C

Clinical signs and symptoms:

Gastric cancer usually manifests itself quite late and it is not specific.

The most common symptoms is discomfort in the epigastric region. In advanced stages of the disease we can observe abdominal pain and weight loss.

Other symptoms include loss of appetite, fatigue, dysphagia, early satiety, nausea and vomiting. Hematemesis (vomiting with blood) is not common finding, however, occurrence of hidden bleeding, hepatomegaly (enlargement of the liver), ascites (the accumulation of fluid in the peritoneal cavity) and jaundice is quite often.

When abdominal pain becomes constant means that the tumor grow out of the stomach.

Treatment of gastric cancer:

Surgery is the main treatment of gastric cancer. Impact of radiotherapy and chemotherapy is limited.

Curative surgery; involve large and small omentum, front leaf of transverse mesocolon and pancreatic capsule removing, regional lymph node dissection and the provision of the passage. The location and shape of the lesion are necessary to be known to decide about surgical procedure that will be performed.