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Dr. Rajesh Patel, MD.
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Ask the Doctor!
October 2009
Q:
I was just wondering which stages of stomach cancer are operable and which stages are considered.. well,
hopeless? Also, what are some of the symptoms?
-- J. Wellington, Benton Harbor, MI
A:
Gastric cancer (cancer of the stomach) will often have no striking features in terms of symptoms. Quite often, symptoms overlap other conditions, namely viral infections of the stomach. As a result, this cancer is picked up at an early stage only about 20% of the time. So it is important to see your doctor for persistent symptoms such as an inexplicable weight loss, vague abdominal pain or swelling, nausea, "heartburn", vomiting, or an unusually full feeling after eating only a small amount of food. To add further confusion, these symptoms can arise from other cancers as well.
Thankfully, we do not seem to have as much incidence of this cancer as before. It is still advisable to limit of the ingestion pickled and smoked foods. Routinely high exposure to these food processes has been correlated with gastric cancer (as found in population studies in Japan). Another great way to help avoid this disease is to quit smoking. Tobacco contains chemical compounds that are harmful to a host of organs, including the stomach. It is also a good idea to identify any family history of cancer and to be vigilant about reducing "heartburn" or any ulcer-like conditions.
There are basically four phases of classification in gastric cancer. In stage 0/I, the tumor is confined to the stomach lining, and possibly some local lymph nodes. Stage II tumors cross the lining and go into the muscle layer of the stomach. Stage III involves either large tumor growth pushing through all the stomach layers or any-size tumor that has spread significantly to lymph nodes. Finally, stage IV consists of a cancer that has either broke through the stomach tissue and spread to other structures, nearby or distant.
As you can tell, there is some ambiguity to these stages. So we utilize surgery on an individual basis, assessing the pros and cons. (Will the surgery remove enough cancerous tissue to benefit the patient? Or will the procedure unnecessarily put the person at risk of surgical complications such as bleeding and infection?) Generally stages I, II, and III are often helped through surgical care. Stage IV is complicated and surgery usually provides less benefit to the patient. So surgery may not always be the best option at that point. However, there are other options that are very beneficial and still give us hope. Laser technology, chemotherapy, and radiation are excellent tools at our disposal to fight off this cancer at various stages. Although experimental, advanced techniques conducted for clinical trials may also be considered.
Again, we look at each person's condition for the unique circumstance that it is and proceed accordingly. There aren't any "hard and fast" rules regarding treatment. Rather, the patient together with his/her team of doctors will formulate a plan best suited to meeting the most reasonable and hopeful of goals.
Submit your questions to askthedoctor@nowoodennickels.org
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