Malignant tumors of the stomach
The Russian-Japanese Oncology Center is engaged in the rehabilitation of patients with stomach cancer at any stage, using only proven and tested treatment methods.
Gastric cancer is a malignant tumor that develops from cells in the lining of the stomach. The incidence of patients with stomach cancer is not the least among all types of cancer. The disease affects men and women, usually aged 35 years and above.
The main questions our patients ask us:
- Causes of stomach cancer
- How does stomach cancer manifest?
- Types of stomach cancer
- Symptoms of stomach cancer
- How to diagnose the disease in time
- Treatment methods for stomach cancer
- What is the prognosis for stomach cancer?
Treatment process
Life expectancy for stage 3 gastric cancer depends on the extent of metastases. Occasionally, with the help of radical surgery, which involves total removal of the stomach (in whole or in part) and nearby tissue structures, it is possible to slow down the development of the disease. If the process is stabilized and the operation is successful, half of the patients survive to the five-year time barrier. But, unfortunately, surgery often has no influence on the metastasis that occurs. According to statistics, only 30% are guaranteed to live for 5 years.
When metastatic oncology of the infiltrative type is neglected, the chances of a favorable outcome are practically zero. As a rule, a person dies within 5-6 months. It is possible to count on an operation only for palliative purposes - to restore gastric patency when the lumen is blocked by a tumor. In addition, regional metastases that have affected the lymph nodes and nearby organs can be eliminated.
Causes of stomach cancer
Doctors at the Oncology Center identify various risk factors for stomach cancer.
- Hereditary causes
- Weakening of defenses with age
- Unbalanced diet
- Products with pesticides
- Eating a lot of salt
- Smoking
- Alcohol addiction
- Chronic gastritis and peptic ulcer
- Helicobacter pylori bacterium and viral infections
- Adenomatous polyposis
- Previous stomach surgeries
- Ecological background of the stay
- Immunodeficiency
The Russian-Japanese Oncology Center uses modern methods to prevent the causes of stomach cancer. Our doctors are ready to provide any assistance in preventing the disease and are focused on cooperation with the patient.
Stages of stomach cancer:
- Elementary
- Common
Adenocarcinoma is divided into 4 stages:
Stage I. The tumor is located within the mucous membrane and submucosa and does not grow into the walls of the stomach.
Stage II. The tumor grows into the muscle layer of the stomach wall and spreads to the lymph nodes.
Stage III. The cancer has grown through the entire wall of the stomach and, possibly, has spread to neighboring organs and managed to more strongly affect the nearby lymph nodes.
Stage IV. The tumor is accompanied by the spread of metastases to healthy organs, followed by disruption of their proper functionality. The tumor is capable of releasing toxic substances that poison the body.
Features of the 3rd stage of gastric oncology
The answer to a common question from patients: “How long do people live with stage 3 stomach cancer?” often depends on whether metastases occur in regional lymph nodes and whether nearby organs are affected, as well as whether the esophagus or small intestine is damaged (here everything depends on the location of the neoplasm). In medical practice, there are three types of stage 3 such cancer:
3a – characterized by the spread of the cancer focus to the gastric muscle layer; in addition, at least 7 lymph nodes are affected; 3b – the cancer lesion grows through the outer gastric wall and also involves at least 7 nodes; 3c – the tumor has spread beyond the boundaries of the stomach walls; a couple of lymph nodes are affected.
Gastric cancer metastases
Cancer cells can break away from the mother tumor, migrate to other parts of the body with the lymph flow and enter the lymph nodes of the abdominal cavity, and from them to the lymph nodes of the supraclavicular region - Virchow's metastasis.
Metastasis to lymph nodes is called Schnitzler metastasis. Through the bloodstream, cancer cells most often spread to the liver, less often to the lungs.
Cancer cells can also spread throughout the abdominal cavity. If they settle on the ovaries, a Krukenberg metastasis is formed, in the navel - a sister Mary Joseph metastasis.
Stomach cancer: symptoms
In the early stages, stomach cancer does not have a pronounced form, or is similar to the symptoms of gastritis and acute gastric ulcers.
- Decreased appetite
- Pain in the stomach area
- Dizziness
- Weakness and increased fatigue
- Decreased performance
- Weight loss
- Unpleasant sensations in the stomach
- Difficulty swallowing solid foods
- Difficulty swallowing liquid food
- Constant heartburn
- Vomiting after eating food
- Abdominal enlargement
- The appearance of black stools mixed with blood
According to the observation of doctors at the Oncology Center, more than 60% of cases of stomach cancer are diagnosed at an advanced stage with possible metastases. Such patients require immediate treatment and emergency care.
We strongly recommend that you undergo an annual routine stomach examination, which does not take much time and is necessary for every person. Since stomach cancer can develop asymptomatically!
Recommended examination:
- Appointment and examination by a doctor
- Classic gastroscopy
- NLS gastroscopy
- Analyzes
- Radiography
- Ultrasonography
Symptoms of stomach cancer
Like most cancers, stomach cancer does not manifest itself for a long time. This is why it is so important to undergo regular health checks. At the initial stage, the disease can make itself felt by fatigue, weakness, discomfort in the upper abdomen, a feeling of bloating after eating, nausea, loss of appetite, and heartburn.
You should be attentive to your health if you already have concomitant diseases of the gastrointestinal tract, for example, stomach and duodenal ulcers and some types of gastritis, including atrophic gastritis, leading to the death of some stomach cells, stomach polyps (the frequency of their degeneration into a malignant tumor is 20 - 50%). One of the reasons for the appearance of a malignant tumor may be anemia caused by a deficiency of vitamin B12, since this vitamin is of great importance in the formation of gastrointestinal epithelial cells.
In later stages, the patient may be bothered by:
- Blood in stool (black stool).
- Vomit.
- Losing weight for no apparent reason.
- Stomach pain, feeling of fullness, belching.
- Jaundice (yellowing of the skin and eyes).
- Ascites (accumulation of fluid in the abdominal cavity - enlargement of the abdomen).
The extreme form of this, like any other type of cancer, is extensive metastasis. This occurs lymphogenously, malignant cells spread through the lymphatic system, after which stomach cancer manifests itself in the form of rare specific types of secondary tumors. Most often, stomach cancer metastasizes to the liver, lungs, brain, kidneys, and bones. Gastric cancer is also characterized by screening of tumor cells into the surrounding tissues of the pleura, pericardium, diaphragm, peritoneum, and omentum.
Treatment of stomach cancer
Stomach cancer is highly treatable at an early stage. If the patient comes to us at a later stage, when the tumor has progressed with possible metastases, a combined treatment method is used.
For advanced cases of stomach cancer, surgery is used with drug support for the patient and an intensive rehabilitation period.
Treatment of stomach cancer is a set of measures aimed at getting rid of the disease, improving the patient’s well-being and returning him to a full life.
There are protocol methods for treating stomach cancer, such as chemotherapy, hormonal therapy, surgical treatment, radiation therapy and others.
The Russian-Japanese Oncology Center uses only proven and proven methods
The maximum effectiveness of treatment for stomach cancer is achieved only if the patient has a great desire for recovery, the support of loved ones, and trust in the doctor in treating the patient, which is carried out in accordance with high international standards, using the scientific clinical base and the experience of scientists from the Russian Federation and Japan.
Statistics from the Oncology Center show stable results in the treatment and rehabilitation of stomach cancer
Patients who applied at stage I.
Within a year after the discovery of stomach cancer after rehabilitation treatment, 100% of those who applied survive and live a full life for more than 20 years - almost 92% of patients
Patients who applied at stage II.
Within a year after the discovery of stomach cancer after rehabilitation treatment, 100% of those who applied survive and live a full life for more than 15 years - almost 79% of patients
Patients who applied at stage III.
Within a year after the discovery of stomach cancer after rehabilitation treatment, 100% of those who applied survive and live a full life for more than 10 years - almost 58% of patients
Patients who applied at stage IV.
Within a year after the discovery of stomach cancer after rehabilitation treatment, 100% of those who applied survive and live a full life for more than 5 years - almost 36% of patients
The patient should never forget that stomach cancer is an aggressive cancer. Relapses are possible, so we make sure to monitor our patients at least twice a year and repeat the supporting set of rehabilitation measures after one and a half to two years.
Our experience shows that treatment of stomach cancer is always possible, even regardless of its stage and location. The developed and tested methods of our oncology center are aimed at curing this disease, reducing its symptoms (difficulty eating, severe pain), preventing the progression of the disease and improving the quality of life!
Gastric cancer with osteolytic metastasis to the skull bones
Stomach cancer in Russia and Eastern Europe traditionally occupies the leading indicators of disease and mortality - it ranks third in prevalence and second in mortality among all malignant neoplasms. At the same time, gastric cancer in Russia is detected most often in the last stages (41.2% are stage 4).
The liver and lungs are most often affected by hematogenous metastasis of gastric cancer. Bone metastases are detected during patient management in 0.9–2.8% of cases (and increasing to 13% in autopsies). The average survival time when bone metastases are detected is reduced to 100 days. Risk factors for the development of bone metastases in patients with gastric cancer include smoking, poorly differentiated adenocarcinoma, high levels of lactate dehydrogenase, alkaline phosphatase, carcioembryonic antigen). Osteoblastic type of metastases worsens survival prognosis.
After surgery for stomach cancer T4N2M1 (Gastrectomy on June 28, 2016 (no extract, Ukraine), the patient, 61 years old, did not seek help for about 9 months. June 19, 2017 - opening of a hematoma and abscess in the area of the tumor on the head at the place of residence, the patient applied to the RNIOI. During further examination at the RNIOI: MRI of the brain with CU on 07/12/2017 - metastatic lesion of the skull bones, a lesion in the left frontal and parietal bones up to 62 by 49 by 58 mm with extra-, intracranial growth location in the region of the falx and the upper sagittal sinus. Hospitalized. Neurological status on admission was unremarkable, Karnofsky index: 60, treated with antibiotics.
Rice. 1. MRI images and photograph of the tumor (state before surgery).
08/1/2017 Progress of the operation: With the patient lying on his back, under MSA conditions, a metastatic tumor up to 8 by 7 by 7 cm was mobilized from the bordering skin incision in the left frontoparietal region, destroying the bone, soft-elastic consistency, gray-pink color, abundantly supplied with blood, with a bleeding exophytic component, spreading epidurally and growing into the outer layer of the dura mater. A resection craniotomy was performed within the intact bone tissue with radical removal of the tumor, the outer layer of the dura mater, germinated by the tumor, was resected, and the dura mater was sealed using a Tachocomb. Staged hemostasis with wax, coagulation and surgy cell.
Prof. N, a combined skin plasty of the resulting defect was performed: plasty with a displaced skin flap from the right frontal-temporo-occipital region and free skin plasty with a skin flap from the anterior abdominal wall. Passive tubular drainage into the subcutaneous space. Stitches on the skin. Aseptic dressing.
The postoperative period was complicated by the development of a subcutaneous suppurating hematoma in the left frontoparietal region, an increase in body temperature to 38.40 C, leukocytosis to 24.4 per 109 /l (PY - 14), the hematoma was evacuated and drained through the angle of the postoperative wound, a drainage tube was installed , when inoculating wound discharge - E.Coli 107, sensitive to meropenem, against the background of adequate antibacterial therapy, consistent with wedge. pharmacologist, and regular sanitation of the subcutaneous space, the patient’s condition improved - body temperature returned to normal, leukocytosis decreased to 15.5 per 109 / l (PY - 9), on the 10th day of the postoperative period there were complaints of bloating, epigastric pain, nausea, absence of stool for 3 days, non-passage of gases, with a survey R-graphy of the abdominal organs - horizontal levels of free fluid in the form of Kloiber cups with the formation of colonic obstruction, the head was consulted. JSC No. 2, prof. S, in agreement with the chief physician of the RNIOI. prof. B. according to urgent indications, the patient was taken to the operating room.
Rice. 2. MRI image and photograph (state after surgery).
Histological examination: adenoid cystic carcinoma with extensive foci of necrosis and infiltrative growth.
General blood analysis:
Hemoglobin (130–170 g/l) — 29.07.17–122; 11.08.17–75;
Red blood cells (4.0–5.0 1012/l) — 29.07.17–4,48; 11.08.17–2,87;
Leukocytes (4.0–5-9.0·109/l) — 29.07.17–4,92; 11.08.17–15,4;
Platelets (180.-320·109/l) — 29.07.17–281; 11.08.17–827;
Erythrocyte sedimentation rate (3–10 mm/h) — 29.07.17–25; 11.08.17–30;
General urine analysis:
Leukocytes (0–3 units/ml) — 29.07.17–1–2; 11.08.17–9–12;
Blood chemistry:
Total blood protein (64–84 g/l) — 29.07.17–84,0; 11.08.17–57,2;
Creatinine ( 62–115 μmol/l) — 07/29/17– 59.0; 08/11/17– 53.0;
Coagulogram:
D-dimer (0–0.55 μg fibrinogen equivalent units per ml) – 08/11/17–1.64;
Based on consultation with a therapist, cardiologist, blood test for HBC, concomitant diseases include: Chronic viral hepatitis C, Heart rhythm disturbances: supraventricular extrasystole, stage 1 CHF, FC 2, stage II hypertension, degree of hypertension 1, risk 1.
Progress of the operation: With the patient lying on his back, under conditions of multicomponent balanced anesthesia, a transrectal laparotomy was performed on the right, during inspection of the abdominal organs: in all sections there was up to 2 liters of ascitic fluid, the abdominal cavity was drained, the small and large intestines were represented as a single dense conglomerate, fused together dense adhesions with multiple dense metastatic foci, it is not possible to determine the area of obstruction. There are also multiple metastatic lesions in the parietal peritoneum in the form of dense foci up to 1 cm in diameter. Due to the generalization of the process and the impossibility of assessing the level of obstruction, it was decided to limit ourselves to diagnostic laparotomy and drainage of the abdominal cavity. Hemostasis. The abdominal cavity is drained by a tube in the pelvis through a counter-aperture in the right iliac region. Layer-by-layer suturing of the abdominal wall wound and application of an aseptic bandage.
Condition at discharge: severe, due to the development of intestinal obstruction. Neurological status at discharge: Consciousness clear, communicative, adequate. There are no focal or meningeal lesions. The tongue is a bit dry. The abdomen is soft, moderately painful in the epigastrium, gases pass poorly, peristalsis can be heard, and there is no evidence of peritoneal irritation. Karnofsky scale - 50 points. Postoperative wounds heal by primary intention, and there is scanty serous-purulent discharge from under the skin flap in the left frontoparietal region. Parenteral nutrition, the nasogastric tube was removed at the patient's insistence. Due to the generalization of stomach cancer - carcinomatosis in the visceral and parietal peritoneum and the formation of intestinal obstruction, further special treatment is not indicated for the patient; at the patient's insistence, he is discharged for symptomatic therapy under the supervision of an oncologist at the place of residence.
The standard algorithm for metastatic cancer is the use of palliative chemotherapy (followed by the possibility of surgical treatment), in the case of an operable tumor, to limit dissemination of the abdominal cavity and prevent further carcinomatosis, the use of postoperative or pre- and postoperative chemotherapy is also indicated. Single use of surgical treatment at stage IV is uncharacteristic.
Considering the activity according to the Karnofsky index = 60% (~ECOG = 2), the elderly age of the patient, concomitant diseases and the complication of intestinal obstruction, it was possible to carry out chemotherapy using the XELOX regimen (Capecitabine 1000 mg/m²x 2 times a day orally from 1 to 14 days of the cycle or from the evening of the first day to the morning of the 15th day of the cycle + Oxaliplatin 100–130 mg/m²/drip on day 1) in combination with symptomatic therapy to improve quality of life
Also, the patient did not undergo an immunohistochemical study for HER2 status, which, in case of a positive result, allows the use of the T-XP regimen (Trastuzumab 8 mg/kg on day 1 of the first course, then 6 mg/kg on day 1 + Capecitabine 1000 mg/m²x 2 times a day orally from days 1 to 14 of the cycle or from the evening of the first day to the morning of the 15th day of the cycle + Cisplatin 80 mg/m² IV drip on day 1)
