What is stomach cancer, what causes and what symptoms

Do you know What is stomach cancer, what its causes are, and what symptoms stomach cancer is one of the most common tumors that has a high mortality rate, primarily due to late detection? Most patients require a combination of surgery and chemotherapy, sometimes combined with radiation and targeted therapy.

For the treatment of stomach cancer in Israel, not only open but also minimally invasive surgical interventions are carried out: endoscopic, laparoscopic, and robot-assisted. In the later stages, doctors perform combined surgeries, hyperthermic intraperitoneal chemotherapy, and use new immune and targeted drugs.

This is a malignant tumor of the corresponding organ, which originates from epithelial tissue, and most often develops against the background of atrophic gastritis associated with Helicobacter pylori infection.

In different countries, the incidence of the disease is not the same. Most of all, the Asian population suffers from stomach cancer, the inhabitants of Western Europe and North America are the least affected. In Russia and other countries of the former USSR, the prevalence of gastric cancer is high: this pathology ranks 3rd in terms of mortality from cancer.

The disease is prognostically unfavorable. In most cases, it is detected late, since the symptoms of gastric adenocarcinoma do not appear for a long time. Screening for this pathology is carried out only in Asian countries: Japan, South Korea, China, and Kazakhstan.

Symptoms of gastric adenocarcinoma by stages

Stage 1-2 - there are no clinical signs;

Stage 3 - poor appetite, nausea, vomiting, rapid satiety, heartburn, vomiting blood, black stools;

Stage 4 - fever, jaundice, enlargement of the abdomen due to accumulation of fluid, weakness, abdominal pain.

Surgical treatment of stomach cancer in world

The basis of gastric cancer treatment in the world is a surgical method. Doctors carry out interventions in different volumes, from the removal of only a section of the gastric mucosa to extensive combined interventions with the removal of several abdominal organs.

Operation options:

endoscopic removal of the tumor;

resection of the stomach;

gastrectomy;

combined operations to remove the stomach and single distant metastases.

In early cancer, intervention can be performed laparoscopically. In other cases, Israeli surgeons use traditional open access.

Endoscopic treatment of stomach tumor

Judging by the reviews, the treatment of stomach cancer in Israel is not only effective, but also very gentle. Physicians always prefer a less invasive intervention if it can lead to similar oncological outcomes.

In the early stages, tumors can be removed endoscopically: from inside the gastrointestinal tract, without incisions in the skin. Through the oral cavity, pharynx, and esophagus, the doctor inserts a gastroresectoscope, with the help of which the area of ​​the affected mucosa is excised. In the future, the defect heals with the formation of a scar.

Operation options:

endoscopic resection of the mucosa;

submucosal dissection.

These surgeries are infrequent. How early tumors are detected only in those who are screened. In addition, timely detection of a neoplasm is possible in patients who are being examined for atrophic gastritis and dysplasia (precancerous conditions) of the gastric mucosa.

Even with a small tumor size, the treatment of poorly differentiated gastric adenocarcinoma using the endoscopic method is impossible due to the high risk of lymphogenous metastasis of the neoplasm. The main candidates for endoscopic surgery are patients with tumors:

up to 2 cm;

not extending beyond the mucous membrane;

without ulceration;

with a moderate or high degree of differentiation;

without ultrasound or CT signs of metastasis to the lymph nodes.

In Israel, magnifying endoscopy, narrow-spectrum endoscopy, chromoendoscopy, endosonography (endoscopic ultrasound) are used to increase the efficiency of the operation. These methods make it possible to assess the depth of tumor invasion and distinguish tumor tissues from normal ones in order to remove the neoplasm completely and avoid local recurrence.

In some patients, endoscopic treatment turns into surgery. This is possible if:

revealed tumor invasion into the submucosal layer;

the size of the neoplasm was more than 2 cm;

positive resection margin (cancer cells at the border of the removed tissue);

germination of the tumor in large blood and lymphatic vessels.

Resection of the stomach in oncology

Subtotal resection of the stomach - performed for early cancer in patients who are not suitable for endoscopic removal of the tumor. This operation involves partial removal of the stomach. Although the remaining part is small, this surgical option provides a lower risk of complications and improves the quality of life of patients.

Recent studies show that laparoscopic removal of early-stage tumors does not worsen oncological outcomes compared to traditional open surgery. Therefore, this technique is preferred by Israeli surgeons. Reviews on the forums about the treatment of stomach cancer in Israel confirm that this operation is more gentle and better tolerated by patients.

According to the volume of the performed intervention, resection can be:

distal - remove the lower part of the stomach, near the duodenum;

proximal - remove the upper part of the organ located near the esophagus.

Surgical intervention is always complemented by lymph node dissection. Usually lymph nodes of two levels are removed. Para-aortic lymphadenectomy is not performed in Israel due to the high rate of complications, despite the fact that this stage of the operation does not increase the survival rate of patients.

Gastrectomy - complete removal of the stomach in oncology

Gastrectomy is a surgery to completely remove the stomach. Intervention is carried out in different ways. Most often, it involves the removal of the stomach as a single block with the surrounding tissue, the greater and lesser omentum, and regional lymph nodes. They recede from the edge of the tumor by 5 cm. In the case of ulcerative-infiltrative and diffuse cancer, the indentation reaches 7 cm. removed tissue).

Together with the stomach, it is often necessary to remove the spleen. This is necessary if:

the tumor has spread to that organ;

the spleen is damaged during the operation;

a tumor corresponding to stage T3 or T4 is located on the posterior wall or greater curvature of the upper third of the body of the stomach;

revealed metastases in the lymph nodes of the gate of the spleen;

the neoplasm has grown into the tail of the pancreas or the vessels of the spleen.

Other methods of treating stomach tumors in the world

In most cases, patients receive combined treatment. It includes not only the surgical stage but also other methods of treating gastric adenocarcinoma, most often chemotherapy.

Combined treatment options:

Perioperative chemotherapy is the standard option used in most patients. Doctors start medication before surgery and continue it after the stomach is removed.

Postoperative chemotherapy - is used less frequently, usually in cases where initial drug treatment is not planned, but after surgery, factors are found that increase the risk of relapse: tumor growth into nerves, blood vessels, low differentiation, removal of less than 15 lymph nodes.

Postoperative chemoradiotherapy is a combination of chemotherapy and radiation. It is rarely used, only in cases where the doctor was unable to remove the tumor completely.

Targeted therapy is used in patients with HER2-positive tumors. Patients have been prescribed trastuzumab. Less commonly used other drugs:

antibody-drug conjugate (fam-trastuzumab deruxtecan) – for the delivery of chemotherapy drugs to HER2-positive tumors;

VEGF-targeted drugs (ramucirumab) - block the formation of blood vessels that feed the tumor;

TRK inhibitors (larotrectinib, entrectinib) are used in a small number of patients with mutations in the NTRK genes.

Immune therapy involves the use of PD-1 inhibitors (nivolumab, pembrolizumab). The treatment is combined with chemotherapy for advanced stomach cancer. These drugs do not suppress the tumor by themselves but enhance the antitumor immune response.

Treatment of oligometastatic form of oncology

Even the appearance of distant cancer metastases is not a reason to give up and move on to symptomatic therapy. In Israel, the treatment of gastric adenocarcinoma at the last stage is carried out using a surgical method if:

the patient responds well to chemotherapy;

according to the results of the examination, doctors believe that the primary tumor and its metastases can be completely removed.

Gastric cancer can metastasize through the blood, lymph, and also spreads through the abdominal cavity, growing into neighboring organs: the pancreas, liver, and colon. In such cases, combined operations are performed. Often, tumor foci are found in the ovaries in women. They can also be removed during surgery.

Another method of controlling oligometastases (single metastases) is the combination of gastric surgery with other methods of suppressing metastatic foci:

stereotactic radiotherapy - irradiation of a metastatic tumor with high doses of radiation in a minimum number of sessions;

radiofrequency or microwave ablation - the destruction of a metastasis by heating a probe or antenna inserted into the center of the tumor;

chemoembolization - most often used to suppress liver metastases, involves blockage of the branches of the hepatic artery with microspheres saturated with chemotherapy drugs.

With the spread of cancer in the peritoneum, a cytoreductive operation is performed with the removal of all visible tumor foci. After resection of R0 or R1 (complete or almost complete), the abdominal cavity is washed with a heated solution of chemotherapy drugs. Chemoperfusion allows high doses of drugs to destroy the remaining cancer cells.

Palliative treatment of stomach cancer in Israel

Palliative interventions are carried out in the advanced stages of cancer, to prevent and eliminate complications. They do not aim to increase the life expectancy of the patient, although it is not uncommon to achieve long-term survival after the removal of most of the tumor foci.

Palliative resection of the stomach or gastrectomy is performed in such cases:

life-threatening complications that cannot be stopped by other means (gastric bleeding, tumor stenosis);

the transition of the tumor to a resectable state under the influence of drug therapy, if the doctor sees opportunities for its complete removal.

In addition to operations, other options for palliative treatment are also used - more sparing. With tumor stenosis, stents (frameworks) are installed in the narrowing zone. They allow food to pass into the lower digestive tract. Before the stent is placed, endoscopic ablation (destruction) of the tumor is possible.

For stomach bleeding, it is not necessary to remove the stomach. In Israel, a sparing method of endovascular treatment is used: embolization of the artery that feeds the tumor. Most often it is the left, right gastric, gastroepiploic artery or branches of the gastroduodenal artery. The operation is performed by a minimally invasive method: through an incision on the leg, under X-ray control. In some patients, it can be performed in the form of chemoembolization. Vessels are clogged with tiny balls containing chemotherapy drugs. Drugs are released from emboli for a long time, reducing the tumor in size.

What is gastric leiomyosarcoma and how is it treated?

Leiomyosarcoma of the stomach is a true muscle tumor. It does not apply to cancer. Only neoplasms from epithelial tissue are considered cancer, while gastric leiomyosarcoma is a malignant leiomyoma - a neoplasm of smooth muscle tissue. In 90% of cases, it is localized in the region of the middle third of the stomach.

The tumor is very rare. It accounts for no more than 0.1% of neoplasms of this localization. For those suffering from leiomyosarcoma of the stomach, reviews on the forums can be found infrequently.

In most cases, the tumor does not grow into the lumen of the stomach, but toward the abdominal cavity. It rarely grows into the wall of the organ. Therefore, it is easier to detect gastric leiomyosarcoma on CT than with the help of endoscopic examination. In general, these neoplasms are detected later, often when they reach large sizes. Sometimes a palpable tumor in the abdomen becomes the first symptom, since gastric bleeding is not typical for it, and the patient's health remains good for a long time.

What are the chances for gastric leiomyosarcoma to cure this disease? They are quite high, especially with timely detection, and the main role in the treatment of pathology belongs to surgery. A feature of the tumor is its low sensitivity to chemotherapy and radiation.

Why is it recommended to treat a stomach tumor in the universe?

You can go to one of the world's clinics to get high-level medical care. It makes no sense to look for prices for gastric cancer treatment in Israel on the forums: this information is often outdated. In addition, different patients receive different types of therapy and undergo it in different clinics. Therefore, it can be difficult to get reliable information about the cost of treating stomach cancer in the world

You can find out the approximate prices for the treatment of stomach cancer on health websites. Contact us by phone or via messengers for a free consultationon these websites Provide us with your medical documents: research results, and epicrises, and we will find out for you the exact cost of gastric cancer treatment in worldIsraHospital specialists will organize your trip abroad and provide support during the entire period of your stay in another country.