A B C D E F G H I J K L M N O P R S T U V W

CANCER OF THE STOMACH

What is Cancer of the Stomach ?

This is a malignant growth or tumour of the stomach. The symptoms will depend on the site of the growth. Tumours at the upper end of the stomach may prevent food from entering the stomach. You might then notice difficulty in swallowing. If the tumour is near the exit of the stomach, stomach emptying may be prevented and vomiting may occur. Tumours in the middle of the stomach produce severe pain on eating. This pain may go through to the back. As a result of these symptoms, weight may be lost and you may become anaemic. Advanced tumours spread and may affect the liver, and even the glands in the neck.

How does Cancer of the Stomach occur ?

The cause of stomach cancer is unknown. Two types of people have a higher risk than average of developing such a growth: those who suffer from pernicious anaemia and those people with blood group A (suggesting that people may be born with a tendency to the condition). Although it was thought that a benign ulcer could turn malignant, it is more likely that a malignant ulcer has been that way all along.

Why does Cancer of the Stomach occur ?

The cause of stomach cancer is unknown. Two types of people have a higher risk than average of developing such a growth: those who suffer from pernicious anaemia, and to a lesser extent those people with blood group A (suggesting that people may be born with a tendency to the condition). Although it was thought that a benign ulcer could turn malignant, it is more likely that a malignant ulcer has been that way all along.

Treatment Involved for Cancer of the Stomach

THE DIAGNOSIS The presence of the growth is confirmed by gastroscopy, and examination of the stomach using a slim flexible telescope. You will receive some sedation or local anaesthetic on the back of the mouth. Then the telescope is passed through the mouth and into the stomach. At this examination, samples of the growth may be taken (a biopsy) and sent for microscopic examination. The extent of the growth can be assessed by an ultrasound scan. This uses sound waves to produce a type of radar image of the inside of the abdomen. Similar information is obtained using special x-rays (a CT scan) or magnetic (MRI) scan. If the growth is confined to the stomach, surgery may be performed. You will be admitted for 1 or 2 days before surgery for a full assessment of your general medical condition. You will then be seen by the surgeon and anaesthetist, who will explain the procedure to be performed. The physiotherapist will also visit to teach breathing exercises that will be important after the operation.

TREATMENT The operation will be performed under general anaesthetic and through an abdominal incision. The appropriate amount of stomach will be removed and a new stomach fashioned, using a section of small intestine.

POST-OPERATIVELY After waking up from the anaesthetic, you may have a number of tubes in place. Intravenous drips may be in the neck and others in the arm. These will allow blood, fluids or antibiotics to be given. The drips are continued until fluid and food can be taken by mouth. A tube is passed through the nose into the newly constructed stomach to withdraw juices and so reduce the chances of vomiting. This nasogastric tube is left until bowel activity has returned to normal. A urinary catheter (tube) will have been introduced into your bladder. This removes the need to pass urine in the immediate post-operative period. An abdominal drain will also have been positioned at the time of surgery to remove accumulations of fluid, as required. It is removed between 2 and 7 days later. Oral fluids and food are withheld until the surgeons are sure that the bowel activity has returned to normal and the internal stitches have healed. This usually takes between 7 and 10 days. Further x-rays may be taken 7 10 days after surgery to confirm that healing is satisfactory. At this stage, a light diet may be started and gradually built up over the next week.

After Treatment for Cancer of the Stomach

Following discharge from hospital you may well feel quite weak and lethargic. It will take many weeks before pre-operative strength and energy is regained. There may be upper abdominal fullness after eating. This will diminish as the new stomach stretches to accommodate more food. Eating small meals frequently rather than large meals infrequently may help. The condition may also improve if food is eaten as dry as possible. Liquids, which tend to expand the volume of food should be taken only 1 to 2 hours after the meal. Most people who have part of their stomach removed will lose weight for up to a couple of months after surgery, because of smaller meal sizes. At this point, your weight will probably level out and you may regain a few pounds. However, it is common to remain 7 to 14 pounds lighter after operation than you were before. Long-term anaemia is a risk, since the stomach is involved in the absorption of iron and vitamin B12. This can be simply remedied by vitamin injections and iron tablets. Your doctors will monitor this aspect in the outpatient department..

If Cancer of the Stomach is Left Untreated

Untreated cancer of the stomach is a very serious condition. If the condition was not treated, the symptoms such as difficulty in swallowing, vomiting and loss of weight, would progress.

Effects on Family of Cancer of the Stomach

Undergoing major stomach surgery requires reassurance and moral support. On returning home you will have lost weight and feel extremely weak and lethargic for the first month. During this time particular attention should be paid to diet. This will be discussed with you and perhaps your family before discharge by the surgeon or hospital dietitian. Small, high calorie snacks and drinks should be encouraged. Vitamin injections and tablets must be continued for life. A blood test must be done each year to ensure that anaemia has not occurred.