Stomach Cancer Treatment

Stomach Cancer Treatment: Symptoms, Diagnosis and Modern Treatment Approaches

Stomach cancer treatment is a multifaceted process planned according to the location of the tumor, its stage, and the patient’s general health condition. While the surgical success rate increases when diagnosed early, in advanced stages, life expectancy and quality of life can be significantly increased with chemotherapy, immunotherapy, and targeted drugs. Therefore, knowing the symptoms, risk factors, and modern treatment options for stomach cancer is critically important in disease management.

Stomach Cancer Symptoms

Since stomach cancer generally does not show obvious and specific symptoms in the early stage, many patients may confuse their complaints with simple stomach problems. However, as the disease progresses, some warning signs affecting stomach functions may emerge. The most common symptoms include bloating, indigestion, early satiety, loss of appetite, and burning sensation in the stomach area. The long-term persistence of these complaints, especially when seen in individuals over 40 years of age, should be evaluated as an important alarm signal. Advanced stage symptoms may include unexplained weight loss, fatigue, bloody vomiting, black-colored stool, severe pain in the upper stomach area, and difficulty swallowing. These symptoms may not be seen in all patients, but in their presence, consulting a gastroenterology specialist without delay significantly increases the chance of early diagnosis.

What Is Stomach Cancer, What Are Its Causes?

Stomach cancer is a serious disease that occurs as a result of cells multiplying uncontrollably and forming a tumor. Although there is no single cause, various factors that irritate the stomach mucosa or affect the genetic structure can lead to cellular changes over time. Chief among these is Helicobacter pylori (H. pylori) infection. This bacterium can disrupt cell structure by creating chronic inflammation in the stomach wall and lay the groundwork for cancer. Not treating H. pylori for many years significantly increases the risk of cancer along with ulcer development.

Another important cause is precursor lesions such as atrophic gastritis and intestinal metaplasia in stomach tissue. These structural changes tend to become cancerous over time. Genetic factors can also be effective in stomach cancer development. Particularly E-cadherin gene mutations increase the risk of familial stomach cancer and can cause the disease to appear even at a young age in some people.

Dietary habits also hold an important place among the causes of stomach cancer. Salted, smoked, and fermented foods can increase the risk of stomach cancer because they contain high amounts of nitrites. Long-term cigarette use contributes to cancer development by causing DNA damage in stomach tissues. Additionally, obesity, reflux disease, and stomach polyps are also among other factors that may pose a risk.

Risk Factors in Stomach Cancer

Stomach cancer can occur with the combination of many factors, and some people are at higher risk because they are exposed to these factors more intensely. One of the most important risk factors is H. pylori infection. Although this bacterium is one of the most common infections worldwide, many people are unaware of it because it progresses asymptomatically. However, in the long term, it can trigger cancer development by causing chronic gastritis and structural changes.

Age is also a determining factor in stomach cancer risk. The disease is generally more common in people over 50 years of age. Similarly, its higher occurrence in men than women suggests the influence of hormonal and environmental factors. Having a history of stomach cancer in the family, especially the presence of the disease in first-degree relatives, indicates genetic predisposition.

Dietary habits are again prominent among risk factors. Excessive salt consumption, processed meats, pickled products, and smoked foods have been linked to stomach cancer. In contrast, high consumption of fresh vegetables and fruits is a condition that reduces risk. Additionally, cigarettes, alcohol, obesity, and long-term stomach ailments also increase risk factors.

How Is Stomach Cancer Diagnosed?

Early diagnosis in stomach cancer is the most important factor directly affecting treatment success. The disease may not show obvious symptoms in early stages, so it is vitally important for people in the risk group to have regular check-ups. The gold standard method in diagnosis is endoscopy. During endoscopy, the inside of the stomach is visualized in detail and biopsies are taken from suspicious areas for pathological examination. This examination allows a definitive diagnosis to be made.

In addition to endoscopy, endoscopic ultrasonography (EUS) is very useful in evaluating how deep the tumor has progressed in the stomach wall and whether there is spread to surrounding tissues. Additionally, imaging methods such as computed tomography (CT) and PET-CT are used to investigate the spread of cancer to other organs.

Although tumor markers in blood tests are not specific, they can be evaluated as follow-up parameters during the treatment process. Detailed diagnosis is critical for determining the stage of the disease correctly and making an appropriate treatment plan.

Types of Stomach Cancer

Stomach cancers are classified into different types according to their cellular origin and behavioral characteristics. The most common type is adenocarcinoma. Approximately 90% of stomach cancers are in this group. Adenocarcinoma originates from the secretory glands in the stomach mucosa and is divided into two different subgroups: diffuse type and intestinal type.

Diffuse type adenocarcinoma is a type with a greater tendency to spread and a more aggressive course. Due to the loose structure of cells, it can harden the stomach wall, leading to a picture called “linitis plastica.” Intestinal type adenocarcinoma is more associated with environmental factors and generally develops as distinct tumor masses.

Among other stomach cancer types, lymphomas are tumors originating from lymphoid tissue in the stomach wall. Particularly MALT lymphoma is associated with H. pylori and can even respond to antibiotic treatment. Neuroendocrine tumors, squamous cell cancers, and stromal tumors (GIST) are among the rarer types of stomach cancer.

Since the behavioral characteristics, response to treatment, and spread pattern of each type are different, correct classification is critically important for treatment decisions.

Stomach Cancer Stages

Staging in stomach cancer is done according to the depth of tumor spread in the stomach wall, lymph node involvement, and distant organ metastasis. The staging system is generally evaluated based on TNM classification.

Stage 0 is the earliest stage where cancer is only in the most superficial layer of the stomach. At this stage, treatment may even be possible with endoscopic methods. Stage 1 is the stage where the tumor is limited to the stomach wall and there is no lymph node involvement or it is very limited.

Stages 2 and 3 cover situations where the tumor has progressed to deeper layers and spread to lymph nodes. In these stages, chemotherapy combinations are frequently applied along with surgery. Stage 4 is considered metastatic disease and refers to the spread of cancer to distant organs such as the liver, lungs, or peritoneum.

Staging is the most fundamental guide in determining disease course, planning treatment, and developing a patient-specific approach.

Stomach Cancer Treatment

Stomach cancer treatment is planned in a personalized way according to the stage of the tumor, the patient’s general health condition, and the biological characteristics of the tumor. In early-stage stomach cancers, the most effective method is surgical treatment where the tumorous area is completely removed. Depending on the location of the tumor, subtotal (partial) or total gastrectomy can be performed. Removal of lymph nodes during this operation is also an integral part of treatment.

In advanced stages, treatment is not limited to surgery alone. Neoadjuvant chemotherapy (pre-operative chemotherapy) can increase surgical success by shrinking the tumor. Adjuvant chemotherapy (post-operative chemotherapy) helps destroy microscopic cancer cells.

In recent years, immunotherapy and targeted treatments have provided significant advances in stomach cancer treatment. These treatments targeting specific molecules on the surface of cancer cells are particularly prolonging life expectancy and improving quality of life in advanced stages. In HER2-positive stomach cancers, targeted drugs such as trastuzumab can be effective. PD-1 inhibitors increase the immune system’s power to recognize and destroy cancer.

Palliative treatments can also be applied in some patients. In patients experiencing nutritional difficulties, quality of life can be maintained with endoscopic stent applications or supportive treatments.

Methods of Protection from Stomach Cancer

The most effective approach to protection from stomach cancer is lifestyle changes aimed at reducing risk factors and regular health check-ups. One of the most important steps is early detection and treatment of H. pylori infection, because leaving this bacterium untreated for a long time can accelerate the process leading to stomach cancer. Small changes in diet also make a big difference; a diet containing fresh vegetables and fruits, rich in antioxidants, contributes to protecting the stomach wall. In contrast, avoiding excessive consumption of salted, smoked, pickled, and processed foods helps reduce risk.

Quitting smoking, regular physical activity, and staying within the ideal weight range are also protective factors against stomach cancer. Having screening tests such as endoscopy at regular intervals, especially for people with a family history of stomach cancer or those experiencing long-term stomach complaints, makes early diagnosis possible. When all these methods are applied together, the risk of developing stomach cancer can be significantly reduced.

Stomach Cancer Treatment Approach with Prof. Dr. Samet Yardımcı

Working with the right specialist in stomach cancer treatment is one of the most important factors directly affecting the course of the disease. Prof. Dr. Samet Yardımcı, while having extensive experience in gastrointestinal system diseases and stomach cancer surgery, provides his patients with modern, evidence-based, and personalized treatment plans. Adopting a multidisciplinary approach from the diagnosis stage to treatment and post-operative follow-up processes, Prof. Dr. Yardımcı aims to apply the most optimal treatment method specific to each patient’s condition. He is a reliable point of reference for patients who want to get an expert opinion on diagnosis, treatment, and process management related to stomach cancer.

Frequently Asked Questions

1. What is the earliest symptom of stomach cancer?

There is generally no obvious early symptom; loss of appetite, indigestion, and stomach discomfort may be seen.

2. How is stomach cancer definitively diagnosed?

Definitive diagnosis is only made by pathological examination of the biopsy taken during endoscopy.

3. Can stomach cancer be completely cured?

Complete recovery is possible in early stages. In advanced stages, treatment aims to prolong life expectancy.

4. Is surgery mandatory in stomach cancer?

Depending on the stage, surgery is the most effective treatment method. However, in some advanced stages, surgery may not be appropriate and other treatments come to the forefront.

5. If H. pylori infection is treated, does cancer risk decrease?

Yes, H. pylori eradication can significantly reduce the risk of stomach cancer in the long term.

6. At what ages is stomach cancer more common?

Stomach cancer mostly occurs in individuals aged 50 and over; however, it can also be seen at younger ages in people with genetic predisposition. As age progresses, decreased cellular renewal and long-term exposure to environmental factors cause increased risk.

7. Is stomach cancer directly related to nutrition?

Yes, intensive consumption of high-salt, smoked, pickled, and processed foods can increase the risk of stomach cancer. In contrast, a diet rich in vegetables, fruits, and fiber contributes to risk reduction.

8. How should nutrition be during stomach cancer treatment?

Nutrition during the treatment process should be planned individually. Especially after surgery, it is important to eat in smaller portions, in frequent meals. Protein-based, easily digestible foods should be preferred and supplements recommended by the doctor should be used. In advanced stage treatments, dietitian follow-up may also be necessary for nutritional support.

Instagram: Prof. Dr. Samet Yardımcı