Introduction
Stomach cancer is a malignant neoplasm that develops in the organ’s gastric mucosa cells. The pathology is found in different organ parts, first affecting the epithelium and then growing into the stomach tissue and neighboring organs. The life expectancy of a patient with a tumor is 10-15 years and depends on how quickly gastric cancer develops Al-Azri et al., 2019, p. 423). There are more than 800,000 new cases of gastric cancer worldwide each year. The highest incidence rate in Japan is 90 people per one hundred thousand population per year (Al-Azri et al., 2019, p. 424). Intestinal tumors that are not cancerous include leiomyomas, fibromas, lipomas, angiomas, and neurinomas. Malignant tumors of the stomach include sarcoma and carcinoma. In some cases, multiple primary gastric cancers occur simultaneously in different parts of the gastric area that are not connected. In advanced stages, gastric cancer is accompanied by metastasis, most often to lymph nodes and the liver. Thus, the causes, symptoms, and treatment of gastric cancer should be determined.
Causes
The immediate cause of gastric cancer, and most other malignant tumors in any given person, is complicated to identify. The nutritional aspect of the disease plays an essential role (Noto & Peek, 2017). A high incidence of stomach cancer is noted among people who consume salty, fried, smoked, and pickled foods excessively. Moreover, the excessive consumption of salt is currently emphasized. Chronic infection with Helicobacter pylori bacteria (the most common cause of chronic gastritis) is considered an influential determinant in the development of gastric cancer (Noto & Peek, 2017). Other causes include shingles; smokers are twice as likely to develop gastric cancer, systematic consumption of hard liquor, and environmental factors. This involves peculiarities in the chemical composition of the soil and drinking water.
A variety of gastric diseases are associated to some degree with the development of stomach cancer. Some of them are actually already tumorous (neoplastic) changes, which are considered benign but can undergo malignant transformation. The most common condition against which gastric cancer develops is referred to as atrophic gastritis. It is an inflammation of the gastric mucosa with a decrease in the number of glands secreting hydrochloric acid and pepsin (Noto & Peek, 2017). With the progression of the lesion under the influence of chronic inflammation and other adverse factors, the mucosa transforms intestinal metaplasia and dysplasia. In intestinal metaplasia, normal cells of the gastric mucosa are replaced by another mucosa cells characteristic of the intestine (Noto & Peek, 2017). Dysplasia is a tumor transformation of the mucosal cells, that is, the last step on the way to cancer.
Signs and Symptoms
The pathology is detected in different parts of the organ, first affecting the epithelium and then spreading into the stomach tissue and neighboring organs. Studies prove that malignant cells do not occur in healthy tissues; the disease is preceded by a precancerous state or referred to as minor signs. These include nausea combined with the loss of appetite. There is often an intolerance to meat food and general persistent weakness and asthenia (Noto & Peek, 2017). Another sign is weight loss without dieting and prolonged heartburn.
A further alarming sign is that the color of the tongue changes, with gray plaque appearing in stomach cancer and the surface becoming glossy and excessively smooth. It can also result in the appearance of whitish spots, thickening, and lumps. Subsequently, as the malignant process spreads, the first symptoms of gastric cancer are noted. Another symptom is persistent nausea, a significant decrease in appetite, and vomiting after meals (Noto & Peek, 2017). The severity of symptoms depends on the tumor size, the process’s spread, and the disease’s stage. The later symptoms of gastric cancer are intense pain associated with tumor sprouting. It is also vomiting, which can be bloody or coffee grounds colored, provoked by the decay of the tumor. The appearance of metastases and secondary tumors in other organs and tissues is a critical sign that gastric cancer is progressing (Noto & Peek, 2017). Once gastric cancer has progressed, the symptoms of the disease are supplemented by signs of complications, such as gastrointestinal bleeding.
Treatment and Care
The therapy of gastric cancer is complex and includes all modern methods of treating malignant tumors. The choice of treatment relies specifically on the size and spread of cancer, that is, the stage of the disease and the location of the tumor in the stomach. The primary and most radical treatment is surgery or complete or partial stomach removal (Liu et al., 2019). Generally, in the case of gastric cancer, the stomach cannot be saved because the rules of oncology establish how far from the edge of the tumor the border of removal should be. This complete removal of the stomach is termed a gastrectomy. Only in the case of microscopic tumors near the entrance or exit of the stomach can a small part of the stomach be left (Liu et al., 2019). This operation is referred to as a subtotal gastric resection. Along with the stomach, the nearby lymph nodes and, if necessary, neighboring organs that were in contact with the tumor are also excluded.
In extremely early forms of cancer, if the lymph nodes surrounding the stomach do not contain metastases, they have also spread to other organs. Then the primary treatment method is to remove the stomach within the correct boundaries (Liu et al., 2019). Many research studies have proven that if cancer has already spread, treatment results are significantly improved if certain antitumor drugs or chemotherapy are administered before and after surgery. This therapy, in turn, can be combined with both biological treatment and radiation. Radiation therapy is not used as an independent method of gastric cancer treatment. In some cases, it is combined with chemotherapy in the preoperative period (Liu et al., 2019). Research and searches are constantly being done worldwide to find an effective treatment for gastric cancer.
My Role
It is important to note that my role in patient care is to provide clear and timely execution of the physician’s orders. At the same time, patient care requires monitoring and proper administration of medications and assistance with vomiting and gastric bleeding. For care, it is essential to have conversations with patients and their relatives about the importance of taking medications systematically to improve the patient’s quality of life (Liu et al., 2019). I should also educate patients and their relatives about taking medications, enemas, and self-care. This is necessary for patients to obtain quality care after they are discharged from the hospital.
Conclusion
Thus, cancer that develops from the epithelial cells of the gastric mucosa is called gastric cancer. The disease can also affect the body for reasons such as the presence of the bacterium Helicobacter pylori, exposure to the environment, supine conditions, and lifestyle. The common signs of the disease include asthenia, nausea, and pale skin. As the tumor develops and grows, other symptoms such as upper abdominal pain, constipation, increased abdominal size, and fluid accumulation appear. In the vast majority of cases, treatment of stomach cancer is combined, consisting of surgical and chemotherapeutic steps to achieve maximum effect on the disease and the best treatment results. Radiation therapy is also sometimes used for the efficacy of the treatment. At the same time, patient care during therapy and rehabilitation is essential.
References
Al-Azri, M., Al-Kindi, J., Al-Harthi, T., Al-Dahri, M., Panchatcharam, S. M., & Al-Maniri, A. (2019). Awareness of stomach and colorectal cancer risk factors, symptoms and time taken to seek medical help among public attending primary care setting in Muscat Governorate, Oman. Journal of Cancer Education, 34(3), 423-434.
Liu, H., Kinoshita, T., Tonouchi, A., Kaito, A., & Tokunaga, M. (2019). What are the reasons for a longer operation time in robotic gastrectomy than in laparoscopic gastrectomy for stomach cancer? Surgical Endoscopy, 33(1), 192-198.
Noto, J. M., & Peek Jr, R. M. (2017). The gastric microbiome, its interaction with Helicobacter pylori, and its potential role in the progression to stomach cancer. PLoS Pathogens, 13(10), e1006573.