Malignant degeneration of the epithelium of the gastric mucosa is called cancer of this digestive organ. It is believed that in most cases, the main cause of the disease in question is the bacterium Helicobacter pylori. However, the development process of this disease consists of several stages. Can stomach cancer be cured without surgery? Read more about this.
The first stage of cancer
Specialists in the field of medicine claim that many different causes affect the spread of stomach cancer in the human body. So, mutations occur due to carcinogens. In general, the oncology in question can develop against the background of benign formations of certain types, peptic ulcer or gastritis. It is also possible to develop an ailment due to the ingestion of carcinogens into the stomach with food (after all, nitrates and glutamates are often added to products to improve the appearance). Tobacco smoking and alcoholic beverages also often trigger stomach cancer.
The lack of sufficient amounts of vitamins C and E often contribute to the occurrence of the disease in question, since these organic compounds protect the epithelium of the stomach.
Among internal carcinogens, heredity, infections, and immunoglobulin deficiency are distinguished.
The second stage of this disease
If diseases such as gastritis, stomach ulcers or the presence of dysplasia of the walls of this organ develop under the influence of carcinogens, then the malignant course of the disease should be noted. In addition to the above reasons, additional factors that are not yet known to science should be mentioned. After all, the mechanism of transformation into malignant cells has not been thoroughly studied. Although it can be said for sure that infection with H. pylori bacterium, violation of the lining of the walls of the stomach and carcinogens lead to the appearance of cancer of the digestive organ in question.
Symptoms
Gastric cancer is a malignant degeneration of epithelial cells. Basically, this disease affects people from 50 to 70 years old. Bacteria Helicobacter pylori affect the walls of the stomach, which leads to neoplasms. This is the most common cancer, men are sick much more often than women. In Russia, stomach cancer occupies a leading position among oncologists, and it must be said that other organs do not stand aside. The colon of the intestine, mammary gland and lung are malignantly affected.
The disease does not develop rapidly, sometimes the period of its development reaches 6 years.
A rather low incidence rate in Western Europe, and the highest in Russia and even in some countries. Gastric cancer is directly associated with H. pylori, mainly preceded by diseases such as gastritis, polyps on the walls of the stomach, peptic ulcer and dysplasia of the mucous membranes. The development of this disease is directly affected by the use of alcohol, smoking, the consumption of flavor enhancers, food colors, and flavorings.
In some developed countries, for example, in Japan, cancer is diagnosed in the early stages of development, and therefore the survival rate of patients is about 70%. The life of men with cancer is about 12 years, and women about 15 years.
Active attempts are being made to diagnose cancer at an early stage of its development. Oncologists use immunohistochemical markers of MMP-9. They are designed to perform surgical intervention at an early stage and rid the body of the growth of cancer cells.
Stages
The designation of the primary tumor is T with the addition of numbers from 1 to 4 and small capital letters (a, b) in order to display elements of carcinogenesis occurring in the primary neoplasm. The designation of the defeat of regional lymphoid structures is N with the addition of numbers from 0 to 3 and small capital letters (a, b). To indicate distant metastases, the Latin letter M is used and the numbers 0, 1 to indicate the absence or presence of distant metastases.
Can stage 1 stomach cancer be cured? Stage 1 is encrypted in three versions:
- Stage 1A (T 1 N 0 M 0 ) - the primary tumor of stage 1, grows in the mucous and submucous layer, there is no damage to lymph nodes and distant metastases.
- Stage 1B, type 1 (T 1 N 1 M 0 ) - the primary tumor grows in the mucous and submucous layer, metastases in 1-6 regional lymph nodes, distant metastases are absent.
- Stage 1B, type 2 (T 2a / b N 0 M 0 ) - the primary tumor has grown in the muscle and subserous layer, lymph nodes and distant metastases are not traced.
Can gastric cancer of the 2nd degree be cured? It is necessary to consider the classification in more detail. Stage 2 can be encrypted in three alternatives:
- (T 1 N 2 M 0 ) - the main tumor grows in the mucous and submucous layer, 7-15 regional lymph nodes are involved, there are no distant metastases.
- (T 2a / b N 1 M 0 ) - the initial tumor in the muscle and subserous layer, the involvement of 1-6 regional lymph nodes and the absence of distant metastases are diagnosed.
- (T 3 N 0 M 0 ) - the primary tumor is located in the serous membrane and visceral wall, there is no involvement of adjacent organs, the defeat of regional lymph nodes and distant metastases are not traced.
Before you know whether it is possible to cure gastric cancer of the 3rd stage, you need to understand its classification. Stage 3 is encrypted in several ways:
- Stage IIIA, type 1 (T 2a / b N 2 M 0 ), which means involvement in the pathogenesis of the muscle and subserous layer of the stomach wall, the defeat of 7-15 regional lymph nodes and the absence of distant metastases.
- Stage IIIA, type 2 (T 3 N 1 M 0 ), means a violation of absolutely all layers of the serous membrane of the stomach, there is no involvement of adjacent organs, damage to 1-6 regional lymph nodes, no distant metastases are observed.
Before you find out whether it is possible to cure gastric cancer of the 4th degree, you need to familiarize yourself with its classification. Stage 4 can be encrypted in three key ways:
- (T 4 N 1 , N 2 , N 3 , M 0 ), tumor advancement into surrounding organs, damage to regional lymph nodes (1-6) - N 1 , or (7-15) - N 2 , or (more than 15) - N 3 , the absence of distant metastases.
- (T 1 , T 2 , T 3 , N 3 M 0 ), damage to the mucous and submucosal layers - T 1 or damage to the muscle and subserous - T 2 , or damage to absolutely all layers, damage to more than 15 regional lymph nodes, the absence of distant metastases.
- (T any , N any , M 1 ), the primary tumor of different growth options, in addition to all kinds of lesions of regional lymph nodes, the inherent presence of distant metastases.
Inoperable cancer
Thus, the stage of the disease is determined in which it is unrealistic or pointless to use methods of surgical removal (resection) of the lobe of the stomach and lymph nodes in order to eliminate the disease. Inoperable cases do not include palliative manipulations in order to alleviate the patient's condition.
Inoperable cancer can be:
- Locally distributed, if a substantial part of the stomach is damaged or numerous lesions are mosaic and affect the vital parts of the body (large arteries, nerves), the cells spread lymphogenously, contact or implantation.
- Metastatic, if lesions of distant organs are detected, usually the liver, lungs, adrenal glands, bones and subcutaneous tissue. Oncological cells spread throughout the bloodstream.
How to treat stage 4 stomach cancer?
The most positive results can be seen with radical radiation therapy of locally common processes. According to certain information, life expectancy after completing the direction of combined treatment can be increased up to 20-24 months. In this case, the complications from the influence of ionizing radiation are significantly less than the therapeutic result, and the patient becomes able to continue life in the absence of pain. Unfortunately, to provide more in the circumstances of current medicine is unrealistic. As you can see, there are not so many ways to treat stomach cancer with metastases.
The main pathways of metastasis occur through the lymphoid system, for this reason secondary tumors and more important metastases are noticed, first of all, in the lymph nodes.
Gastric cancer metastases:
- in pararectal fiber or in a place near the rectum;
- in the navel;
- in the left supraclavicular region;
- in the ovary area.
These secondary tumors are considered confirmation of the advanced stages of the disease, in which case the treatment strategy is selected individually and is most of all palliative in nature, that is, aimed at improving the quality of patient's existence.
Diagnostics
Since the cancerous tumor can increase in size, the timeliness of the examination and identification of the problem can be very important. Diagnosis is carried out in several stages, which include several methods. The first step is a routine examination by a doctor. At an early stage, it is possible to determine the presence of stomach cancer by some signs. These include, for example, pain in the abdomen and the condition of the skin.
The next step is instrumental diagnostics. Most often, methods of contrast x-ray diagnostics are used. However, this is just an indirect method for determining stomach cancer. Only some pathologies will be visible from the image. In this case, the doctor will pay attention to a number of features. First of all, he will pay attention to the features of the shape of the stomach. Are there any seals on its walls. It is also worth paying attention to a decrease in the elasticity of organ tissues. However, this is just an indirect method for determining stomach cancer. But there is a chance of detection.
A more accurate method is endoscopy. There are already more factors to determine the disease. Thanks to the use of biopsy, color visualization is possible. An innovation in this direction is an uncontrolled video capsule. It allows you to see the image of the stomach in real time on the monitor screen.
However, gastroendoscopy has several disadvantages. Some patients may experience a gag reflex while swallowing the tube. It is also very difficult to distinguish a malignant from a benign tumor.
Another diagnostic method is morphological. Based on cytological and histological examination, it is possible to determine the type of tumor.
Therapy selection
The selection of a treatment strategy is determined by the stage of carcinogenesis and is discussed at a consultation with the participation of experts from several medical specialties. The primary treatment for the initial stages is surgical removal in combination with chemotherapy. Late-stage treatments are considered palliative and symptomatic.
All patients are conditionally divided into 3 categories:
- The first is that patients have initial stages.
- The second - patients with an operable locally common stage.
- The third - patients with an inoperable stage.
Sometimes even patients with initial stages are recognized as inoperable, for example, when a tumor afflicts a vital organ or if the operation is not feasible due to other circumstances.
The greatest possibility of absolute cure without significant consequences for the body in the first category of patients. The prognosis within the second category has a significant spread due to many aspects of this stage of the disease. Least positive prognosis in patients of the last, third category. In this case, it is necessary to say about the extension and improvement of the quality of life of patients during the period of the disease.
How to treat stomach cancer?
Surgery for absolute treatment is usually not enough. The patient is observed for a long time in order to establish clinical dynamics. During this period, gastric cancer can be treated with chemotherapy to eliminate secret local sources of secondary carcinogenesis.
Chemotherapy shows a general negative effect on the body. Using it is advisable only if there is a real possibility of increasing the chances of a cure, or at least improving the quality of life of the patient.
Adjuvant treatment is often used. The term `` adjuvant '' means increase or addition. That is, this type of chemotherapy is used after surgery, in contrast to the non-adjuvant chemotherapy, which is used before the intervention to reduce the volume of the tumor before surgery. In recent years, the approach to adjuvant exposure has changed. Previously, this method was considered not effective.
Such therapy is carried out in the form of polychemotherapy (exposure to several substances) in two or three courses with different intervals. Pharmaceutical cytostatics are used in various combinations: Doxorubicin, Etoposide, Cisplatin, Fluorouracil, Mitomycin, and others.
Palliative care is another type of therapy that is used if partial or complete removal of the stomach and affected lymph nodes is not possible.
Complications after chemotherapy are inevitable. Cytostatics destroy the development and growth of malignant cells.
Juices
The disease is accompanied by the loss of large volumes of water by the body after repeated vomiting and gastric bleeding. In cancer, patients may complain of a decrease in appetite due to the loss of taste and olfactory feelings, pain and other factors. There are many ways to treat stomach cancer with folk remedies. But you should pay attention to this one.
Juices, especially with pulp, can almost always be beneficial for patients, especially if there is no swelling. Recommended water intake is up to 2 liters per day. In addition to juices, milk, lactic food products, teas, compotes, fruit drinks are allowed.
How to treat stomach cancer with folk remedies using juices? It is rational to consume them freshly squeezed with pulp from:
- vegetables (carrots, beets, tomatoes, cabbage, celery, bell pepper, lettuce);
- fruit (apple, pear);
- berries (currants, cherries, cranberries).
Diet
A serious illness requires a long course of treatment and appropriate care. Therapy can last more than one year, extending the patient's life by several years. Along with effective methods of combating malignant neoplasms, it is also necessary to adhere to a properly selected diet. The patient's nutrition should be adjusted so that the risk of developing the disease is reduced. An integrated approach, including therapeutic and surgical procedures, the presence of a certain diet, will increase the chances of a full recovery.
Recommendations for creating a diet menu:
- The amount of fat consumed should be reduced.
- Eat more plant foods, eat more fruits.
- Try to eat in small portions, but often.
- Limit the use of salt, sugar and flour products.
- Exclude alcohol and coffee from the diet.
Products that cause irritation of the gastric mucosa, only provoke a relapse of the disease. The patient needs to eat only dishes made from fresh and natural products. You only need to cook for one day. Following all the recommendations for proper nutrition in cancer, it will be easier to cope with the disease.
Prevention
For the prevention of gastric cancer at various stages, special work is being carried out with the aim of educating the population. At the same time, regarding general events, there are several main points:
- A detailed description of the degree of danger of this disease, the urge of the population to take certain precautions in everyday life.
- What needs to be done if the person is already sick.
- Motivation of the population to a healthy lifestyle.
Regarding medical events, work is being carried out with people at risk. This work consists in the prevention and treatment of pathologies preceding cancer. Moreover, the main efforts in this case are aimed at combating the bacterium Helicobacter pylori, which is the cause of the disease in most cases.
People at risk have a history of:
- genetic predisposition;
- the presence of a carrier bacterium;
- stomach resection;
- long work experience in enterprises related to the chemical industry;
- chronic insufficiency of production of hydrochloric acids;
- pernicious anemia;
- autoimmune atrophic gastritis;
- adenoma of the stomach.
Possibility of recovery and mortality statistics
On average, the life expectancy of men with gastric cancer is reduced by 12 years. In women, this figure is 15 years. According to Russian statistics, the survival of patients is as follows:
- In the first stage, as a rule, it is possible to detect pathology in about 10-20% of patients. And in most cases, 60-80% of them survive for 5 years.
- In the second and third stages, regional lymph nodes are affected. And this symptom, as a rule, is determined in 30% of patients, among whom about 15-45% survive for 5 years
- At the fourth stage, metastases in neighboring organs are already present, therefore, at this stage, pathology is much easier to detect, and it is detected in half of the patients. Only 5-7% of them survive within 5 years
There are plenty of clinics where gastric cancer of the 4th degree is treated in Russia. Nevertheless, experts advise receiving a course of treatment in Israel or Germany. Their methods are newer and more productive.
In the process of researching this disease, new methods are being created for better treatment of this disease and methods for its detection at various stages.