Stomach cancer, which is also called Gastric
cancer is one of the most commonly occurring cancers in India.
Most of the time gastric cancers present with very vague symptoms like
just loss of weight, a loss of appetite, early fullness after meals,
drop-in hemoglobin which is unexplained, or a lump in the abdomen.
While stomach cancer is extremely common in Southeast Asian countries
because of their dietary habits, especially the consumption of smoked
fish, we really do not know the cause of this cancer in the Indian
population.
One of the causes is H pylori infection which is fairly common in the
Indian population. Early treatment of H pylori infection can help reduce
the incidence of gastric cancer.
While H pylori infections predominantly cause distal gastric cancers,
there is a rising incidence of proximal gastric cancers, especially in
urban India.
This is similar to the patterns which are seen in the western world
because of obesity, metabolic syndrome, and poor dietary habits
including consumption of a fatty and carbohydrate-rich diet.
An upper GI endoscopy and biopsy is the best method to diagnose gastric
cancer. A CT scan is also always performed in order to stage the disease
accurately. Many gastric cancers do not show uptake on PET scans, hence
it may not be a very reliable modality of investigation.
The treatment of choice for gastric cancer is surgery if the disease is
limited to the stomach and not spread elsewhere. A complete D2
lymphadenectomy is recommended.
Many patients with locally advanced diseases would need chemotherapy
first followed by surgery. Unfortunately, a vast majority of gastric
cancers present in a late stage and are candidates for only palliative
chemotherapy or palliative care.
Early diagnosis and prompt treatment are the only ways to treat gastric cancer
successfully.