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GASTRIC (STOMACH) CANCER

Etiology and predisposing factors

  1. nitrites and nitrates
  2. benzpyrenes
  3. asbestos
  4. previous stomach surgery
  5. infections e.g. H. pylori infection predisposes to gastric
    lymphoma (MALTOMA) which is treated with antibiotics
  6. smoking
  7. atrophic gastritis (pernicious anemia)
  8. blood group A
  9. chronic reflux esophagitis

SIGNS AND SYMPTOMS

    • heartburn
    • epigastric mass
    • easy fullness
    • anemia due to blood loss giving rise to iron deficiency or pernicious anemia
    • significant weight loss without trying
    • bone pains
    • aspiration pneumonia
    • abdominal pain
    • painful swallowing
    • generalized weakness

TREATMENT

    • Surgical resection offers the best chance for cure in localized disease

    • Radiation therapy for palliation of locally advanced, unresectable lesions

    • Chemotherapy generally has no impact on survival in advanced lesions, FAM, FAMTx regimens are very toxic

    • combined radiation and chemotherapy

    • Adequate pain management

    • Long term benefit of neoadjuvant chemotherapy