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Gastric Cancer

Background Knowledge ๐Ÿง 

Definition

Malignant tumour originating from the lining of the stomach.

Epidemiology

  • Common in East Asia, Eastern Europe, and South America.
  • Risk increases with age.

Pathophysiology

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Risk Factors

  • Helicobacter pylori infection: Major cause of non-cardia gastric cancer.
  • Diet high in salted, smoked, or pickled foods.
  • Chronic atrophic gastritis.
  • Family history or genetic predisposition.
  • Previous stomach surgery.
  • Tobacco and alcohol use.

Clinical Features ๐ŸŒก๏ธ

Clinical Features

  • Often asymptomatic in early stages.
  • Unexplained weight loss.
  • Epigastric pain or discomfort.
  • Dysphagia (difficulty swallowing).
  • Anaemia or signs of gastrointestinal bleeding.
  • Vague abdominal fullness.
  • Nausea and vomiting, especially haematemesis.

Signs

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Investigations ๐Ÿงช

Investigations

  • Endoscopy: Allows direct visualisation and biopsy.
  • Barium X-ray: To detect abnormalities.
  • CT scan: To assess spread and staging.
  • Staging laparoscopy: To detect metastasis.
  • Blood tests: Full blood count, liver function tests, and tumour markers like CEA.

Management ๐Ÿฅผ

Management

  • Surgery: Mainstay for curative treatment; gastrectomy (partial or total) is performed depending on tumour location and size.
  • Chemotherapy: Used pre-operatively (neoadjuvant) to shrink tumours, post-operatively (adjuvant) to kill remaining cells, or for metastatic disease.
  • Radiation therapy: Used in combination with chemotherapy, especially in advanced cases.
  • Palliative care: For symptom management in advanced stages.

Prognosis

  • Early detection significantly improves outcomes.
  • Overall 5-year survival rate varies greatly depending on stage and region.

Prevention

  • Treating Helicobacter pylori infections.
  • Dietary modifications: Increase fruits and vegetables, reduce salt and processed foods.
  • Regular screenings in high-risk populations.

Key Points

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