Gastric Cancer

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Gastric Cancer: aka Stomach Cancer, Abdominal Cancer, Gastrectomy, Cancer of the Digestive System, Adenocarcinoma of the Stomach




What is it?


Gastric cancer is cancer that is part of the stomach or digestive system. Gastric cancer occurs in the upper abdomen, which is between the esophagus and part of the small intestine. Many people refer to the terms “stomach cancer” and the term gastric cancer as one in the same.


Usually gastric cancer can be categorized as an adenocarcinoma. That means it occurs in the mucosa or lining of the stomach. Up to 85 percent of gastric cancers in fact occur in this area, while 40 percent will occur in the pylorus or the lower part of the stomach. Another 40 percent may occur in the trunk or body of the stomach while just 15 percent will occur in the upper part or cardia but not the lining of the abdomen or stomach.


Sometimes gastric cancer occurs in many different parts of the stomach and spreads to other organs (metastasizes) including the liver, ovaries and pancreas for example. Roughly ¾ of a million people suffer from stomach cancer yearly. Men are much more likely to develop it than women, and it usually occurs in those 50 and older.




The Operation


Gastrectomy is a surgery performed to eliminate gastric cancer. Oncologists performing gastric cancer surgery are highly specialized and perform surgery as the number one treatment for stomach cancer. Tumors must be removed for the best possible outcome.


Often gastrectomy helps but is difficult to perform because cancer arises in areas difficult to treat, including in areas difficult to access without removing the entire stomach, a procedure known as a complete or total gastrectomy. If a cancer occurs in the upper stomach usually a total gastrectomy is necessary. The surgeon will then connect the esophagus directly to part of the small bowel, and food will pass directly here with nutrients absorbed directly into the bloodstream.


This is how an individual can continue to eat (although in very small amounts) following surgery.


Typically a surgeon will also remove the lymph nodes surrounding the stomach also when they remove the stomach to endure the cancer has not spread to these areas, and if it has so they remove them in one surgery rather than going back into the body during another surgery. Many oncologists believe that it is important to improve outcome in patients with stomach or gastric cancer by performing what is known as a D2 lymphadenectomy, which involves extensive removal of lymph nodes rather than removal of just a small section of lymph nodes, because stomach cancer is so pervasive and deadly.




Alternatives to Surgery


There are few options available to consider as alternatives to gastric surgery. In some cases chemotherapy will be used if there are small traces, but in the event of a large cancerous presence or tumor, surgery is the only available option.




Before the Operation


Your doctor will take many different labs and X-ray or other imaging studies to confirm your diagnosis and will review the risks and benefits of surgery. Be sure you ask your doctor any questions you have regarding surgery. You may need to be on a clear liquid diet for some time before surgery and will probably need to stop eating and drinking for 12 hours or more before surgery.




After the Operation- In the Hospital


The time in the hospital following surgery is used for waking up and recovering from anesthesia to the point that the patient will be able to go home. In many cases, the ability to take in fluids will be the requirement to allow the patient to leave the hospital, although some medical facilities have additional requirements for discharge.



After the Operation- At Home


Following gastric surgery most patients will undergo chemotherapy and radiation therapy because gastric cancer can spread to distant sites in the body, including the liver and the lung. Chemotherapy can often kill what are known as “foci” of tumor cells. Chemotherapy often is combined with radiation therapy because together the treatments are most likely to result in a positive outcome and better prognosis.


Immediately following surgery most patients are not able to eat or drink. Recovery after discharge is often gradual. A tube is often placed into the small intestine and remains there for a few days until bowel movement restarts. This takes a few days but when it does restart healing is beginning.


Most patients can start walking around within 24 hours of surgery. This is a good way to prevent complications from surgery.




Possible Complications


Complications from surgery include infection and blood clots. One way to avoid clots is to start moving within 24 hours of surgery. Most patients will experience pain from the incision site. Infection along the incision site is common so patients should be careful to keep the site clean and dry.


Eating is often challenging following surgery, especially for patients that have the entire stomach removed because of cancer. Food and liquid reaches the intestines quickly and this can cause uncomfortable sensations. Many patients find they feel best when they eat many mini meals including those that have more protein than carbohydrate and sugar. Working with a dietician can help patients adjust to their new dietary restrictions.
The diet is somewhat like that of a patient that has undergone a gastric bypass surgery. Many patients find they have to stay in the hospital for a few weeks and others months. During that time the patient can become accustomed to new lifestyle changes including learning how to eat. Other complications may include debilitating diarrhea.


Chemotherapy and other medications can complicate or exacerbate problems like this, but nurses and doctors work closely with patients to try to minimize these problems. Other common complications or side effects of surgery reported by patients may include:


  • Abdominal cramps or cramping of the intestine
  • Diarrhea
  • Dizziness and syncope
  • Nausea and frequent vomiting
  • Shortness of breath
  • Sweating or lack of
  • Infection
  • Inflammation of the intestines
  • Anemia
  • Digestive difficulty




General Advice


Gastric cancer is one of the more severe forms of cancer, one that strikes many different parts of the stomach including the stomach lining. If you suspect you have gastric cancer it is important you seek help from a qualified medical professional as soon as possible. The costs of surgery for gastric cancer vary considerably from person to person depending on the extent of surgery required. Some patients will require full removal of the stomach and removal of a large section of lymph nodes to facilitate the best possible recovery.




Estimated Costs for Gastric Cancer Surgery


The estimated cost for gastric cancer surgery does not necessarily take into consideration expenses associated with lengthy hospital stays.


Country Costs
USA $15,000-20,000
India $7,500-10,000
Singapore $10,000-16,000
Malaysia $7,000-9,000
Thailand $6,000-10,000

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