Gastric Cancer

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<p>Created by: Katherine L. Laud, SN</p> <p>Created by: Katherine L. Laud, SN</p> <p>Created by: Katherine L. Laud, SN</p> <p>INCIDENCE</p> <p> According to the National Cancer Institute (NCI, 2008), approximately 760,000 cases of stomach cancer are diagnosed worldwide. New cases: 21,000 in United States (NCI, 2010); 13,000 men and 8,000 womenCreated by: Katherine L. Laud, SN</p> <p>INCIDENCE</p> <p> In Philippines, cancer of the stomach is the 8th leading site of cancer overall. According to Department of Health (DOH), it is 6th among males and 10th among femalesCreated by: Katherine L. Laud, SN</p> <p>INCIDENCE</p> <p> New cases: 2,563 in Philippines; 1,511 among males and 1,052 among females (DOH, 1998)Created by: Katherine L. Laud, SN</p> <p>INCIDENCE Most (85%) cases of gastric cancer are adenocarcinomas that occur in the lining of the stomach (mucosa). Approximately 40% of cases develop in the lower part of the stomach (pylorus); 40% develop in the middle part (body); and 15% develop in the upper part (cardia). In about 10% of cases, cancer develops in more than one part of by: Katherine L. Laud, SN Created the organ.</p> <p>Created by: Katherine L. Laud, SN</p> <p>MORTALITY Stomach cancer is the second leading cause of cancer death worldwide (737, 000 deaths, 10% of the total). The highest mortality rates are in Eastern Asia and the lowest in Northern America (World Cancer Research Fund International, 2008). Deaths: 10,570 in United States (NCI, 2010) Deaths: 1,484 in Philippines (DOH, 1998) Created by: Katherine L. Laud, SN</p> <p>Created by: Katherine L. Laud, SN</p> <p>ETIOLOGY/RISK FACTORS</p> <p> Family history of gastric cancer Helicobacter pylori infection (a common bacteria that can also cause stomach ulcers) History of an adenomatous gastric polyp larger than 2 centimeters Common in men SmokingCreated by: Katherine L. Laud, SN</p> <p>ETIOLOGY/RISK FACTORS</p> <p>Risk increases after age 50 History of chronic atrophic gastritis Previous stomach injury History of pernicious anemia Evidence suggest that gastric cancer may be linked to diet, such as salty food, smoked fish, preserved meats, and low in fresh fruits and vegetables.Created by: Katherine L. Laud, SN</p> <p>ETIOLOGY/RISK FACTORS Some studies have found that a diet high in red meat is another possible risk factor. Eating red meat an average of about twice a day seems to raise the risk of stomach cancer. This risk is increased even more if the meat is barbecued and well done. Workers in the coal, metal, and rubber industriesCreated by: Katherine L. Laud, SN</p> <p>Created by: Katherine L. Laud, SN</p> <p>PREVENTION, SCREENING, DETECTION</p> <p> Changing lifestyle or eating habits (balanced diet) Avoiding things known to cause cancer Taking medicines to treat a precancerous condition or to keep cancer from startingCreated by: Katherine L. Laud, SN</p> <p>PREVENTION, SCREENING, DETECTION</p> <p> There is no standard or routine screening test for stomach cancer. However, upper endoscopy has been studied as a screening test to find stomach cancer at an early stage.Created by: Katherine L. Laud, SN</p> <p>PREVENTION, SCREENING, DETECTION</p> <p> Scans - these may include ultrasound, MRI or CT scans Complete blood count (CBC) to check for anemia Esophagogastroduodenoscopy (EGD) with biopsy Stool test to check for blood in the stoolsCreated by: Katherine L. Laud, SN</p> <p>Created by: Katherine L. Laud, SN</p> <p>CLASSIFICATION</p> <p> T Stage for Gastric Cancer - Tis (Carcinoma in situ), T1, T2, T3, T4 N Stage of Gastric Cancer - N0, N1, N2, N3 M Stage for Gastric Cancer - M0, M1Created by: Katherine L. Laud, SN</p> <p>Created by: Katherine L. Laud, SN</p> <p>CLINICAL FEATURES</p> <p> Weight loss and persistent abdominal pain, Dysphagia Feeling bloated after eating only a small meal Nausea and vomiting, Hematemesis MelenaCreated by: Katherine L. Laud, SN</p> <p>Created by: Katherine L. Laud, SN</p> <p>DIAGNOSIS AND STAGING</p> <p> Thorough history and physical examination MRI, CT Scan, Upper Endoscopy Biopsies</p> <p>Created by: Katherine L. Laud, SN</p> <p>DIAGNOSIS AND STAGING *STAGING Stage 0: Tis, N0, M0 Stage IA: T1, N0, M0 Stage IB: Any of the ff: T1,N1,M0; T2,N0,M0 Stage IIA: Any of the ff: T1,N2,M0; T2,N1,M0; T3,N0,M0 Stage IIB: Any of the ff: T1,N3,M0; T2,N2,M0; T3,N1 SN T4a,N0,M0 Created by: Katherine L. Laud, M0;</p> <p>DIAGNOSIS AND STAGING Stage IIIA: Any of the ff: T2,N3,M0; T3,N2,M0; T4a,N1,M0 Stage IIIB: Any of the ff: T3,N3,M0; T4a,N2,M0; T4b,N0 or N1,M0 Stage IIIC: Any of the ff: T4a,N3,M0; T4b,N2 or N3,M0 Stage IV: Any T,any N,M1Created by: Katherine L. Laud, SN</p> <p>Created by: Katherine L. Laud, SN</p> <p>METASTASIS</p> <p> Stomach cancer usually begins in cells in the inner layer of the stomach. Over time, the cancer may invade more deeply into the stomach wall. A stomach tumor can grow through the stomach's outer layer into nearby organs, such as the liver, pancreas, esophagus, or intestine.Created by: Katherine L. Laud, SN</p> <p>METASTASIS Stomach cancer cells can spread by breaking away from the original tumor. They enter blood vessels or lymph vessels, which branch into all the tissues of the body. The cancer cells may be found in lymph nodes near the stomach. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues. by: Katherine L. Laud, SN Created</p> <p>Created by: Katherine L. Laud, SN</p> <p>SURVIVALStage IA Stage IB Stage IIA Stage IIB Stage IIIA Stage IIIB Stage IIIC Stage IV 71% 57% 45% 33% 20% 14% 9% 4%</p> <p>*The survival rates above come from the National Cancer Institute's SEER database. They are based on people diagnosed with stomach cancer and treated with surgery between 1991 and 2000</p> <p>The overall 5-year relative survival rate of people with stomach cancer in the United States is about 28%. One reason for this is that most stomach cancers are found at an advanced stage. The outlook for survival is better if the cancer is in the lower part of the stomach than if it is in the upper part (American Cancer Created by: Katherine L. Laud, SN Society).</p> <p>Created by: Katherine L. Laud, SN</p>