INTRODUCTION

STAGES OF GASTRIC CARCINOMA

adenocarcinoma stomach cancer include:

Stage I. At this stage, the tumor is limited to the layer of tissue that lines the inside of
the stomach. Cancer cells may also have spread to a limited number of nearby lymph
nodes.

Stage II. The cancer at this stage has spread deeper, growing into the muscle layer of
the stomach wall. Cancer may also have spread to more of the lymph nodes.

Stage III. At this stage, the cancer may have grown through all the layers of the
stomach. Or it may be a smaller cancer that has spread more extensively to the lymph
nodes.

Stage IV. This stage indicates that the cancer has spread to distant areas of the body.

Risk Factors:
H. Pylori in stomach
A diet high in complex carbohydrates, grains
Low in fresh, green leafy vegetables and fresh fruit
Alcohol Ingestion
Smoking
Consumption of salted, smoked, or poorly preserved foods
History of Gastric ulcers and pernicious anemia
Men older than 40 years of age
Heredity

Signs and symptoms:

Subjective:
Lack of interest in food (anorexia)
Nausea and Vomiting
Ingestion and epigastric discomfort
Heartburn (Dyspepsia)

Objective:
Weight loss
Stools positive for occult blood
Anemia
Absence of Hydrochloric acid
Pale skin
Ascites
Palpable mass
Bowel obstruction
Hepatomegaly

Diagnostic Evaluation:

Physical exam

Endoscopy

Biopsy

When stomach cancer spreads, cancer cells may be found in nearby lymph nodes, the
liver, the pancreas, esophagus, intestine, or other organs. The following tests may be
ordered:

Chest x-ray

CT scan

Endoscopic ultrasound

Laparoscopy

Medical Management:

Surgical Resection

1. Billroth I (Gastroduodenostomy) – Partial gastrectomy, with remaining segment

anastomosed to the duodenum,

2. Billroth II (Gastrojejunostomy) – Partial gastrectomy, with remaining segment

anastomosed to the jejunum.

3. Total Gastrectomy (Esophagojejunostomy) – Removal of the stomach with

attachment of the esophagus to the jejunum or duodenum.

Radiation Therapy before and or after surgery

Chemotherapy before and or after surgery

Chemoradiation

Anatomy and Physiology of the GI System:

Functions:

1. Ingestion
2. Propulsion. (Peristalsis)
3. Food breakdown: mechanical digestion.
4. Food breakdown: chemical digestion.
5. Absorption.
6. Defecation.