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STOMACH CANCER (Treatments (Surgery to remove cancerous tissues,…
STOMACH CANCER
Treatments
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Dietary modifications including high intake of fruits & veggies, vitamin C, carotenoids, and fiber. Reduced intake of salt, salted foods, and red meat.
Survival is probable after 5 years post treatment but quality of life may be greatly diminished due to poor dietary intake and dietary restrictions (Kaptein et al., 2015)
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Pathophysiology
Duodenal reflux also may contribute to intestinal metaplasia. The reflux contains caustic bile salts that destroy the mucosal barrier that normally protects the stomach.
Gastric adenocarcinoma usually begins in the glands of the stomach mucosa. Insufficient acid secretion by the atrophic mucosa creates a relatively alkaline environment that permits bacteria to multiply and act on nitratesThe resulting increase in nitrosoamines damages the DNA of the mucosal cells promoting metaplasia and neoplasia.
Epigenetic alterations (DNA methylation, histone methylation, and histone acetylation) and multiple genes are involved in gastric cancer.
Causative Factors
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H. pylori infection which leads to mucosa-associated lymphoid tissue (MALT) lymphoma that can originate in the stomach
Smoking decreases the production of prostaglandins that maintain gastric mucosal integrity, and smokers have a higher incidence of H. pylori infection
Risk Factors
Nonenvironmental Risk Factors - Family History, Blood type (blood group A), Type A atrophic gatritis, Pernicious Anemia
Environmnetal Risk Factors - Infection with H. pylori, Dietary Factors (added salt, food additives in pickled food, low intake of fruits and veggies), Lifestyle (alcohol & smoking)
XRCC1 gene homozygosity, particularly Arg/Arg, on the risk for stomach cancer is elevated by a high intake of vegetable oils and salt (Putthanachote et al., 2017)
Diagnostic Tests
Prognosis poor because symptoms usually do not occur until the tumor has penetrated the muscle layers of the stomach, spread to the surrounding tissues, and entered the draining lymph nodes and veins
Esophagogastroduodenoscopy (EGD) which visualizes tumor through the use of endoscopy or biopsy of cells obtained during endoscopy
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Clinical Manifestations
Early stages of gastric cancer are generally asymptomatic or produce vague symptoms (loss of appetite, malaise, weight loss)
Later manifestations include upper abdominal pain, vomiting, change in bowel habits, and anemia caused by persistent occult bleeding.