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Stomach cancer is a common disease in East Asia (Japan, South Korea, China). Amongst Japanese person who develops cancer increase over age of 40th. But recently, fatal number by stomach cancer is in decreasing tendency so that it is 3rd rank in 2014, followed by lung cancer and bowel cancer. By gender, 2nd rank among male and 3rd rank among female. Even with excluding aged effect, it is decreasing.
It is considered, as the cause of stomach cancer, helicobacter pylori infection or lifestyle habit like high-salted meal or smoking. Especially amongst middle age people, helicobacter pylori infection rate is high, thus it is considered pylori bacterial infection has largely affected on stomach cancer development.
Stomach cancer has no symptom on early stage, so that it is very important to have periodical check-up. Traditionally, stomach X-ray exam or gastric endoscopic exam are performed, but recently measuring pepsinogen by blood drawing, or because of the implementation of stomach cancer risk test (ABC Check-up) which combines pepsinogen measuring with helicobacter pylori antibody exam to pick up high stomach cancer risked personnel effectively, it is contributing for early stage diagnosis and curing for stomach cancer. It is considered, as the cause of stomach cancer, helicobacter pylori infection or lifestyle habit like high-salted meal or cigarette smoking. Especially amongst middle age people, helicobacter pylori infection rate is high, thus it is considered pylori bacterial infection has largely affected on stomach cancer development.
When disease advances, symptoms like nausea, vomiting, blood vomiting, abdominal pain, or reel by anemia may occur. But on early stage it has no symptoms.
The diagnosis is comprehensively made by Gastric Endoscope Exam (in the past it is called as stomach camera), tissue test from pathologic abnormality, blood test, Gastric X-Ray exam, or CT exam. Looking at inside of the stomach by Gastric endoscope exam, pathology diagnostic is made in picking out cancer suspicious pat tissue by its form or coloring tone. Evaluate the depth or broadness by Gastric X-ray exam, and check whether metastasis exist by blood test (Tumor Marker) or CT exam.
There are Endoscopic Treatment, Surgery Operation (abdominal surgery, or laparoscopic surgery), Chemotherapy, Radiation Therapy.
In case of early stage stomach cancer (stage 1), the depth of cancer stays within mucosal and there is no metastasis, treatment can be done with conserving stomach by endoscopic submucosal dissection (ESD) which peels cancer only off from gastric wall. In this case, if all cancer part not yet cut off, or provability of recurrence or metastasis is considered as high after when pathological test complete for cut off stomach, additional surgical operation may be requested.
In case when depth of cancer is deep, or metastasis is suspicious (Stage II or III), standard treatment is surgical operation.
Total Gastric Resection, Pyloric Side Gastrectomy (exit side 2/3 cut off) is normally performed. Lymphatic node around it also cut off. Else, if it is in early stage, fundectomy (entrance side cut off) or Pyloric Sparing Gastric resection (entrance/exit are conserved but middle part is cut off) may be performed. Laparoscopic Surgery is spreading over, especially Laparoscopic Pyloric Side Gastric Resection becomes as common surgical method.
For Stage II & III cancer (exclude certain part), Chemotherapy is adequate to prevent postsurgical recurrence.
In case Cut Off surgery is difficult (Stage IV), where cancer develops metastasis to other internal organ like kidney or lung, chemotherapy is made for curing purpose.
When Chemotherapy is effective, it is focused that there is a case where conversion surgery is possible.
Public Interest Incorporated Foundation Cancer Research Promotion Foundation “Cancer Statistic 2015” Quote from; 5 year Relative Survival Rate (2004 – 2007 diagnosed case) at National Cancer (Adult Disease) Center associated facility
