Gastric Cancers is also known as cartilage, fat, muscle, blood

stomach cancer, is a malignant vessels, fibrous tissue, or other

growth that originates from the connective or supportive tissue.
cells lining the stomach. It is one
of the most common cancers Neuroendocrine tumor, forms
worldwide, with varying from cells that release hormones
prevalence in different into the blood in response to a
geographical areas ranking 12th signal from the nervous system.
among the leading cancers here in Patient History
the Philippines. The prevalence
and mortality are higher in male When evaluating a patient for
than in female. There are several possible gastric cancer, this
types of gastric cancer, and the comprehensive history-taking is
most common is crucial:
adenocarcinoma, which accounts Demographics such as,
for about 90-95% of cases. Other Age: More common in individuals
less common types include over 50.
lymphomas, sarcomas, and Gender: Higher incidence in men.
neuroendocrine tumors. This
cancer is often asymptomatic in its Family History:
early stages, leading to late Any family member with gastric
diagnoses and poor prognosis. cancer or other malignancies.

Adenocarcinoma, a cancer that If the patient had a medical history

forms in the glandular tissue, of:
which lines certain internal organs
and makes and releases Previous gastric conditions: peptic
substances in the body, such as ulcers, chronic gastritis, or gastric
mucus, digestive juices, and other surgery.
fluids.
History of Helicobacter pylori
Lymphoma, a type of cancer that infection or treatment.
begin in the lymphatic system (the
various lymph glands around the Autoimmune diseases (e.g.,
body) when abnormal white blood pernicious anemia &
cells grow. SLE)

Sarcoma, a type of cancer that Their lifestyle can also contribute

begins in bone or in the soft as a risk factor, such lifestyle are:
tissues of the body, including
 > High intake of preserved foods, Signs of malnutrition or cachexia
smoked foods, and salt. (weakness due to chronic illness)

> Alcohol consumption and Abdominal Examination:

smoking. Inspection: Distention, visible
masses, or discoloration.
> Occupation and exposure to
hazardous materials. Palpation: palpable mass,
abdominal rigidity, or guarding.
When a patient is suspected to
have this condition some of this *Percussion might reveal fluid if
symptoms can be manifested on ascites is present.
them: Lymphadenopathy:
Inspect for any enlarged lymph
Persistent stomach pain nodes, especially in the
Loss of appetite supraclavicular and axillary
Early regions.
Heartburn
symptoms Signs of Anemia:
Regurgitation Pallor of conjunctiva, oral mucosa,
Nausea and skin.
Hematemesis
Dysphagia (difficulty swallowing) Diagnostics
Early satiety Laboratory Tests:
Unintentional weight loss > Complete Blood Count (CBC): To
Fatigue check for anemia.
Generalized weakness > Liver Function Tests (LFTs): To
Palpitations evaluate liver involvement or
Dyspnea metastasis.
Pallor. > Tumor Markers: Some non-
specific markers such as
Physical Examination carcinoembryonic antigen (CEA)
A thorough physical and cancer antigen 19-9 (CA 19-9)
examination tends to focus on the can be elevated but are not used
gastrointestinal system but also for screening.
evaluates for systemic
manifestations. Specialized Tests:
Laparoscopy: A minimally invasive
General Appearance: surgical procedure that can
provide a direct assessment of
abdominal organs and lymph 2. Lymphadenectomy: Removes
nodes, also allowing for biopsy. regional lymph nodes to reduce
recurrence.
Histopathology:
3. Reconstruction: Billroth I/II or
Examination of tissue samples
Roux-en-Y anastomosis.
obtained from biopsies during
endoscopy or laparoscopy helps Medical
determine the type and grade of
1. Chemotherapy:
cancer, guiding treatment
• Neoadjuvant Therapy:
decisions.
Shrinks the tumor
preoperatively.
Imaging • Adjuvant Therapy:
Prevents recurrence post-
1. Endoscopic Ultrasound (EUS):
surgery.
For staging and tumor depth
• Common agents:
assessment.
Fluorouracil, cisplatin,
Esophagogastroduodenoscopy docetaxel.
(EGD): This is the gold standard 2. Targeted Therapy:
for directly visualizing the stomach • HER2-positive tumors:
lining. Biopsies can be taken for Trastuzumab.
histopathological examination. • Anti-angiogenic agents:
Ramucirumab.
2. CT Scan: Detects local invasion
and distant metastases. 3. Immunotherapy: PD-1 inhibitors
like pembrolizumab.
3. PET Scan: Evaluates metastatic
disease. 4. Palliative Care: Pain
management, nutrition, and
4. Barium Swallow: Shows gastric symptom relief in advanced stages.
wall irregularities or mass.
Patient Education
5. MRI: For specific evaluations,
e.g., liver metastasis. 1. Diet and Lifestyle:
• Avoid high-salt, smoked
foods; include fresh fruits
Management Curative/Surgical and vegetables.
• Smoking cessation and
1. Gastrectomy: • Subtotal moderate alcohol intake.
Gastrectomy: For distal cancers. •
Total Gastrectomy: For proximal or 2. Early Signs and Symptoms:
extensive tumors. Importance of recognizing early
signs (persistent epigastric pain,
unexplained weight loss, anemia).

3. Post-Surgery Care:

• Dietary modifications post-

gastrectomy (small, frequent
meals).

• Vitamin supplementation (e.g.,

B12 due to malabsorption).

4. Follow-up and Surveillance:

Regular endoscopy and imaging
for early detection of recurrence.

5. Support Systems: Encourage

mental health support and joining
patient advocacy groups.