Stomach and pancreas cancer
Stomach and pancreas cancer are some of the most aggressive types of cancer. Typically, these diseases detected at later stages. After a thorough examination, our doctors will prescribe relevant supportive treatment.
The stomach is a part of the digestive system. It is located between the esophagus and the small intestine. Its function is to dissolve and digest food.
The direct causes of gastric cancer are unknown. Factors that increase your risk of stomach cancer:
- over 50 years old
- male gender
- food with processed red meat
- canned and smoked foods
- diet low in fruits and vegetables
- Smoking, obesity and reflux also increase the risk of stomach cancer.
In rare cases, the gastric bacteria Helicobacter pylori or a genetic syndrome (hereditary disease) may be the cancer cause.
Stomach Cancer Symptoms
The early symptoms are:
- heartburn, which does not go away despite its treatment;
- pain in the upper abdomen;
- hiccups and indigestion;
- premature fullness;
- poor appetite.
We select a specialized doctor for each type of cancer, because this makes the treatment as effective as possible and helps to improve the life quality of our patients. If you or any of your relatives were diagnosed with such disease, please contact us.
Prof. Dan Aderka – leading Israeli doctor, oncologist. Chairman of the Gastrointestinal Cancer Service. Head of GI Biology and Immunotherapy Program Sheba Medical Center. Consultant at Cell Regulation Department, Weizmann Institute. Head of the Gastrointestinal Cancer Unit at the Assuta Hospital.
We provide you with examination program focused on your problem, according to which you will clearly understand before coming to Israel, on what day and at what time you scheduled for a consultation and procedures.
Diagnosis and treatment
Stomach Cancer Diagnosis
The first step to effective treatment is a correct diagnosis. It usually lasts 4-5 days, after which the patient receives written expert’s conclusion about the diagnosis.
- Extensive blood test
- general analysis
- liver and kidney functions
- tumor markers (CEA, CA19-9, CA125).
- PET-CT (positron emission tomography of the whole organism). It is intended to reveal pathological processes and to determine whether metastases have spread in the body.
- Gastroscopy and Endoscopic Sonar (EUS) – their role is to assess the local spread or how deep the disease has penetrated the stomach itself, the nearby lymph nodes or nearby tissues. It is also used for a tumor biopsy taking.
- Histological examination of a biopsy tissue.
- Consultation by oncologist (diagnosis and treatment recommendations).
There are several types of stomach cancer:
- Stomach adenocarcinoma is the most common. It begins from the glandular epithelium of the gastric mucosa and is divided into:
- papillary adenocarcinoma;
- tubular adenocarcinoma;
- low-grade adenocarcinoma;
- mucinous adenocarcinoma;
Other types of gastric cancer includes:
- Cricoid cancer of the stomach
- Squamous cell cancer
- Glandular squamous cell carcinoma
- Undifferentiated cancer
- Lymphoma (MALT lymphoma or maltoma) – about 5% of all malignant tumors in the stomach.
At stages I and II of stomach cancer, when there are no metastases in the body, there is the possibility of:
- endoscopic resection of the mucous membrane and adjacent lymph nodes;
- further chemotherapy or radiation, as indicated by the doctor.
At present, our specialists adhere to this order:
- patients who do not have metastases in the lymph nodes are sent directly to the surgery
- those who suspect for glands’ dissemination receive chemotherapy before the surgery
The surgery type depends on the location and size of the stomach tumor. It may be necessary to ensure that there are no rest of cancer cells, so surgeon may remove the whole stomach or its part, including the healthy tissue around the tumor. Also, during surgery it may be required to remove:
- lymph nodes adjacent to the stomach
- sometimes the lower part of the esophagus
- upper part of the duodenum
- spleen or part of the pancreas.
Types of surgery
In this case, gastrectomy (subtotal or total) and laparoscopic surgery may be options .
♦ Subtotal gastrectomy or removing a portion of the stomach. Sometimes only partial resection can be performed, part of the stomach is preserved. It depends on the size of the tumor and its location. If the tumor is located in the lower part of the stomach, near the small intestine, the surgeon will remove the bottom of the stomach and suture the duodenum, as a result of a smaller stomach.
♦ Total gastrectomy or removing the entire stomach. When the tumor is concentrated in the upper part or in the center of the stomach, a complete resection of the stomach is usually required. In this case, the surgeon attaches the lower part of the esophagus to the small intestine and creates a small sac working just like the stomach.
♦ Laparoscopic surgery. In some cases, laparoscopic surgery may be performed to remove all or part of the stomach. At the same time, several small incisions are made in the abdominal cavity (instead of one large incision) through which a laparoscope is inserted. Thus, the surgeon can see the entire stomach. Recovery time after laparoscopy may be faster.
In cases where the operation is carried out without prior treatment, the next step is to perform a treatment aimed at reducing the disease relapse. It combines chemotherapy (intravenously or in pill form) and daily radiation therapy for about 5 weeks.
Stage III of stomach cancer
At III stages of the disease, as a rule, tumor cells spread through into more distant lymph nodes. In this case, complex chemotherapy or biological treatment mainly is used.
Indications for biological treatment and immunotherapy for stomach cancer are gene expression levels – HER2, VEGFR2 and PD-L1 (positive or negative).
Stage IV of stomach cancer
At this stage, the cancer spreads to nearby tissues and distant lymph nodes, or to other organs. At Stage IV, palliative therapy is often used to extend the patient’s life and maintain its life quality. Laser therapy, surgical methods, and stent placement are sometimes used to preserve the function of the digestive tract.
Treatment of stomach obstruction
Cancer can sometimes cause a blockage that prevents food to pass the intestines. In this case, therapeutic options include chemotherapeutic treatment, radiation therapy or other methods:
- stenting of the occlusion area, which will allow food to pass freely.
- stomach resection – an operation to remove part of the stomach where obstruction is located.
- gastric bypass surgery – creating a rearrangement or a new connection between a small upper pouch of stomach and the intestine to allow food to pass through.
These operations help to relieve symptoms, but do not cure stomach cancer.