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Cancer develops with the uncontrolled growth of cells in the layers of the stomach wall. These cancers originate predominantly from the lining of the stomach lining (adenocancer). Tumors may also form in other layers of the stomach wall (gastrointestinal stromal tumor).
Stomach cancer has a wide range of symptoms:
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Burning, heartburn and pain in the stomach
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Reflux symptoms
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Vomiting
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bloody vomiting
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black stools
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Significant weight loss in a short time, etc.
Diagnosis of stomach cancer (adenocancer) is made by examining the part taken in endoscopy and endoscopy under a microscope. Gastrointestinal stromal tumors may not be seen in endoscopy because they arise from the middle part of the gastric wall layers, only very large ones can be seen to exert pressure from the outside. The best diagnostic method for gastrointestinal stromal tumors is abdominal computed tomography. With this method, a mass-forming tumor can be detected.
ADENOCANCER TREATMENT
The treatment of stomach cancer is done with the contribution of many departments. General Surgery, Medical Oncology and Radiation Oncology, Nuclear Medicine, Radiology, Pathology and other relevant departments work in cooperation in treatment.
After the diagnosis of the disease, the first step in planning the treatment is to determine the stage. For this, computerized tomography, PET-CT or other imaging methods are used if necessary. The disease may be limited only to the stomach or surrounding lymph nodes and tissues, or it may have spread to distant organs. Distant organ spread is called metastasis. It is the degree of spread of the disease that determines the stage.
Surgery, drug therapy (chemotherapy) and radiation therapy (radiotherapy) are used together in treatment. After it is proven that the disease is limited to the stomach and surrounding tissues, surgery is planned with the aim of removing all visible cancerous tissue first. In surgical treatment, the stomach is removed together with the surrounding lymph nodes and, if necessary, the organs affected by the disease through the neighborhood. After the pathological examination of the removed part, its stage is finalized and chemotherapy and radiotherapy are programmed. Depending on the extent of the disease , preoperative chemotherapy (neoadjuvant chemotherapy) may also be applied. This decision is taken with a consultation attended by all relevant departments. If the disease has spread to distant organs, surgical treatment is performed only to eliminate complications (bleeding, inability to feed due to obstruction). Rarely, if distant spread is very limited, distant disease (metastasis) may be removed along with the stomach. This is a decision that all departments should take jointly.
GASTROINTESTINAL STROMAL TUMOR (GIST) TREATMENT
GIST treatment principles are different from adenocancer. In treatment, a drug called imatinib (Glivec) is used together with surgery. While the stomach is completely removed in adenocarcinoma, in the treatment of GIST, a limited removal procedure including only the diseased part is performed. According to the pathological examination of the part, it is decided whether to add imatinib to the treatment or not. Radiation therapy (radiotherapy) has no place in the treatment of GIST.