Stomach Cancer Awareness Month: How It Spreads And The Most Common Sites of Metastasis, As Per Cancer Expert

November marks Stomach Cancer Awareness Month, a critical time to raise awareness about one of the most prevalent cancers globally. Dr Sanjeev Kumar, Associate Director of GI Cancer at Max Super Speciality Hospital, Dwarka, sheds light on how stomach cancer spreads and the most common sites of metastasis, offering vital insights for early detection and prevention.

Understanding Stomach Cancer

Globally, stomach cancer ranks as the fifth most common cancer and is responsible for the fifth leading cause of cancer-related deaths. According to the International Agency for Research on Cancer, there were 64,611 new cases and 57,727 deaths in India alone in 2022. The incidence of stomach cancer has been rising, with over 40% of patients presenting with metastases at the time of diagnosis. This trend underscores the importance of early detection and timely treatment.

Dr Kumar explains, "The epidemiology of gastric cancer suggests that it is not a single disease or caused by a single factor, but a combination of genetic, socio-cultural, and environmental factors in a given region dictates its presentation."

Causes of Stomach Cancer

Several factors contribute to the development of stomach cancer, with some being more preventable than others:

• Helicobacter pylori infection: This bacterium is a leading cause of stomach cancer, responsible for 65-80% of cases. It is prevalent in 80-90% of asymptomatic individuals. Dr Kumar emphasises that "timely detection and treatment of H. pylori infection are essential to reduce the risk of gastric cancer."
• Dietary Factors: While no direct causal link has been established, consumption of fried foods, smoked items, processed meats, and pickles has been associated with a higher risk. Dr Kumar suggests that "a diet rich in fresh fruits, vegetables, and citrus fruits, along with antioxidants, can lower the risk."
• Alcohol and Tobacco Use: Dr Kumar highlights the increased risk associated with alcohol and tobacco, noting that "smoking increases the risk of stomach cancer by up to 40%, and heavy smoking can raise the risk by as much as 82%."
• Genetic Factors: Inherited genetic conditions such as hereditary diffuse gastric cancer (HDGC) can make individuals more susceptible.

Stomach Cancer Symptoms

In the early stages, stomach cancer may not present any noticeable symptoms. When symptoms do appear, they are often vague, including indigestion, heartburn, and stomach discomfort. However, as the cancer progresses, more severe symptoms may occur, such as:

• Unintentional weight loss
• Persistent abdominal pain
• Nausea and vomiting
• Difficulty swallowing
• Blood in stools or black stools
• Extreme fatigue
• Feeling full or bloated after eating small meals

Dr Kumar warns, "It is possible for symptoms to remain unnoticed until the cancer has progressed significantly."

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How Stomach Cancer Spreads?

Stomach cancer can spread to distant parts of the body through several mechanisms:

• Direct Extension: The cancer may grow into nearby organs, such as the pancreas, diaphragm, duodenum, or transverse colon.
• Lymphatic Spread: Stomach cancer can spread through the lymphatic system, affecting nearby lymph nodes.
• Hematogenous Spread: The cancer cells can enter the bloodstream and travel to other organs, causing metastasis.
• Peritoneal Spread: The cancer can spread to the peritoneum, the lining of the abdominal cavity.

Most Common Sites of Metastasis

Dr Kumar outlines the most common sites where stomach cancer tends to spread:

• Liver (48%)
• Peritoneum (32%)
• Lung (15%)
• Bone (12%)

Stomach Cancer Prevention and Early Detection

Understanding the key risk factors for stomach cancer, particularly the role of H. pylori infection, is crucial for prevention. Dr Kumar advises that timely detection and treatment of precancerous conditions like gastric ulcers can help prevent the progression to full-blown stomach cancer. Additionally, adopting a healthy lifestyle—such as reducing alcohol consumption, quitting smoking, and eating a balanced diet—can significantly lower the risk.

As we observe Stomach Cancer Awareness Month, it's important to educate ourselves on the risk factors, symptoms, and most common metastasis sites for this deadly disease. With early detection and lifestyle changes, the risk of stomach cancer can be significantly reduced.

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