CARCINOMA STOMACH (pathology)

    
Risk factors :
        -  helicobactor pylori infection
        - stomach lymphoma
        - age after 50 years
        - more common in males
        - more common in Japan, China, Southern and Eastern Europe, and South and Central America
        - large amounts of smoked foods, salted fish and meat, and pickled vegetables. Nitrates and nitrites are substances commonly found in cured meats
       - tobacco use, obesity, previous stomach surgery
       - type A blood, family history of stomach cancer
       - EBV infection
       - immune deficiency

Clinical symptoms :
        - weight loss
        - persistent abdominal pain
        - dysphagia
        - occasional nausea and intestinal obstruction

Investigations :
        - Check FBC (possible anemia)
        - Rapid-access flexible endoscopy
        - Chromoendoscopy (use of dyes to highlight various aspects of the gastric mucosa), narrow band imaging and auto-fluorescence
        - biopsy

Management :
       - Surgery is the treatment of choice for gastric cancer
       - Distal (antral) tumours should be treated by subtotal gastrectomy and proximal tumors by total gastrectomy
       - Limited gastric resections should presently only be used for palliation or in the very elderly.