Gastric cancer stage 3 metastases of adenocarcinoma. Gastric adenocarcinoma: symptoms, modern methods of treatment. Stages of progression of the disease in question

Among oncological diseases, the diagnosis of glandular cancer – gastric adenocarcinoma – is increasing. It affects in most cases men after 45 years of age.

Symptoms on early stages almost does not manifest itself and is similar to other diseases. It is necessary to conduct an examination if even mild symptoms are present. Timely detection of a tumor increases the prognosis to 90%. Treatment is complicated by the formation of metastases in the early stages of tumor development.

Features of the formation and development of adenocarcinoma

The tumor develops slowly in the early stages, symptoms are mild or completely absent. Glandular cells are located between dense smooth muscles and the mucous membrane they produce. In addition to mucus, they create gastric juice. Three types of glands produce different substances:

• The main ones are chymosin and pepsinogens.
• Parietal - hydrochloric acid, gastromucoprotein.
• Mucocytes are a mucoid secretion.

When glandular cells are damaged, their activity decreases. As a result, acidity decreases. The protective film decreases, the walls of the stomach are exposed, ulcers and inflammation form. Gastric adenocarcinoma has symptoms similar to gastritis and ulcers:

• Heaviness in the stomach.
• Aching pain.
• Weight loss.
• Fast fatiguability.
• Lack of appetite.
• Refusal of usual foods, especially meat.
• Nausea.
• Vomiting, possibly with blood.
• Abnormal stool.
• Dry skin, pallor and slight yellowness.

The disease can be distinguished by pain. With a stomach ulcer, it goes away after eating. In the case of adenocarcinoma, aching and spasmolytic pain appears regardless of food intake. Additionally, the temperature rises and anemia develops. At an early stage, only acidity changes. Symptoms hardly appear. Signs of the disease can be detected in later stages, when the prognosis worsens. The early formation of metastases complicates the treatment of adenocarcinoma. They can appear already at stage 2 of tumor development and affect neighboring organs and lymph nodes.

Causes of glandular stomach cancer and classification of formations

Presence in the stomach provokes the development of adenocarcinoma large quantity bacteria Helicobacter pylori. They do not die in the aggressive acidic environment of gastric juice and develop. The presence of Helicobacter in the stomach provokes gastritis, changes acidity and causes heartburn. When bacteria remain for a long time, tumors develop on the damaged walls of the stomach.

Can provoke malignant formation various diseases stomach:

• Gastritis.
• Ulcer.
• Polyps.
• Scars left after surgery.

At the same time, Helicobacter pylori causes exacerbation of inflammation and ulcers on the walls of the stomach. The reasons for the development of bacteria are often associated with poor nutrition, hypothermia, and environment, bad habits. Various factors increase the likelihood of adenocarcinoma.

• Fast food.
• Hot and spicy food.
• Exotic dishes.
• Binge eating.
• Obesity.
• Prolonged fasting and insufficient intake of vitamins, proteins, and fiber.
• Consumption of large amounts of salt.
• Lack of ascorbic acid in the body.
• Smoking.
• Alcohol.
• Cold and hot food.
• Uncontrolled use of medications.
• Poorly cooked meat and fish.
• Colds.
• Sedentary lifestyle.
• Air pollution.
• Overload.

All these reasons cause stomach diseases. Against their background, a tumor of glandular cells appears and develops. Depending on the cause of adenocarcinoma, there are several types of tumor:

• Ulcerative - has expanded borders.
• Polyploid - small sizes, compactly located.
• Pseudo ulcer - similar to a stomach ulcer.
• Unclassified, polyploid type.
• Diffuse-infiltration.

Each type is formed against the background of a specific disease of the organ and often externally repeats the form. Pseudo ulcerative adenocarcinoma is considered the most dangerous, with a poor prognosis. Her metastases form at an early stage of development. Cancer cells are carried by the blood and penetrate deep into other organs. Outwardly it looks like an ulcer, and when examined by probing it does not differ from a normal benign formation.

Types of stomach tumors

At an early stage, metastases also form in tumors of the diffuse infiltration type. Signs of adenocarcinoma appear strongly, with a sharp increase in the affected area. Glandular malignancies are not limited to the internal region of the stomach and damage to the mucous layer. They penetrate dense outer tissues. The prognosis for the diffuse infiltration type of adenocarcinoma is the worst.

The opportunity to cure the ulcerative type of tumor is great. When diagnosed, histology shows that 30% of tumors are benign. Externally, the formation has torn boundaries of the formation area and often without wall thickening.

The best prognosis is for the polyploid type of glandular cancer. The tumor has a clear boundary separating it from healthy tissue. The formation without ulcerative covering is small and does not grow. Metastases do not develop earlier than stage 3 of the disease is reached. Occurs in approximately 18% of cases of stomach cancer. The underlying disease is advanced polyps.

There are 4 types of tumors based on their shape.

1. The signet ring cell form is characterized by the formation of individual glandular cancer cells that penetrate pointwise into the mucous membrane and muscle tissue.
2. The mucous type of tumor is accompanied by the constant release of large amounts of mucus. Easily determined by gastroscopy.
3. Papillary - has the shape of elongated glandular cells. Grows inside the mucous membrane and cavity of the stomach. Externally similar to fingers.
4. The tubular tumor has a branched structure with the formation of brushes and is widely scattered throughout the cavity.

The papillary form is most often characteristic of the polyploid type of tumor. Turbular is the most difficult to treat surgically. It affects large areas and has many branches - metastasis.

Diagnosis of gastric adenocarcinoma

Adenocarcinoma does not appear in a healthy stomach. It forms and develops against the background of other diseases. It can be detected in a timely manner during an examination. The main indicators are:

• Reduced acidity of gastric juice.
• Increased protein content.
• Presence of Helicobacter pylori.

If symptoms are detected, the patient is examined together with a therapist, gastroendocrinologist and oncologist. A test of blood, urine, feces and gastric juice is taken. The initial examination consists of analyzing the condition of the skin and palpating the walls of the stomach. Palpation on the back and sides alternately allows you to determine the presence of a tumor if it is not located on the back wall of the organ.

Contrast X-ray examination allows you to see the contours of the tumor, its location and size. Before the examination, the patient drinks a contrast solution, which penetrates the tissue depending on its density. In the image you can clearly see the boundaries of dense tissues, the degree of damage to the lymph nodes, tumor formation, and the presence of metastases. The tumor has a malignant or benign nature, which x-rays do not show.

Esophagogastroduodenoscopy allows you to use a probe to penetrate the esophagus into the stomach, examine its walls and take scrapings for analysis. The laboratory can give an accurate answer about the nature of the tumor. Computed tomography and magnetic resonance imaging provide a general picture of the extent of damage to neighboring organs and the area of ​​spread of metastases. It takes images of body organs layer by layer, without penetrating inside or destroying tissue, and produces horizontal images.

Ultrasound examination provides an opportunity to see the condition internal organs. If there are no metastases, then it is difficult to determine the nature of tumor formation. An ultrasound is performed to confirm the results of the analysis and determine the condition of the internal organs.

Degree of differentiation of gastric adenocarcinoma and prognosis

Poorly differentiated gastric adenocarcinoma has a poor prognosis. This type of glandular cancer is different:

• Mild primary symptoms.
• Rapid tumor growth.
• Damage to a large area.
• Early formation of metastases affecting lymph nodes and neighboring organs.
• High degree of malignancy.

The disease is diagnosed mostly late, at stages 3–4, when the liver is affected. The operation cannot be performed because the metastases penetrate the lymph nodes and large blood vessels. Most often it is a pseudoulcerative tumor of tubular form. Chemotherapy and radiation are ineffective because cancer cells are spread over a large area.

The disease develops against the background of advanced diseases, especially stomach ulcers and gastritis. It is more often diagnosed in men over 50 years of age, working in hazardous work, smoking and drinking alcohol.

Well-differentiated gastric adenocarcinoma has the best prognosis. Tumor cells have a mild malignancy and are similar to healthy ones. Metastases are practically absent. A highly differentiated type of glandular cancer develops slowly, over 10–20 years. It mainly affects older people. The likelihood of getting sick increases:

• Bad heredity.
• Diabetes.
• Unbalanced diet.
• Taking a large number of medications.

Can provoke the development of glandular cancer chronic illness other organs and their improper treatment or lack thereof.

Moderately differentiated adenocarcinoma has an average severity of tissue damage. Has no characteristic features. It is difficult to diagnose using biopsy and probing. The structure of glandular cells is slightly changed. It does not grow through dense tissue in the first stages. If detected early, the prognosis is good. In advanced forms, at stage 3 cancer, metastases begin to develop. Timely diagnosis and surgery give good results.

The cause of the development of a moderately differentiated tumor is:

• Bad ecology.
• An area with a high content of lead, zinc, molybdenum and other heavy metals in the soil.
• Poor nutrition.
• Smoking.
• Alcohol.

Prevention of adenocarcinoma and other types of stomach cancer

It most often affects men over 45 years of age who are addicted to alcoholic beverages and smoking. Glandular cancer develops against the background of mild ulcers and gastritis, which are not treated properly.

The main causes of glandular cancer are not fully understood. Risk groups for each species have been identified. The prognosis can only be improved through regular examinations. In case of illness of the stomach and related organs, it is necessary to consult a doctor and undergo a full course of treatment.

Smoking and drinking alcohol increases the risk of the disease. A balanced diet contains a set of vitamins and minerals necessary to maintain the normal functioning of all organs. Moderate exercise improves health hiking. Timely detection of a tumor significantly increases the chance of recovery.

Gastric adenocarcinoma occurs primarily in people between forty and fifty years of age. Men are one and a half times more likely to develop malignant carcinoma. Among all tumors of the gastrointestinal tract, adenocarcinoma is diagnosed in ninety-five percent of cases. When doctors diagnose stomach cancer, in most cases they have this particular pathology in mind. Epithelial glandular cells of organ tissues take part in the formation of adenocarcinoma, which change under the influence of certain provoking factors.

In cases of cancer in any part of the stomach early diagnosis is difficult, since the oncological process has a sluggish course and may not show any signs for years. Pathology develops for a very long time, sometimes up to fifteen or twenty years. The first symptoms in almost half of the cases occur in the third or fourth stage of the disease, although in more than eighty percent of cases the formation of metastases occurs in the early stages.

Causes

The main reason for the formation of a tumor and the development of stomach cancer is a deterioration in the nutrition of the walls of the organ, impaired blood supply, as well as a decrease in its secretion, which leads to malignancy of the cells of the glandular layer. The factors that cause pathological changes in the lining of the organ, followed by glandular cancer of the stomach, are as follows:

1. Junk food – abuse of fatty, salty, spicy and smoked foods increases the risk of tumors.
2. Frequent dieting - if dietary fiber, nutrients and vitamins enter the body in insufficient quantities, this leads to a weakening of the entire body and negatively affects the gastrointestinal tract.
3. Smoking and alcoholism increase the risk of adenocarcinoma several times. Very often, tumors develop in long-term smokers due to exposure of the body to carcinogens contained in tobacco smoke.
4. Diseases of the stomach such as chronic ulcers, gastritis, dysplasia of the organ mucosa often cause neoplasms.
5. The above-described diseases are caused by the bacterium Helicobacter pylori. With prolonged infection, not only an ulcer can develop, but also adenocarcinoma.

The risk group includes people living in an environmentally polluted area, working in hazardous industries, as well as those whose family has already had cases of stomach cancer.

Classification

Stomach cancer has a broad classification. Depending on the histological structure and type, adenocarcinoma can be:

• polyposis;
• ulcerative;
• pseudo-ulcerative;
• diffuse;
• non-secretory.

There are also four subtypes of tumor:

• papillary - arises from structures that have a papillary appearance, grows inside the stomach and has a finger-like shape;
• signet ring cell – a tumor that is an isolated neoplasm affecting the body of the stomach;
• mucous membrane – at the site of cancer localization there is a constant production of mucus, which can be seen during gastroscopy;
• Tubular adenocarcinoma of the stomach - it consists of branched or cystic-enlarged structures.

There are other forms of pathology; the classification of the disease is determined according to the degree of differentiation the neoplasm has:

1. Poorly differentiated;
2. Highly differentiated;
3. Moderately differentiated.

Differentiation depends on the difference between cancer cells and healthy ones - the lower it is, the worse the prognosis.

Poorly differentiated

With this degree of malignancy, the pathology in the early stages can already metastasize to nearby tissues and to nearby lymph nodes. Metastatic tumors can affect the entire gastrointestinal tract. If poorly differentiated gastric adenocarcinoma is diagnosed, patient survival is very low.

Highly differentiated

Well-differentiated gastric adenocarcinoma is the most favorable in terms of prognosis, since its cells continue to perform part of their functions. There is no damage to nearby tissues; the structure of the pathological cells is almost the same as that of the cells of the healthy gastric mucosa. The degree of malignancy is low, the patient has a good chance of recovery.

Moderately differentiated

Moderate in malignancy – moderately differentiated adenocarcinoma of the stomach. This neoplasm is of an intermediate type, the change in cell structure is insignificant, the prognosis for the patient depends on many factors.

Stages

In highly differentiated and moderately differentiated tumors, there is no clear staging of the oncological process. Poorly differentiated neoplasms are divided into five stages, zero of which is the asymptomatic course of adenocarcinoma. The next four stages are:

1. The first stage is diagnosed when the patient has metastases to regional lymph nodes, as well as involvement of the submucosal membrane in the malignant process;
2. In the second stage, the smooth muscle layer of the organ and the lymphoid tissue of the lymph nodes are affected;
3. At the third stage, all cells of the regional lymph nodes are affected, the tumor grows through all layers of the stomach and occupies a large area;
4. At the fourth stage, metastases to other organs, ascites and other life-threatening complications occur.

At each stage there are different signs of adenocarcinoma, but the initial stages often occur with hidden symptoms, so it is important to undergo periodic examinations in gastroenterology.

Symptoms

1. The patient's weight gradually decreases;
2. The person constantly feels weakened;
3. The patient quickly gets tired even with minor physical and mental stress.

Other signs are added in proportion to the growth of the tumor:

• loss of appetite occurs;
• after eating your stomach starts to hurt;
• heartburn and frequent belching appear.

The last stage is characterized by symptoms of adenocarcinoma, which are inherent in this particular pathology:

• there is an aversion to meat dishes and any food containing protein;
• iron deficiency anemia begins;
• when the tumor begins to disintegrate, internal hemorrhage occurs, which leads to stool that has a tarry appearance and consistency;
• food stagnates in the stomach, which is why the patient feels that the stomach is constantly full;
• salivation increases;
• nausea and vomiting occurs.

Depending on the type of stomach cancer and how good the patient’s immunity is, even at the last stage the symptoms may be mild.

Diagnostics

Making a diagnosis begins with an external examination of the patient, listening to complaints and collecting an anamnesis. The following diagnostic methods are used:

• general clinical blood test - shows an increase in leukocytes and reduced level red blood cells;
• computed tomography or magnetic tomography - helps to identify metastasis;
• gastroscopic examination - thanks to this method you can see the condition of the mucous membrane from the inside;
• blood for specific proteins - tumor markers;
• laparoscopy – helps to see metastases and determine the stage of the disease;
• contrast radiography - the introduction of a micropreparation (barium sulfate) into the stomach and intestines in order to identify destroyed areas of the organ in the image and identify secondary tumors;
• tumor biopsy with esophagogastroduodenoscopy – helps determine the degree of malignancy of the degenerated cells;
• Ultrasound of organs abdominal cavity– carried out to identify metastasized cells.

After the diagnosis of gastric adenocarcinoma is completed, the doctor decides on the possibility of surgical intervention.

Treatment

Treatment for gastric cancer is selected depending on the size of the tumor, the degree of its differentiation, the patient’s age and his general condition. The most effective is surgical removal of the tumor. There are two types of surgery that can be performed for stomach cancer:

1. During subtotal resection, the tumor is removed along with part of the tissues involved in the malignant process or a small area of ​​the organ itself;
2. During a gastrectomy, the entire stomach and surrounding tissues - regional lymph nodes, part of the esophagus and small intestine - are removed.

In case of contraindications to surgery, cancer cells are removed through endoluminal laser therapy. In order for the patient to be able to feed on his own, sten is inserted into his stomach (a procedure called endoluminal stenation). Before and after the operation, the person is prescribed the following treatment measures:

• Radiation therapy. Radiation is given before surgery to reduce the size of the tumor, and also after surgery to destroy cancer cells remaining after surgery. Radiation can reduce pain and prevent internal bleeding.
• Chemotherapy is carried out with Cisplatin, Bleomycin or Ftorafur to shrink the tumor before surgery and destroy metastatic tumors after surgery. Chemical treatment also helps reduce the risk of cancer recurrence.
• Immunotherapy. Chemical drugs negatively affect not only tumor cells, but also healthy tissues, therefore it is necessary to use special means increase the body's defenses.

Traditional medicine is not used to treat adenocarcinoma, but after consultation with a doctor it can help eliminate side effects after chemotherapy.

Prognosis and prevention

How long a person will live depends on the stage at which treatment was started, as well as the type of therapy performed. After surgery in the first stage, the survival rate is about eighty percent; in the second stage, the figure drops to forty percent. After treatment of the third stage, five-year survival is observed in only twenty percent of patients, and in the fourth - no more than five out of a hundred people. Also, the prognosis of gastric adenocarcinoma depends on the age of the patient - young people cope with the disease more easily.

To prevent cancer, you need to eat right, give up bad habits, visit a doctor if you have any complaints, and promptly treat diseases of the gastrointestinal tract.

Gastric adenocarcinoma is a common malignant lesion of this organ. At the first stage, the tumor develops almost asymptomatically, which complicates diagnosis. Thus, the disease is extremely rarely detected early. Moreover, it often causes metastases already at initial stages pathology, which seriously aggravates the course of cancer and the prognosis for recovery.

Description and statistics of the disease

Gastric adenocarcinoma develops from glandular epithelial cells that have undergone certain malignant changes as a result of exposure to unfavorable factors. This is the type of tumor that most patients face.

In this regard, this disease in medical textbooks is called nothing more than stomach cancer. The pathological process tends to develop slowly - tumor formation can take from 2-5 years to several decades.

Most often, gastric adenocarcinoma occurs in older middle-aged people, mainly in men. Moreover, in 40% of cases, the primary diagnosis reveals the third and even fourth stage of the disease, when the patient is already included in the group of inoperable patients and most treatment methods are simply meaningless. This happens due to the lack of a clinical picture of adenocarcinoma at an early stage. In 85% of cases, cancer causes metastases.

Code according to the international classification of diseases ICD-10: C16 Malignant neoplasm of the stomach.

Causes

The fundamental cause of adenocarcinoma is disruption of normal blood flow and nutrition of the stomach walls and deterioration of secretory functions in the organ. Similar changes, as a rule, are formed under negative impact some components with carcinogenic properties.

We list the main causes of gastric cancer:

• alcoholism and smoking. Quite often, adenocarcinoma is detected in people who have many years of experience of alcohol abuse and nicotine addiction.
• poor nutrition. An abundance of harmful or potentially dangerous food in the diet is fraught with the development of an oncological process in the stomach. For example, nitrites, which are contained in smoked meats and chips, once in the digestive tract, form chemical complexes that have a destructive effect on the mucous membrane of the organ, provoking the degeneration of healthy cells into cancerous ones.
• passion for diets. Long-term unbalanced nutrition with a low content of dietary fiber, vitamins and minerals sooner or later leads to atypical processes in the stomach.
• Helicobacter pylori. A well-known bacterium that causes gastritis and atrophic ulcerations in the gastrointestinal mucosa. If left untreated, microorganisms lead to a variety of complications, including cancer of the stomach.
• genetic predisposition. Plays a certain role. If there is an unfavorable hereditary factor for cancer in the family, the doctor will not exclude it when identifying gastric carcinoma.

Clinical studies have helped to find out that stomach cancer almost never forms on its own if there are no underlying diseases in the body. The risk of pathology increases if a person has the following conditions:

• polyps on the walls of the stomach;
• ulcer and gastritis;
• organ operations.

Who is at risk?

The group of predisposition to adenocarcinoma includes persons who permanently live in areas with poor environmental conditions, work in hazardous industries and are over 50 years of age. It is also impossible to exclude people suffering from tobacco and alcohol addiction and untreated gastrointestinal diseases.

Classification

There are several forms of gastric adenocarcinoma, which can be differentiated into separate categories. Depending on the nature of the oncological process, there are four types:

• Neoplasm of polyploid structure. The most favorable prognosis for survival. There are no ulcerative changes in the surface of the organ tissues, the pathology is strictly limited. The incidence rate is 1 case in 20 cancer patients.
• Tumor of ulcerated type. The neoplasm has uneven edges, is not convex and not voluminous, the mucous membrane is affected by ulcers. Occurs in 30% of diagnosed stomach cancer cases.
• Partially ulcerated neoplasm. Gives metastases in the early period. The most dangerous. Adenocarcinoma cells penetrate into the deep layers of the stomach and spread through the bloodstream throughout the human body.
• Diffuse infiltrating tumor - scirri. Creates a vast area of ​​the oncological process, capturing organ tissue under the mucous membranes. A person develops symptoms of pathology early, and metastasis also begins quickly. The prognosis for survival is one of the worst.

According to the degree of differentiation, adenocarcinoma is divided into the following types:

• Undifferentiated (G0). The prognosis is unfavorable. The process is characterized by malignancy of cancer cells.
• Low differentiated (G1). The structure of the tumor does not depend on its origin, the likelihood of dissimilation of metastases is increased. High degree of malignancy.
• Moderately differentiated (G2). Contains a large percentage of atypical cells. With timely help, the prognosis is favorable.
• Highly differentiated (G3). Cancer cells are few and difficult to distinguish from healthy ones. The outcome of the disease has a good chance of recovery.

Stages

There are four stages of development of gastric adenocarcinoma. As mentioned above, the initial ones are difficult to diagnose, since the disease is hidden. Let's talk about them in more detail in the following table.

Symptoms

In most cases, adenocarcinoma does not make itself felt for a long time. The first symptoms are general and nonspecific, for example, weakness, increased fatigue and slight weight loss in a person.

Later, these clinical manifestations complement signs that can be confused with gastritis and other gastrointestinal pathologies:

• food-related abdominal pain;
• belching, heartburn;
• loss of appetite.

At the third and fourth stages of gastric adenocarcinoma, the symptoms of the disease become specific. Most often, a person consults a doctor at this stage, as he is concerned about the following problems:

• a feeling of constant fullness of the organ even after eating a small amount of food, especially if the tumor is located in the lower part of the stomach;
• black stool and persistent anemia caused by chronic microblood loss due to the growth of adenocarcinoma;
• change in food preferences - most people categorically refuse meat.

As a rule, at this stage the oncological process is considered to be very advanced.

Difference between gastric adenocarcinoma and carcinoma

Experts have found that 85% of cancers are carcinomas, that is, this type of tumor is the most common in oncology. They develop from the epithelial tissue lining the gastric mucosa.

Carcinomas originate from squamous cells, which predominate in the digestive tract. Adenocarcinoma is formed from glandular cells that form the basis of the secretory glands of the stomach. Both tumors can occur in any human organ.

Diagnostics

If a patient exhibits symptoms similar to gastric adenocarcinoma, the doctor prescribes the following laboratory and instrumental studies:

• Esophagogastroduodenoscopy. The most informative method in diagnosing this disease. It determines the presence of any disturbances in the structural structure of the stomach tissue, not to mention glandular cancer. In addition, during the procedure, the specialist has the opportunity to take biomaterial from the suspected tumor for subsequent histological examination.
• Ultrasound. Scanning is used not only in the stomach, but also in other organs - lymph nodes, liver, etc. This helps determine the nature of the tumor and the presence of metastasis in the tissues.

• X-ray of the stomach. This is done using a contrast agent. Helps accurately determine the location and size of tumors.
• CT and MRI. The human body is scanned in layers. Both methods are modern. With their help, it is possible to determine not only the size and location of gastric adenocarcinoma, but also metastases throughout the body.
• Blood analysis. Reveals inflammatory changes characteristic of the oncological process in the body.

Which doctor should I contact?

If a person experiences symptoms such as loss of appetite, indigestion, and stomach pain, it is important to visit a gastroenterologist. If adenocarcinoma is suspected, the specialist will prescribe a number of the tests listed above and, if the malignancy of the disease is confirmed, he will refer the patient to an oncologist.

Stomach cancer is an insidious and common phenomenon, most often diagnosed in the last stages - the third and fourth. The treatment tactics for adenocarcinoma depend on the stage of the tumor process, its location and the histological nature of the tumor.

Treatment

Treatment for stomach cancer is selected individually after a complete diagnostic examination. At initial stages After an oncological process, an operation is prescribed, during which a specialist removes the tumor and nearby tissues affected by cancer, for example, the intestines or pancreas. The stomach is excised completely or partially, depending on the location of the tumor. In all cases, regional lymph nodes are subject to resection, since at any stage of the disease they can contain cancer cells, which will subsequently metastasize throughout the body.

If we are talking about the third and fourth stages of stomach cancer, carrying out surgical treatment not always justified. The fact is that the operation at this stage should result in not only the removal of the stomach, but also other vital organs where there are already metastatic changes, and it is not advisable to deprive them of a living person.

In this case, the patient is recommended maintenance treatment based on radiation and chemotherapy sessions, the prescription of strong analgesics and drugs that improve the functional activity of the gastrointestinal tract. Surgery in the final stages of gastric adenocarcinoma is recommended for the development of obstruction of the esophagus and duodenum.

Radiation and chemotherapy are also prescribed for surgical treatment of initial forms of the disease. They can be performed before and after surgery to reduce the malignancy and reduce the likelihood of its recurrence.

Removal of the stomach - in what cases is it necessary?

In case of adenocarcinoma, as mentioned above, the surgeon can remove the stomach completely or only part of it with lymph nodes, which significantly reduces the likelihood of a recurrence of the oncological process. As a rule, organ resection can be performed at any stage of cancer, while focusing on contraindications to surgery - if they exist, surgical treatment becomes irrational and inapplicable to a particular patient. Restrictions on removing the stomach for adenocarcinoma are:

• metastases in different parts bodies;
• tumor disintegration, cancer peritonitis;
• hemophilia - poor blood clotting;

• chronic pathologies of the heart, blood vessels and kidneys;
• the last stages of the oncological process, which are characterized by exhaustion, general loss of strength, etc.

If these contraindications exist, surgery is not prescribed.

Is gastric transplantation performed for cancer?

All over the world, gastric transplantation is practically not performed. This is primarily due to the fact that the transplantation of a given donor organ is extremely complex and rarely ends successfully. And secondly, the stomach is not as important for the patient, for example, as the bone marrow or liver.

Many people, after its partial or complete removal, continue to live and do not experience any special difficulties. Thus, proper rehabilitation following surgical treatment, adherence to recommendations for nutrition and a healthy lifestyle help to avoid the consequences associated with the removal of gastric adenocarcinoma.

Folk remedies

The fight against oncology should be carried out exclusively within the walls of a medical institution under the supervision of a doctor. There are unconventional methods of treating stomach cancer, the use of which can be started after permission from a specialist. They shouldn't become independent remedy from adenocarcinoma.

Let's list some methods traditional medicine having positive reviews among patients regarding their effectiveness.

Aconite tincture. Rinse 100 g of aconite rhizomes and brew with boiling water for 60 minutes. Then chop the softened parts of the plant and pour 60% alcohol. Leave for 21 days. Take 1 drop 30 minutes before meals, diluting the product in a glass of water. Add 1 drop daily to the starting dosage. The course is 2 weeks, then a break for the same period, and the treatment can be repeated.

Decoction of potato inflorescences. Collect the inflorescences, dry in the dark and grind to a powder. 1 tbsp. l. Brew 0.5 liters of boiling water of vegetable raw materials. Take 150 ml orally 3 times a day before meals. The course is 2 weeks, after 7 days it should be repeated. The total duration of treatment is 6 months.

Walnut tincture. Grind 33 nuts with their shells and pour high-quality vodka over them. Leave for 40 days. Drink 1 tsp. 3 times a day before meals. Keep medicine in a refrigerator.

Diet

For people suffering from gastric adenocarcinoma, several options have been created therapeutic nutrition based on certain principles. Let's look at them in more detail:

Patients without significant metabolic problems and with normal weight recommended:

• energy value - 2400 kcal per day;
• proteins - 90 g, 50% of which are of animal origin;
• fats - 120 g, 25% - vegetable;
• carbohydrates - 330 g.

Persons who are overweight and suffer from chronic liver and kidney disorders are prescribed:

• energy value - 2650 kcal;
• proteins - 60 g, 50% - animals;
• fats - 90 g, 30% - vegetable;
• carbohydrates - 400 g.

For patients with low weight and signs of exhaustion, it is recommended:

• energy value - 3600 kcal;
• proteins 140 g;
• fats - 120 g;
• carbohydrates - 500 g.

The doctor gives individual wishes regarding diet after examining the patient. Basic principles of the diet: cooking should be done by steaming or baking, the total number of meals should be up to 6 times a day. After gastrectomy surgery, most patients may require tube feeding during the recovery period.

Persons suffering from stomach cancer are prohibited from:

• smoked meats;
• salted and pickled foods;
• fatty and fried foods;
• strong coffee;
• too hot food;
• alcohol.

The following products will benefit the patient:

• sea ​​fish;
• citruses;
• carrot;
• black currant.

Course and treatment of the disease in children, pregnant and lactating women, the elderly

Children. Stomach cancer in childhood is quite rare - 1 case per 1 million young patients. The ambiguous clinical picture of adenocarcinoma, similar to other pathologies of the digestive organs, virtually eliminates the possibility of early detection of the disease, when patient survival is at least 80%. In children, chemotherapy is not advisable; most often, specialists decide to remove the affected part of the stomach and nearby tissues.

Pregnancy. Gastric adenocarcinoma in expectant mothers has virtually no specific differences from other patients. That is, the disease develops according to the same principle, but in the first trimester of pregnancy its clinical manifestations can be disguised as early toxicosis. For this reason, diagnosing stomach cancer in expectant mothers is quite problematic, and the pathology itself is often aggravated by various complications.

This is due to the increased load on the body of a pregnant woman, who will have to bear the fetus and at the same time fight the existing malignant process. Complications often include gastric bleeding and obstruction of the esophagus and intestines associated with tumor growth. In such cases, rest and emergency hospitalization of the woman in a hospital, as well as urgent surgical intervention, are recommended.

Stomach cancer in pregnant women is extremely rare, and the prognosis for recovery is considered poor. The fact is that carrying and giving birth to a child, and then curing a tumor - difficult task. However, such cases are known to medicine. A lot depends on the desire of the woman herself to overcome the disease and find the happiness of motherhood. Well, the stage of the oncological process at which adenocarcinoma is detected plays an important role. If it is early, the chances of recovery are high.

Treatment of stomach cancer in expectant mothers is associated with some peculiarities. If the disease is detected in the first trimester, doctors may insist on immediate termination of pregnancy - induced abortion, since the health risk is high. If the disease is diagnosed in the second and third trimester, the specialist may suggest waiting with treatment until the baby is born or inducing premature birth if the baby is viable.

Lactation. Gastric adenocarcinoma is rarely detected in women who breastfeed. Usually we are talking about an oncological process that began during pregnancy. At the time of treatment - surgical, drug or radiation therapy - it is recommended to refuse lactation. The fact is that the listed methods of fighting cancer can negatively affect breast milk women and harm the child.

Advanced age. According to statistics, stomach cancer most often occurs in elderly people over 60 years of age. As in other cases, the symptoms of the disease have much in common with signs of other organ pathologies digestive tract Therefore, it is often diagnosed very late.

Surgical intervention is radical and the most effective way treatment of gastric adenocarcinoma. But often this method is contraindicated for older people, since operations are not performed for heart and vascular diseases, disorders respiratory system, which is often observed at this age. In such a situation, doctors are limited to symptomatic therapy using painkillers, etc.

Treatment of gastric adenocarcinoma in Russia, Germany and Israel

Needless to say, gastric adenocarcinoma requires quick and high-quality care. We invite you to learn about its features in different countries.

Treatment in Russia

The fight against stomach cancer in domestic specialized oncology centers is quite real, since they are equipped necessary equipment and there is practice in identifying diseases, treating them and rehabilitating the patient.

Where can I get the help I need?

• CELT Clinic, Oncology Department, Moscow. The leading medical institution in Russia, providing specialized services for more than 20 years. Every year, CELT performs over 4 thousand operations with an average success rate of 92%.
• LDC MIBS, Oncology Center, St. Petersburg. The high professionalism of doctors is successfully complemented by the use of advanced therapeutic techniques. Patients receive care that meets international standards.
• "Sofia", oncology center, Moscow. A modern center, opened in 2013, with the latest equipment. It operates in accordance with European standards and is supervised by world experts in the field of radiation and chemotherapy.

We invite you to find out what reviews are found about these medical institutions?

Maria, 48 years old.

“I had a good impression about the oncology center of the LDC MIBS in St. Petersburg. My sister came to them with stage 2 gastric adenocarcinoma, tumor 4 cm. 6 years have passed since the operation, she does not remember the disease.” Irina, 38 years old.“Stomach cancer was discovered by accident during...

routine medical examination

. First stage. The tumor is small. I went for an examination at the Sofia Oncology Center, located in Moscow. The stomach was partially removed. There were no complications. 2 years have passed since the operation, there are no relapses.”

Treatment in Germany

• Treatment of gastric adenocarcinoma by German specialists is highly effective. According to statistics, 82% of patients after treatment in Germany were able to return to a full life. So where is treatment for stomach cancer in this country?
• University of Cologne, Department of Oncology, Solingen. Profile certified center for the treatment of stomach cancer.
• Clinic Nordwest, Frankfurt. Leading medical institution in Germany. World-famous specialists work here.

Nord Clinic Alliance, Department of Oncology, Bremen.

Professor Hussein Bektas, a surgeon specializing in this diagnosis, is treating stomach cancer. Operations are performed laparoscopically, using the latest generation Da Vinci robot with express hystology (biopsy sampling during surgery). Let's look at reviews of therapy in Germany.

Margarita, 45 years old.

“I underwent treatment in the city of Solingen, the oncology center of Cologne. The examination and operation were carried out quickly. Chemotherapy was needed. Leaving Germany, I felt much better than before arriving in this country. I am grateful to the doctors."

Igor, 40 years old.

So where can you go for help?

• Medical Center“Rambam”, Department of Gastrointestinal Oncology, Haifa. Thanks to close cooperation with leading European and American cancer treatment centers, the clinic uses progressive and innovative techniques.
• "Assuta", Institute of Oncology, Tel Aviv. The medical center is recognized as the most equipped in Israel. Its equipment is updated every 2 years.
• "Shaare Zedek", oncology department, Jerusalem. A leading multidisciplinary treatment and diagnostic institution where gastric cancer treatment is carried out.

We invite you to find out what reviews you can find about the listed clinics.

Marina, 37 years old.

“I brought my mother to Israel for treatment with stage 3 gastric adenocarcinoma, metastases to the lymph nodes. We were received well and provided with a translator. After the operation, my mother lived for another 8 years, which is not bad for patients with this stage of cancer. The relapse occurred unexpectedly, but we were warned about its possibility. Unfortunately, we didn’t have time to influence him.”

Anna, 50 years old.

“I treated my niece for stomach cancer at the Israeli Assuta clinic. There are no words to express our family’s gratitude to the doctors. The young girl not only recovered, but has not remembered her illness for 3 years. I recommend".

Recovery after treatment

The rehabilitation period after treatment lasts from 3 months to 1 year. As a result of surgery, during which part of the stomach or the entire organ was removed, it is necessary to follow a liquid, salt-free diet high in proteins and vitamins, and monitor regular bowel movements.

It is important to adjust your daily routine so that your body muscles do not overstrain. That is, it is necessary to strictly dose physical activity during the entire recovery period after surgery. Many patients are sent to specialized sanatoriums, where they receive the necessary preventive treatment.

Metastasis

The presence of metastases in gastric cancer seriously aggravates the overall picture of the disease. Most often, atypical cells are the first to penetrate the abdominal organs, namely the liver, spleen, and intestines.

Sometimes metastases are found in the bronchi and lungs. In this case, the patient begins to experience a painful cough with the release of sputum containing streaks of blood.

• Perforation of the organ. After damage to the walls of the stomach, the neoplasm often leads to their perforation and removal of the contents into the peritoneum. Against this background, peritonitis develops - an acute emergency condition, which, in the absence of proper medical care, ends in the death of a person.
• Internal bleeding. As the pathological process develops, tumor cells gradually grow into the vessels, causing their damage. As a result, the patient faces constant blood loss.

• Anemia. A chronic decrease in hemoglobin levels is associated with blood loss and the paucity of the patient's diet - many people in the third and fourth stages refuse to eat.

Relapse

Gastric adenocarcinoma quite often provokes relapses after treatment. Re-development clinical manifestations tumors appear after some time - these symptoms are considered to be more dangerous than the primary tumor.

Relapses of gastric adenocarcinoma occur against the background of incomplete elimination of the malignant process during therapy, for this reason the oncological process develops with renewed vigor. They are usually localized in the same place where the former tumor was located.

Forecast

How long a patient with detected gastric adenocarcinoma will live depends on the stage of the pathological process and the body’s response to the therapeutic effect used.

At the onset of the disease, in particular with a moderately differentiated tumor, almost 50% of patients survive for 5 years. This means that, having overcome this period, the disease is completely defeated - relapses of adenocarcinoma are practically impossible.

In the following table we will look at how the stage of the oncological process affects the prediction of survival for stomach cancer.

As we can see from the table, the last stage of adenocarcinoma is characterized by the lowest percentage of victory over the disease.

Prevention

The risk of developing stomach cancer is much lower in people who eat healthy and rationally. Besides balanced diet, excluding harmful food additives and outright chemicals, to prevent pathology, you should give up smoking and alcohol.

You also need to remember the need to treat any diseases of the digestive tract and stomach in particular. The remaining infectious and inflammatory processes in the gastrointestinal mucosa can give impetus to the development of a malignant tumor.

Are you interested in modern treatment in Israel?

Poorly differentiated adenocarcinoma of the stomach, as oncologists call the pathology, is a fairly common disease of this organ, which is observed in 95% of cases of incipient stomach cancer.

The disease is dangerous because it can affect other nearby organs. Gastric adenocarcinoma is formed from particles of the mucous membrane of the organ. Under the pressure of several unfavorable causes, the protective layer is broken, and healthy cells are transformed into cancerous foci.

Gastric adenocarcinoma affects men more often than women. The formation of a tumor continues for a long time, can take from 1 to 20 years, and in most cases makes itself felt at the age of 45-50 years.

In almost half of the episodes, pathology is detected at the penultimate or last stage, when treatment is difficult. The reason for this is the asymptomatic continuation of the disease in the initial stages.

Surgery for a thoroughly advanced disease is unacceptable, since all tissues, nearby organs and lymph nodes located near the organ are captured by the malignant process

Factors causing the development of the disease

Doctors consider the main cause to be interruptions in the blood supply to the walls of the stomach, their nutrition, and suppression of secretion. Such perturbations in the organ are caused by carcinogens.

In addition, the following contribute to the progression of stomach cancer:

• Alcohol, its excessive use;
• Long history of smoking (tobacco tar);
• Unbalanced diet - passion for smoked meats, deli meats, fried and salty foods, pickled vegetables, which contain a lot of nitrates. Once in the stomach, they react with hydrochloric acid, resulting in complexes that damage the mucous surface and provoke the transformation of healthy glandular cells into tumor cells;
• Strict long-term diets with small doses of microelements, vitamins, and minimal dietary fiber.
• A bacterium that provokes inflammation of the gastric mucosa and reduces its resistance is Helicobacter pylori.

To this we can also add: extra kilograms of body weight, low stomach acidity, background radiation and unfavorable ecology of the place of residence, hereditary factor.

Classification of glandular cancer

The disease is classified depending on the level of demarcation of tumor cells:

• The most dangerous type of disease is poorly differentiated adenocarcinoma of the stomach. It has a significant level of malignancy. The prediction of this type of cancer is usually unsatisfactory: the tumor rapidly metastasizes to neighboring organs and lymph nodes;
• Well-differentiated adenocarcinoma of the stomach - in the light of predictions, this is the most promising, favorable type of disease. The formation cells are almost no different from the structural cells of healthy tissue. The degree of malignancy is quite low;
• Moderately differentiated gastric adenocarcinoma is an average type of tumor. This species has no characteristic signs. Changes in tissue structure are moderate.

There is another population of malignant tumors - tubular adenocarcinoma. It appears as branched tubular structures embedded in fibrous stroma.

This type of glandular cancer requires the most serious consideration and immediate consultation with a doctor.

Symptoms of the disease

Importance in the prevention of malignant tumors of the stomach is given to timely diagnosis and treatment of chronic gastric diseases.

Gastric adenocarcinoma is an insidious disease, it develops slowly, and its initial symptoms are very difficult to feel. At first, patients may complain of lack of appetite, heaviness, nausea, constipation, weight loss, without paying serious attention to this. Such manifestations may be characteristic features many pathologies.

At subsequent stages of the disease, symptoms become more pronounced. Glandular cancer, also called adenocarcinoma, in almost 90% of cases causes metastasis to nearby and distant organs.

It happens that the diagnosis is made only at stage 4 of the disease, when no treatment methods can stop the development of the malignant process.

The most characteristic and frequent signs of the development of pathology in the early stages are:

• Reorientation of gastronomic preferences - aversion to protein-rich foods (meat);
• Salivation is higher than usual;
• Vomiting - episodic, constant, when eating or for no reason. If vomit is mixed with blood, this is a serious sign of a malignant process occurring in the stomach.
• Pain in the epigastric region - part of the abdomen in the upper and middle hypochondrium.

Glandular tumors, even with their intense enlargement, cannot always be detected. Doctors call such tumors “silent” and consider them the most dangerous.

How is gastric adenocarcinoma diagnosed?

A gastroenterologist, a therapist and an oncologist are involved in identifying the disease. The latter is involved in treatment, but to make a quality diagnosis, you need to perform a set of measures:

• X-ray with a contrast agent – ​​barium sulfate;
• Ultrasound examination of the stomach and entire abdominal cavity;
• Determination of the presence of metastases in the abdominal cavity, liver, using diagnostic laparoscopy.
• Observation of the condition of the mucous membrane - gastroscopy;
• Blood test for tumor markers.

Treatment

If it is possible to correctly diagnose the disease in the initial stages, the patient is offered surgery to remove the tumor along with nearby altered tissues. In this case, more than 50% of the stomach and nearby lymph nodes are removed.

Surgical intervention in the final stages is not advisable. In this case, all vital organs affected by cancer will have to be removed along with the stomach.

In the final stages, the patient is prescribed supportive treatment:

• Radiation therapy;
• Painkillers;
• Chemotherapy sessions are prescribed simultaneously with radiation therapy.

Efficacy of chemotherapy

The type of chemical drug is selected depending on the severity of the disease, on an individual basis for each patient. Treatment programs have been developed that include the use of several chemicals.

In most cases, this type of treatment is very difficult to tolerate - patients experience weakness, nausea, and hair loss. The main goal of chemotherapy is to reduce the possibility of relapse of the disease and prolong the patient’s life. The method is effective with the simultaneous use of radiation therapy and the possibility of surgery.

Conclusion

The life expectancy of a person diagnosed with gastric adenocarcinoma also depends on the patient’s body’s response to the prescribed course of treatment.

anonymous, Female, 54 years old

Hello, Elena Sergeevna! My mother (54 years old) 2 years ago was diagnosed with adenocarcinoma of the stomach with metastases to the peritoneum and ovaries (based on the results of a trial laparotomy). Chemotherapy was prescribed every 3 weeks, CT scan every 2 months. In June 2014, removal of the uterus and appendages due to their growth during chemotherapy with epirubicin + oxaliplatin + xeloda. After the operation, a new regimen of taxotere + cisplatin + xeloda. Mom did not tolerate this regimen well (low levels, but biochemistry was normal) because of the low levels, chemotherapy was delayed for several days. According to the CT results, there are no changes in the lymph nodes, organs of the chest, abdominal cavities and pelvis. Against the background of stress (death of my grandmother), physical exhaustion (funeral), low blood levels and poor diet, symptoms of acute cholecystitis appeared: pain in the right hypochondrium, radiating to the collarbone, heaviness in the abdomen, nausea, gas in the small intestine, there was vomiting of bile for one day. According to ultrasound and examination by a gastroenterologist - acute non-calculous cholecystitis. Although, according to surgeons, after only a clinical examination, the tumor has spread in the abdominal cavity... He is currently undergoing treatment for cholecystitis, taking Xeloda. The condition has improved. I have a question: your guess - could this be ordinary cholecystitis? How gastric adenocarcinoma progresses, what problems can be encountered during the progression of gastric adenocarcinoma. And what would you recommend in this case? Thank you! Health to you and your family and friends! Best regards, Alsou.

Good day. Sorry for the late reply, I was on a business trip.