Like most cancers, gastric cancer is caused by a combination of genetic, environmental, and lifestyle factors. Some of the key risk factors include:

1. Helicobacter pylori infection
   • A chronic infection of the stomach lining that increases inflammation and ulcer risk, eventually leading to precancerous changes.

2. Dietary habits
   • High intake of smoked, salted, and pickled foods.

   • Low consumption of fresh fruits, vegetables, and fiber.

3. Smoking and alcohol
   • Tobacco doubles the risk of stomach cancer, while heavy alcohol consumption accelerates mucosal damage.

4. Genetic predisposition
   • Family history of gastric cancer.

   • Inherited conditions such as Lynch syndrome or hereditary diffuse gastric cancer (HDGC).

5. Pre-existing medical conditions
   • Chronic gastritis, gastric polyps, pernicious anemia, or previous stomach surgery.

6. Age and gender
   • More common in people over 50, with a higher incidence in men.

One of the challenges with gastric cancer is that early-stage symptoms are subtle and often mistaken for indigestion. By the time symptoms become severe, the cancer may already be advanced.

Early Symptoms:

• Persistent indigestion or heartburn

• Bloating after meals

• Mild nausea

• Loss of appetite

Advanced Symptoms:

• Unexplained weight loss

• Vomiting (sometimes with blood)

• Difficulty swallowing

• Stomach pain or discomfort, especially after eating

• Fatigue due to anemia

• Black or tarry stools (a sign of internal bleeding)

When to seek help: If indigestion or bloating lasts more than two weeks, or if you notice alarming signs such as weight loss, vomiting blood, or difficulty swallowing, consult a gastroenterologist immediately.

Accurate diagnosis requires a combination of endoscopic evaluation, imaging, and biopsy. Common diagnostic methods include:

1. Upper GI Endoscopy (Gastroscopy)
   • A flexible tube with a camera is inserted into the stomach to detect abnormal growths. Biopsy samples are taken for laboratory testing.

2. Biopsy and Histopathology
   • Determines whether the tissue is cancerous and identifies the cancer type.

3. Imaging Tests
   • CT scan / MRI – Detects spread to nearby organs.

   • Endoscopic ultrasound (EUS) – Measures tumor depth and lymph node involvement.

   • PET scan – Helps evaluate metastasis.

4. Blood Tests
   • Checks for anemia, liver function, and tumor markers like CEA and CA 19-9.

Staging helps doctors plan treatment by describing how far the cancer has spread:

• Stage I: Tumor limited to the inner lining of the stomach.

• Stage II: Spread to nearby muscle or lymph nodes.

• Stage III: Invasion into deeper stomach walls and more lymph nodes.

• Stage IV: Cancer has metastasized to distant organs (liver, lungs, or peritoneum).

The stage directly impacts survival rates and determines whether surgery is possible.

Treatment depends on the stage, overall health, and patient preferences. A multidisciplinary team usually includes oncologists, surgeons, gastroenterologists, and nutritionists.

1. Surgery

• Gastrectomy (partial or total): Removal of part or all of the stomach, often combined with lymph node dissection.

• Minimally invasive surgery (laparoscopic/robotic): Reduces recovery time and improves outcomes in selected cases.

2. Chemotherapy

• Used before surgery (neoadjuvant) to shrink tumors or after surgery (adjuvant) to destroy remaining cancer cells.

• Common drugs: fluorouracil (5-FU), cisplatin, oxaliplatin, capecitabine.

3. Radiation Therapy

• Targets cancer cells with high-energy beams, often combined with chemotherapy (chemoradiation).

4. Targeted Therapy

• Drugs like trastuzumab (for HER2-positive gastric cancer) or ramucirumab (anti-angiogenesis therapy) attack specific cancer pathways.

5. Immunotherapy

• Drugs such as pembrolizumab help the immune system recognize and attack cancer cells.

6. Palliative Care

• For advanced cases, the focus shifts to symptom management, pain relief, and quality of life.

The outlook for gastric cancer depends largely on the stage at diagnosis:

• Early-stage detection: 5-year survival rates can exceed 60–70%.

• Advanced-stage detection: Survival rates drop significantly, often below 20%.

Regular screening in high-risk individuals can improve survival by enabling earlier treatment.

While not all cases can be prevented, certain lifestyle and dietary changes reduce the risk:

• Treat H. pylori infections early with antibiotics.

• Adopt a balanced diet rich in fresh fruits, vegetables, and whole grains.

• Reduce intake of smoked, salted, and processed foods.

• Quit smoking and limit alcohol consumption.

• Maintain a healthy weight and stay physically active.

• Regular health check-ups if you have a family history or chronic gastric conditions.
  

Beyond medical treatment, patients face emotional, nutritional, and social challenges. Key aspects include:

• Nutritional support: After surgery, small frequent meals and supplements may be necessary.

• Psychological support: Counseling and support groups help patients cope with anxiety and depression.

• Rehabilitation: Physical therapy aids recovery and reduces fatigue.

• Family involvement: Strong support networks improve outcomes and quality of life.

Gastric cancer remains a serious global health challenge, but awareness, early detection, and modern therapies have dramatically improved patient outcomes. Recognizing symptoms early, undergoing timely diagnosis, and seeking expert care are crucial in fighting this disease. If you or a loved one experience persistent digestive discomfort, unexplained weight loss, or other warning signs, do not ignore them early intervention saves lives.