Etiology of the lesion
The cause of most stomach cancer is believed to be through the infection of Helicobacter pylori (Kumar, Suzan and Robbins 134). However, other conditions increase the risk levels including aspects such as genetic factors, intestinal metaplasia and autoimmune atrophic gastritis. Some of the most common risk factors include;
Poor diet: Excessive cholesterol and fats in the diet increase the chance of stomach cancer. Salted meat and fish, smoked foods and pickled vegetables appear to raise the risk to adenocarcinoma of the stomach (Wang and Giraud 123). Cured meats contain nitrites and nitrates, which can be converted by bacteria, H. pylori, into compounds, which cause stomach cancer (Wang and Giraud 123).
However, the consumption of fresh fruits and vegetables that contains antioxidant vitamins such as A and C do considerably lower the risk of stomach cancer (Kumar, Suzan and Robbins 198). Taking a balanced diet is recommended to curb the disease. There has been a correlation between iodine deficiency and cancer (Wang and Giraud 123). There was a case of reduced mortality rates after the implementation of I-prophylaxis (Wang and Giraud 83).
Smoking and alcohol consumption: A great percentage of patient suffering from stomach cancer is smokers (Wang and Giraud 78). Heavy smoking increases the chances of this disease to about eight-two percent. Additionally, drinking and smoking elevate the situation to more severe levels.
Genetic factors: Stomach cancer shows male dominance with one female affected for every three males (Baynes and Dominiczak 78). Some hormones are effective especially estrogen in women that help in minimizing chances of developing cancerous cells. Alternatively, some percentage of this cancer has been identified to be hereditary (Baynes and Dominiczak 78).
Macroscopic and microscopic findings
The microscopic and macroscopic findings of stomach cancer revealed the following cases. Macroscopically, the cyst around the duodeni had cognate mucosa without communication with gastric (Baynes and Dominiczak 94). The existence of muscular wall was histologically confirmed within the gastric duplication cyst and stomach. There are more than “4 microscopic foci of intramucosal signet ring of adenocarcinoma cell in six macroscopically normal stomachs, often foci size 0.1-10mm diameter” (Baynes and Dominiczak 94).
Symptoms and signs and laboratory findings caused by the lesion
In the early stages of stomach cancer, only nonspecific symptoms are observable (Baynes and Dominiczak 114). Once the symptoms are manifested, the cancer is fully-fledged and this is a reason for poor prognosis. Stomach cancer poses the following signs:
- Stage 1: This stage has mild and generally nonspecific symptoms (Kumar, Suzan and Robbins 124). Some signs at this stage include heartburn with indigestion and burning sensation in the gastric, irritation and abdominal disturbances and lack of appetite, mostly for meat (Baynes and Dominiczak 99).
- Stage 2: Symptoms that clearly manifest at this stage are bloats in the stomach often after meals and fatigue with weak body.
- Stage 3: This stage represents the maturity of the cancer and it shows clear signs and symptoms that can be associated with the cancer. Having abdominal pains mostly in the upper abdomen with constipation and diarrhea will be felt. Considerable weight loss, blood in stool or vomiting blood that appears blackish occurs and may lead to anemia (Kumar, Suzan and Robbins 208). Dysphagia, tumor in the cardia or elongation of gastric tumor, is common (Kumar, Suzan and Robbins 208). Occasional vomiting and nausea is also featured at this stage. These symptoms however, can be as a result of other problems such as ulcers, stomach virus or tropical sprue (Kumar, Suzan and Robbins).
Treatment and prognosis
Prognosis is relevant because its application increases chances of a patiehelps in the recovery process (Wang and Giraud 78). Stomach cancer prognosis is based on research collected over many years and statistics from groups who present similar situation to that of the patient are utilized. The process of prognosis only gives prediction; therefore, doctors are not certain on the outcome or reaction of specific patient (Kumar, Suzan and Robbins 213).
The treatment for adenocarcinoma for stomach includes chemotherapy, radiation therapy surgery and biological therapy, which form the new treatment approach.
Surgery is the most common treatment approach. A surgeon removes all or part of stomach with the aim of removing the cancerous cell with some part of normal tissues (Wang and Giraud 231). Depending on the extent and location of the tumor cell, parts of the pancreas or intestines can be removed. With the tumors located in the lower part of the stomach Billroth I or Billroth II procedure can be invoked (Wang and Giraud 123).
The EMR (Endoscopic mucosal resection) is the pioneered treatment for early stomach cancer that is currently used. The procedure involves the removal of the tumor, together with the mucosa (the inner lining of the stomach) using electrical wire loop through the endoscope (Wang and Giraud 215). It is more relevant and beneficial since it does not advocate for removal of the stomach, but removes a portion of it. The ESD (Endoscopic submucosal dissection) is used to resect large mucosal area in one piece (Baynes and Dominiczak 112).
Use of Chemotherapy in treatment does not utilize specific established care principles. Gastric cancer pose less sensitivity to the chemicals and the use only reduces the size of the tumor, prolongs survival, and acts as pain reliever. Some of the drugs used are 5-FU fluorouracil, carmustine BCNU and doxorubicin (Adriamycin) (Baynes and Dominiczak 152). In addition, Mitomycin C, cisplatin and taxotere can be used. Because chemotherapy kills cancer cells along with other cells, the side effects are many including hair loss, illness blood disorders and drop in blood count (Baynes and Dominiczak 115). Therefore, patients are programmed to on and off therapy to minimize the side effects.
Radiotherapy is the use of high-energy rays such as X-rays, to kill cancerous cells and stop them from growing (Baynes and Dominiczak 52). It is mostly used with combination of other procedures such as surgery or chemotherapy to cure this cancer. this forms of treatment is useful in reducing pain since it by shrinks tumor cells (Wang and Giraud 123). Rays from radiation are released at an angle to provide best strike on the tumor cells (Baynes and Dominiczak 88).
Lastly, combination of treatment methods such as chemotherapy, surgery and radiotherapy provides a survival benefits to patients with non-metastatic, completely resected stomach cancer (Wang and Giraud 123).
Relevance to dental practice
The relevance of this research to dental practice is of great significance. The knowledge acquired from the study provides adequate tools, which can be applied in the field of dentistry. Measures taken to prevent stomach cancer are correlated to those of curbing oral cancer. Avoidance of smoking and drinking significantly contributes to good dental health.
Statistics shows that stomach cancer is the fourth most common cancer in the world and it has high death rates being second to lung cancer with men being highly affected (Wang and Giraud 45). This type of cancer is relatively high in under developed and developing countries because of poor hygiene and diet issues. The study of this type of cancer helps in dental management as well. The cancer management will adversely improve the oral health. This type of cancer has challenges in its prognosis since it portrays asymptomatic features, which cannot be easily recognized and often mistaken for other problems such as stomach ulcers.
Works Cited
Baynes, John, and Marlek Dominiczak. Medical biochemistry. (3rd edn.). Philadelphia: Elsevier, 2009. Print.
Kumar, Vinny, Suzan Cotran Robbins Leornards. Basic Pathology. (8th edn.). Philadelphia, PA: Saunders, 2007. Print.
Wang, Timothy and Adrew Giraud. The Biology of Gastric Cancers. Tsinghua University Press: Springer-Verlag, 2009. Print.