Stomach cancer
Cancer of the stomach Early diagnosis provides the most favorable prognosis. Clinical symptoms of the disease are nonspecific: nausea, vomiting, belching, dysphagia, general weakness, weight loss, anemia, etc. It is important to pay attention to the appearance of these symptoms in previously healthy people and change their character in chronic gastritis or peptic ulcer. The crucial importance in establishing the diagnosis is gastroscopy (with biopsy) and radiographic examination of the stomach.
The stomach cancer is localized in the upper third (cardinal part and bottom of the stomach), middle third (body of the stomach) or lower third (pyloric section of the stomach). Metastases of stomach cancer often affect the regional lymph nodes, liver. Perhaps metastasis on the peritoneum (with the development of ascites), in the ovaries (Croukenberg's metastases), fatty tissue of the small pelvis (Schnitzler's metastases), rarely into the lungs, skin, bones, etc.
There are 4 stages of the disease: 1 stage-tumor diameter of not more than 2 cm, germination only of the mucosa without visible metastases in the lymph nodes; II stage - tumor diameter 4-5 cm, germination of submucosal and muscular layers, there may be regional metastases; III stage - large tumor size, germination of the serosa, adjacent organs; There are distant metastases. After surgery, the tumor is usually classified according to the TNM system.
Treatment. The main method of treatment is surgical, which can be used for localized forms of the disease. Apply proximal gastrectomy, gastroectomy, subtotal resection, under certain circumstances - resection of 2/3 of the stomach, combined resection. Reduction of clinical symptoms is achieved with palliative operations (gastroenteroanastomosis, esophago gastroanastomosis, gastrostomy, recanalization with the help of a laser).
Clinical improvement with inoperable tumor and metastases in 20-40% of patients can be achieved as a result of the use of chemotherapy. Assign 5-fluorouracil (5-FU) alone or as part of medicinal combinations (5-FU, adriamycin, mitomycin C, 5-FU, cisplatin, adriamycin). The appointment of postoperative chemotherapy is impractical. Radiation therapy is rarely used; As a rule, it is ineffective.
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