Gastric Cancer

Stephanie Monks
BMSC 3211 – Clinical Anatomy
Topics
 The Stomach

• Expanded part of
gastrointestinal
tract.
• Functions
– Storage and mixing
– Secretion

(www.uwgi.org)
 Stomach Cancer

• Tumour
– Abnormal swelling
• 2nd most common fatal malignancy
• Higher prevalence in Japan, China,
Columbia and Finland.
 Histopathology

Adenocarcinoma

Adenocarcinoma Signet ring cells

(edcenter.med.cornell.edu) (depalm.med.uth.tmc.edu)
 Risk Factors

• H pylori infection and Chronic gastritis

• Lifestyle (Diet or smoking)
• Older age
• Male
• FAP or gastric polyps
• Family history
• Pernicious anaemia
H. Pylori (www.nature.com)
 Signs and Symptoms

• Pain in epigastrium and palpable mass

• Nausea and vomiting
• Anorexia and weight loss
• Dysphagia
• Anaemia
• Signs and symptoms of metastases
 Investigations

• Blood sample (FBC), faecal occult blood

test
• Endoscopy and biopsy
• Barium Swallow
• CT
• Ultrasound scan
• Laparoscopy
 Endoscopy

Signet ring (www.endoatlas.com) Ulcerated AC (www.endoatlas.com)

Barium Swallow

Irregular luminal narrowing

(instruct.tri-c.edu)
 CT

CT of abdomen with
carcinoma of the cardia
(Wegener, 1993)
 Investigations

• Blood sample (FBC), faecal occult blood

test
• Endoscopy and biopsy
• Barium Swallow
• CT
• Ultrasound scan
• Laparoscopy
 Staging
• T (tumour)
• N (nodal involvement)
• M (metastases)

CT showing
metastases and
ascites
(www.murrasaca.com)
 Treatment

• Surgery – gastrectomy, stent

• Chemotherapy
• Radiotherapy
• Chemoradiation
• Biologic therapy
 Conclusion – Gastric Cancer

• 2nd most common fatal malignancy

• Various risk factors (H. Pylori, diet, male)
• Vague symptoms
• Often present with later stage disease
• Endoscopy, CT
• Surgery, chemo, palliative care

THE END
 References

• Kumar, P. & Clarke, M. (1999). Clinical Medicine, 4th

ed., WB Saunders
• Underwood, J.C.E. (2001). General and Systemic
Pathology, 3rd ed., Churchill Livingstone
• Burkitt, H.G. & Quick, C.R.G. (2002). Essential
surgery, 3rd ed., Churchill Livingstone
• Sadler, T.W. (2000). Langman’s Medical Embryology,
8th ed., Lippincott, Williams & Wilkins
• Wegener, O.H. (1993). Whole body computed
tomography, 2nd ed., Blackwell Scientific Publications