After a partial gastrectomy, there are fewer areas where gastric cancer can occur, so is it true that you won’t get it again, or that the likelihood of it is low? Is this really the case?
After gastrectomy, residual gastric cancer can still occur
Some patients who have undergone a major gastrectomy for complications related to a gastric ulcer or other benign disease still have the potential for cancer to occur in the residual gastric tissue after surgery. In medicine, this primary cancer that develops in the remnant stomach more than 5 years after a major gastrectomy for benign disease is called remnant gastric cancer.
The literature reports that the incidence of residual gastric cancer is about 1% to 5%, and the time interval between gastrectomy and cancer in the residual stomach varies, some even up to 40 years or more, but the interval between most residual gastric cancers and major gastrectomy is about 10 to 20 years.
Why does residual gastric cancer occur?
The current study suggests that the development of remnant gastric cancer may be related to the disruption of the barrier role of the remnant gastric mucosa after gastrectomy. The destruction of the protective effect of the normal gastric mucosa as a result of major gastric resection, together with the long-term irritation of the mucosa at the surgical anastomosis by reflux of duodenal fluid and bile, and the possible presence of H. pylori infection, can induce carcinogenesis over time.
How to prevent and treat residual gastric cancer?
The presentation of residual gastric cancer is not typical. The main symptoms include a feeling of fullness after eating, discomfort or pain in the upper abdomen, nausea, vomiting, vomiting blood, black stools, anemia, and weight loss. When these symptoms occur, they are often mistaken by patients as gastrointestinal dysfunction or ulcer recurrence after gastrectomy surgery, resulting in neglect of the condition.
Therefore, after gastrectomy, patients should still not take abnormal symptoms lightly. The patient with a residual stomach after gastrectomy, especially if it is more than 10 years after gastrectomy, or if he or she develops peptic symptoms or ulcer-like symptoms, should undergo regular gastroscopy. Patients with H. pylori infection after gastrectomy may consult their physicians for options to further eradicate H. pylori to prevent the development of residual gastric cancer.
Once abnormal changes are detected under gastroscopy to suspect the possibility of remnant gastric cancer, physicians will often perform multi-point, multi-site sampling of the remnant stomach to clarify the diagnosis. Once the diagnosis of remnant gastric cancer is confirmed, doctors will formulate the best treatment plan taking into account the patient’s own condition. The principle of treatment is mainly surgical resection, supplemented by other forms of comprehensive treatment.
In conclusion, post-gastrectomy patients still have the potential to develop gastric cancer, and should not let down their guard against gastric cancer because of gastrectomy. Early diagnosis and treatment are very important to improve the outcome of patients with residual gastric cancer.