Gastric cancer: it is one of the common malignant tumors in China, and its early stage is insidious, and about 70% of patients are diagnosed at middle and late stages. Due to the lack of effective treatment means, the overall treatment effect of middle and late stage gastric cancer is not ideal, and the 5-year survival rate of patients is only about 30%. Specific suggestions on how to prevent the attack of gastric cancer are as follows.
How should we detect gastric cancer at an early stage and are there any clues that can help us to determine it?
80% of gastric cancer patients do not have early symptoms, but based on clinical experience, we have summarized some early signs of gastric cancer, which we hope can alert you. men over 40 years old (those who are addicted to smoking and alcohol should be relaxed to 35 years old); those with family history, history of chronic gastric disease, combined with Helicobacter pylori infection and slight upper abdominal discomfort should be screened; those who have had gastric resection surgery many years ago, recovered well after surgery, and recently experienced Those who have had a gastrectomy many years ago, have recovered well from surgery, and have recently experienced indigestion, epigastric pain, vomiting, black stools, and decreased health status should also go to the hospital for gastroscopy before it is too late.
The use of gastroscopy has allowed more gastric cancers to be detected at an early stage, greatly reducing the mortality rate. If gastric cancer is limited to the mucosal layer of the stomach wall, the 5-year survival rate can reach 95%. Therefore, early detection and treatment are the most critical means to reduce the mortality rate of gastric cancer.
What is the incidence rate of gastric cancer in China and what adverse symptoms will gastric cancer patients have?
In the second national cause of death survey organized by the Ministry of Health from 1990 to 1992, the mortality rate of gastric cancer in China accounted for 23.2% of all deaths due to cancer. According to the statistics of Beijing Cancer Institute Tumor Control Office, the incidence rate of gastric cancer in Beijing is 18.995/100,000, and it has remained high.
The incidence of gastric cancer is relatively insidious, and nearly half of the early gastric cancer patients have no clinical symptoms, only some of them have mild indigestion and other symptoms, such as hidden pain and discomfort in the upper abdomen, slight fullness, pain and nausea. Only gastroscopy is the best screening method.
How do doctors usually diagnose gastric cancer?
The real diagnosis of gastric cancer has to be made through pathological puncture or endoscopic biopsy or puncture, ultrasound-guided biopsy, etc. Histological confirmation is the most important diagnosis method.
Pathological diagnosis is the basis of gastric cancer diagnosis. Pathological analysis should consider the typing of tumor and lymph nodes. Nowadays, all patients will routinely check the status of HER2 (abbreviation of human epidermal growth factor receptor-2) to see whether it is positive or negative. If it is positive, it means that the patient has excessive HER2 protein appearing on the surface of cancer cells, the cancer cells grow faster and become more aggressive, and the condition of such patients is relatively more likely to deteriorate.
What are the specificities of the high incidence and age of gastric cancer?
The incidence rate of stomach cancer in men is 1.5-2.5 times higher than that of women, second only to lung cancer and prostate cancer, and its mortality rate is second only to lung cancer, and it also increases significantly with age, with the peak incidence rate concentrated in the age of 40-80. Among them, middle-aged men are the main incidence group of gastric cancer. The reasons for this may be mainly related to heavy hunger, excessive smoking and drinking, irregular life, genetic characteristics and other unknown factors. Meanwhile, some data show that most middle-aged men suffer from gastric diseases to varying degrees, especially gastric ulcers, like gastric polyps, gastric ulcers and chronic atrophic gastritis, all of which have the possibility of evolving into gastric cancer. Moreover, scientists have also found that estrogen may have a protective effect on the stomach, so the incidence is relatively low in women.
How much is the association between genetic and lifestyle habits and stomach cancer?
Among the risk factors for stomach cancer, genetics is an important point. If someone in this family has had tumors in 2-3 generations, especially digestive system tumors, including stomach cancer, esophageal cancer, biliary system tumors, intestinal tumors, etc., then you may have a much higher chance of developing stomach cancer in the future than normal people. If more than two people in this family have had stomach cancer, then the chance of other clansmen getting the disease will be more than tens of times higher.
People with chronic digestive diseases, such as ulcers and chronic atrophic gastritis combined with atypical hyperplasia or intestinal epithelial hyperplasia, are also much more likely to develop stomach cancer than normal people. If this is combined with H. pylori infection, the risk is even higher. Smokers and drinkers should also be alert, not that drinkers are only at high risk for liver cancer or smokers are at high risk for lung cancer, but smoking and drinking are closely related to the occurrence of many tumors, including stomach cancer.
In addition, there are dietary habits such as high salt diet, pickled food, especially unpickled food, which has high nitrite content and is a clear carcinogenic substance. There are also some bad dietary habits, such as the long-term preference for hot and stomach irritating food, eating moldy food, contaminated food, including water pollution, industrial pollution, pesticide pollution, etc., which can cause chronic damage to the digestive system, and the process of repeated repair may also mutate and produce tumors.
Japan is a country with high incidence of stomach cancer. Its vegetables are more expensive than meat, many of them are fried or preserved, and the high salt diet combined with H. pylori infection all contribute to the high incidence of stomach cancer. However, after the second generation of Japanese immigrated to western countries, researchers found that the incidence of gastric cancer decreased, so there is still a relationship between the occurrence of gastric cancer and dietary habits.
What are the main methods of stomach cancer treatment at present?
The treatment methods for gastric cancer include surgery, drug therapy, radiation therapy and other treatments. Surgery is a radical treatment, which is only applicable to early and middle stage patients. However, in China, most of the patients belong to the middle stage, and nearly 60% of them will recur after surgery, and this group of patients also needs follow-up drug treatment.
There is a wide range of drug therapy, and now there are targeted drug therapy and so on. Targeted drug therapy is mainly selective and has a clear target site, targeting a key point in the cell membrane receptor or ligand or downstream signaling pathway, and is targeted to different groups of people, because the biological characteristics of different gastric cancer patients may be different, for example, for HER2-positive gastric cancer patients, trastuzumab combined with chemotherapy is often used.
It is worth reminding that there are some adjuvant treatments before and after surgery, which are used to prevent postoperative recurrence and metastasis or to improve the surgical resection rate, but it cannot be said that there is no need for surgical treatment because of drug treatment. In addition, for some patients who have lost the chance of surgical treatment, or who have recurrence and metastasis after surgery, the purpose of chemotherapy is to improve the quality of life, reduce pain and prolong survival.