Moderately differentiated tubular adenocarcinoma of the stomach. Hidden threat: adenocarcinoma of the stomach. Treatment in Russia

Adenocarcinoma of the stomach is called a malignant tumor that grows from the cells of the glandular epithelium. This type of cancer is very common and ranks fourth among all cancers.

In this article, we will introduce you to the main predisposing factors, varieties, manifestations and methods for diagnosing and treating gastric adenocarcinoma. This information will help you decide on the need for regular examinations and timely visits to the doctor when the first possible signs of this dangerous disease appear.

As a rule, the tumor begins to grow in the pyloric or antrum of the stomach and does not manifest itself at the initial stage of growth. Its formation can take a very long time and sometimes this period lasts about 15-20 years. The course of this cancer significantly aggravates the early appearance of metastases. They develop in 82% of cases.

As a rule, gastric adenocarcinoma is detected in people older than 45-50 years and more often the tumor is detected already at stage III-IV. Men are more susceptible to this disease.

Causes

Nicotine and alcohol are powerful carcinogens that can trigger the development of gastric adenocarcinoma.

The underlying cause of the development of a cancerous tumor from the cells of the glandular epithelium of the stomach is the inhibition of secretion and a pronounced violation in the flow of blood and nutrients to the walls of the organ. Such changes are usually provoked by exposure to various carcinogens and factors:

• tobacco tar;
• alcohol;
• eating foods with a high level of nitrites: fatty, salty and smoked foods;
• long diets;
• the presence of the bacterium Helicobacter pylori in the stomach;
• work in hazardous industries;
• living in ecologically unfavorable or radioactive zones;
• genetic predisposition.

Most experts note that the following conditions become common background diseases of gastric adenocarcinoma:

• chronic hyperplastic or;
• (with B12 deficiency);
• a history of gastric surgery.

Classification

According to the Bormann classification, there are five main types and four subspecies of gastric adenocarcinoma.

Types of adenocarcinoma of the stomach:

• polypous - a limited type of neoplasm;
• ulcerative - a neoplasm with extended boundaries;
• pseudo-ulcerative - a neoplasm resembling a stomach ulcer;
• diffuse - a neoplasm that does not have clear boundaries;
• a group of neoplasms of an unclassified genus.

Subtypes of gastric adenocarcinoma:

• papillary - the neoplasm has a finger-shaped shape, grows from the papillae of the epithelium inside the stomach;
• tubular - the neoplasm consists of cystic-dilated or branched structures;
• mucous - the neoplasm constantly produces mucus (it is always noticeable when performing gastroscopy);
• cricoid cell - the neoplasm spreads into the inner layers of the stomach.

According to the type of cellular structure, gastric adenocarcinoma can be:

1. Low differentiated. It belongs to the most malignant and aggressive. Cells do not perform their functions, because their structure is completely disrupted. The tumor forms very quickly, spreads into the thickness of other walls of the organ. It quickly forms secondary foci and has a poor prognosis.
2. Highly differentiated. The structure of tumor cells differs little from the structure of normal cells. They partially fulfill their functions. The cell nucleus becomes elongated. The neoplasm grows slowly and may be asymptomatic for many years. In most cases, the prognosis of the outcome of the disease is favorable, but the likelihood of no recurrence is higher when the cancer process is detected in the early stages.
3. moderately differentiated. It occupies an intermediate position between a highly and poorly differentiated tumor. Compared with a highly differentiated neoplasm, it has a greater number of atypical cells. When detected in the initial stages, it has a favorable prognosis.
4. Undifferentiated. Unlike other varieties, there are almost no glandular structures in such a neoplasm.
5. Undifferentiated. The neoplasm does not form from glandular structures, has no signs of any differentiation, and has an unfavorable prognosis.

Symptoms

One of the first symptoms of gastric adenocarcinoma may be a lack of appetite.

In most cases, adenocarcinoma develops slowly, which is why the tumor is usually detected in stages III-IV, and in the initial stages it is discovered by chance during examination for another disease or during preventive examinations.

In the first stages, adenocarcinoma may not manifest itself in any way or be accompanied by short-term dyspeptic disorders, which are perceived by the patient as ordinary overeating or eating poor-quality food. They can be expressed by belching, nausea, lack of appetite, minor pain in the stomach, or occasional bloating. The patient often has an aversion and intolerance to protein foods - fish and meat dishes.

In later stages, the following symptoms appear:

• pain - their occurrence is not associated with food intake, pain may radiate to the sternum, shoulder blade or back;
• stool disorders - the neoplasm causes destabilization of the digestion of food and leads to or;
• complete lack of appetite - appears in the later stages;
• - caused by a violation of appetite and digestion of food;
• tarry stool - appears with gastric bleeding caused by the decay of the tumor and its spread to the walls of the stomach and adjacent organs;
• vomiting of food or blood - caused by digestive disorders or tumor decay;
• general intoxication - lethargy, weakness and decreased ability to work.

Loss of appetite, indigestion, and occasional stomach bleeding cause anemia. As a result, the patient becomes pale, and the skin has a slightly yellowish tint. A decrease in hemoglobin levels leads to a deterioration in the appearance of hair, skin and nails.

With adenocarcinoma of the stomach, the patient may periodically experience hypersalivation and an increase in temperature to or above 37.5 ° C. The functioning of the nervous system is disturbed, expressed in excessive irritability, apathy and the development of depression.

In some cases, the appearance and development of adenocarcinoma is not accompanied by pain and signs of indigestion. Such a course of the disease is the most dangerous, since such cancerous tumors are detected at the last stage and their surgical removal is already ineffective.

Stages of adenocarcinoma of the stomach

I stage

The tumor process affects only the gastric mucosa. The size of the neoplasm is minimal, and it does not penetrate into other organs. Symptoms of intoxication and specific signs are still absent. The patient may experience only a deterioration in appetite.

II stage

The tumor process spreads to the muscle layer and to the nearest lymph nodes. The patient has mild signs of indigestion, periodically there are mild pains, appetite worsens and the first manifestations of general intoxication are observed.

III stage

The tumor process spreads to all layers of the stomach and begins to penetrate into other organs (pancreas, esophagus, liver) and peritoneal tissues. Metastases are detected not only in nearby lymph nodes, but also in distant ones.

IV stage

The tumor process is characterized by multiple metastases.

Metastasis

The early onset of metastases in gastric adenocarcinoma significantly aggravates the prognosis of the outcome of this cancer. Usually secondary foci are formed in the organs of the abdominal cavity: the liver, pancreas or spleen. Sometimes metastases affect the soft tissues of the umbilical region or the lungs. With the defeat of the latter, the patient has painful coughing attacks, in which streaks of blood appear in the sputum.

Complications

Adenocarcinoma of the stomach can be complicated by the following conditions:

• perforation of the stomach - the tumor grows through all layers of the organ and can cause their melting and perforation, in which the contents are poured into the abdominal cavity and provoke the development of peritonitis;
• stomach bleeding - cancer cells cause damage to the walls of blood vessels and the development of bleeding;
• anemia - indigestion and frequent bleeding lead to a decrease in the level of hemoglobin in the blood;
• pyloric stenosis - the growth of tumor tissue can cause a narrowing of the pyloric lumen and lead to difficulty in passing food from the stomach to the intestines;
• ascites - tumor tissue compresses the venous vessels and causes the accumulation of fluid in the abdominal cavity.

Diagnostics

To confirm the diagnosis of gastric adenocarcinoma, the following types of studies should be carried out:

• esophagogastroduodenoscopy - this endoscopic research method allows you to identify suspicious foci of the gastric mucosa and perform a biopsy of the tissues necessary for histological analysis;
• radiography with contrast - allows you to establish the area of ​​​​localization of the neoplasm and identify violations in the peristalsis of the stomach;
• Ultrasound of internal organs - is prescribed to detect metastases;
• CT - performed to identify the primary focus of adenocarcinoma and its metastases;
• tests for Helicobacter pylori (blood, feces and respiratory test) - if it is detected, appropriate treatment is prescribed;
• a blood test for tumor markers - is performed if gastric adenocarcinoma is suspected;
• clinical blood tests - are prescribed to detect anemia, inflammation and digestive disorders.

Treatment

The tactics of treatment for adenocarcinoma of the stomach is determined after a detailed examination of the patient and the identification of the stage of the tumor process.

Depending on the stage of cancer, the location of the tumor and its histological structure, a surgical technique for removing the neoplasm is chosen:

• subtotal resection - part of the stomach and part of the tissues located near the tumor are removed;
• gastrectomy - the entire stomach is removed with part of the esophagus, small intestine, with lymph nodes and tissues around.

Before and after surgery, the patient may be prescribed radiotherapy and chemotherapy, aimed at reducing the size of the tumor and preventing the development of relapses after the intervention.

At the advanced stages, when the surgical operation is no longer effective, the patient undergoes palliative interventions:

• endoluminal laser therapy - the technique allows you to destroy cancer cells with a laser;
• endoluminal stenting - a stent is inserted into the stomach, which allows the patient to eat independently.

In the later stages of adenocarcinoma, the patient is prescribed radiotherapy, chemotherapy sessions, taking painkillers and drugs to improve stomach function.

The chemotherapy regimen includes the intake of two or more cytostatics. For this can be used:

• Epirubicin;
• Docetaxel;
• Cisplatin;
• Oxaliplatin;
• Irinotecan etc.

Treatment with folk methods

Remember that it is impossible to cure adenocarcinoma of the stomach with the help of folk methods! Alternative recipes can be used only on the advice of a doctor and only to improve digestion.

Forecasts

The overall five-year survival rate for gastric adenocarcinoma is about 20%. Such a disappointing prognosis is due to the fact that in most cases the tumor is detected already at advanced stages.

Poorly differentiated adenocarcinoma of the stomach, as oncologists call the pathology, is a fairly common disease of this organ, which is observed in 95% of cases of incipient stomach cancer.

The disease is dangerous because it can affect other nearby organs. Adenocarcinoma of the stomach is formed from particles of the mucous membrane of the organ. Under the pressure of several unfavorable causes, the protective layer is broken, and healthy cells are transformed into cancerous foci.

Men are more likely to be affected by adenocarcinoma of the stomach than women. Tumor formation continues for a long time, can take from 1 to 20 years, and in most cases makes itself felt at the age of 45-50 years.

In almost half of the episodes, pathology is detected at the penultimate or last stage, when treatment is difficult. The reason for this is the oligosymptomatic continuation of the disease in the initial stages.

A surgical operation with a thoroughly advanced disease is unacceptable, since all tissues, nearby organs and lymph nodes located near the organ are captured by the malignant process

Factors causing the development of the disease

Doctors consider interruptions in the blood supply to the walls of the stomach, their nutrition, and suppression of secretion as the main reason. Such perturbations in the body cause carcinogens.

In addition, the following contribute to the progression of stomach cancer:

• Alcohol, its excessive use;
• Long history of smoking (tobacco tar);
• Unbalanced diet - passion for smoked meats, deli meats, fried and salty foods, pickled vegetables, where there are a lot of nitrates. Once in the stomach, they react with hydrochloric acid, resulting in complexes that damage the mucous surface and provoke the transformation of healthy glandular cells into tumor cells;
• Rigid long-term diets with small doses of trace elements, vitamins, and a minimum content of dietary fiber.
• A bacterium that provokes inflammation of the gastric mucosa and reduces its resistance is Helicobacter pylori.

To this we can add: extra pounds of body weight, low acidity of the stomach, radiation background and unfavorable ecology of the place of residence, a hereditary factor.

Classification of glandular cancer

Classify the disease depending on the level of demarcation of tumor cells:

• The most dangerous type of disease is low-grade adenocarcinoma of the stomach. It has a significant level of malignancy. The prediction of this type of cancer is usually unsatisfactory: the tumor rapidly metastasizes to neighboring organs and lymph nodes;
• Well-differentiated adenocarcinoma of the stomach - in the light of predictions, this is the most promising, favorable type of disease. Formation cells are almost the same as structural cells of healthy tissue. The degree of malignancy is quite low;
• Moderately differentiated adenocarcinoma of the stomach is an average type of tumor. This species has no characteristic features. Changes in the structure of tissues - moderate.

There is another population of malignant formation - this is tubular adenocarcinoma. It looks like branched tubular structures enclosed in a fibrous stroma.

This type of glandular cancer requires the most serious attitude and immediate medical attention.

Symptoms of the disease

Timely diagnosis and treatment of chronic gastric diseases is of great importance in the prevention of malignant tumors of the stomach.

Adenocarcinoma of the stomach is an insidious disease that develops slowly, and its initial symptoms are very difficult to feel. At first, patients may complain of lack of appetite, heaviness, nausea, constipation, weight loss, without paying serious attention to this. Such manifestations can be characteristic signs of many pathologies.

As the disease progresses, the symptoms become more pronounced. Glandular cancer, also called adenocarcinoma, in almost 90% of cases becomes the cause of metastasis to near and distant organs.

It happens that the diagnosis is made only at 4 stages of the disease, when no methods of treatment can stop the development of the malignant process.

The most characteristic and frequent signs of the development of pathology in the early stages are:

• Reorientation of gastronomic addictions - aversion to food rich in proteins (meat);
• Salivation higher than usual;
• Vomiting - episodic, constant, when eating or for no reason. If vomit mixed with blood is a serious sign of a malignant process occurring in the stomach.
• Pain in the epigastric region - parts of the abdomen in the upper and middle hypochondrium.

Glandular tumors, even with their intense increase, are far from always possible to detect. Doctors call such neoplasms "silent", and consider them the most dangerous.

How is gastric adenocarcinoma diagnosed?

A gastroenterologist, a therapist and an oncologist are engaged in identifying the disease. The latter is engaged in the treatment, but to make a qualitative diagnosis, you need to perform a set of measures:

• X-ray with a contrast agent - barium sulfate;
• Ultrasound examination of the stomach and the entire abdominal cavity;
• Determination of the presence of metastases in the abdominal cavity, liver, by the method of diagnostic laparoscopy.
• Observation of the state of the mucous membrane - gastroscopy;
• Blood test for tumor marker.

Treatment

If it is possible to correctly diagnose the disease in the initial stages, the patient is offered an operation to remove the tumor along with the adjacent altered tissues. In this case, more than 50% of the stomach and nearby lymph nodes are removed.

Surgical intervention in the final stages is impractical. Together with the stomach, in this case, all vital organs affected by cancer will have to be removed.

In the last stages, the patient is prescribed maintenance treatment:

• radiation therapy;
• Pain medications;
• Chemotherapy sessions are prescribed simultaneously with radiation therapy.

The effectiveness of chemotherapy

The type of chemical preparation is selected depending on the neglect of the disease, individually for each patient. Treatment programs have been developed that include the use of several chemical preparations.

In most cases, this kind of treatment is very difficult to tolerate - patients are worried about weakness, nausea, and hair loss is observed. The main task of chemotherapy is to reduce the possibility of recurrence of the disease and prolong the life of the patient. The method is effective with the simultaneous use of radiation therapy and the possibility of surgery.

Conclusion

The life expectancy of a person diagnosed with adenocarcinoma of the stomach also depends on the reaction of the patient's body to the prescribed course of treatment.

Adenocarcinoma of the stomach is one of the most common forms of tumors affecting this organ. Of all the neoplasms diagnosed by doctors, it includes almost all cases of cancer. Most often, patients are men over forty-five years old.

The greatest danger of adenocarcinoma of the stomach lies in the fact that its metastasis occurs at a very high rate. Almost all patients suffer from severe spread of cancer cells penetrating into neighboring anatomical formations and lymph nodes. Most often, the pathology is incurable.

According to the microbial disease, the disease belongs to the class C16, which includes malignant neoplasms of the organ.

The main danger of the development of the disease is that for a very long time it proceeds almost completely hidden. The patient does not experience any severe symptoms, so it is very rare that he turns to a specialist in a timely manner.

When the deterioration of health that has become distinct forces him to come to the appointment with a gastroenterologist, the tumor usually has time to spread beyond the stomach. Metastases form in regional lymph nodes and neighboring organs.

In half of the patients, the disease is detected already at the third or fourth stage of its development. In this case, most often a complete cure can no longer be achieved, so oncologists are fighting only to prolong a person's life.

In general, the pathology passes in its formation a period of about twenty years, leading to irreversible changes in the body.

What is adenocarcinoma of the stomach and the causes of its development

It is necessary to immediately clarify what is adenocarcinoma of the stomach. This type of cancer develops from cells of the glandular epithelium due to the influence of a variety of pathogenic factors.

The main cause of gastric adenoma are the following circumstances.

Of great importance in the development of the oncological process is the adverse effect of the environment and occupational hazards.

The main risk factor is also a person's hereditary predisposition to this type of malignant neoplasm.

Crossing the fifty-year milestone greatly increases the risk of developing a tumor.

Types and stages of gastric adenocarcinoma

Specialists identify the main types of pathology, which include diffuse, unclassified, polypous, pseudo-ulcerative, ulcerative forms. In addition, papillary, cricoid, mucous, tubular adenocarcinoma of the stomach is also distinguished.

The tumor is divided into the following types:

• well-differentiated gastric adenocarcinoma(the prognosis is sometimes quite favorable, since most of the mucous membrane of the organ continues to function, carrying out digestion);
• low-grade adenocarcinoma of the stomach(metastases develop almost immediately after the formation of cancer and penetrate into neighboring tissues or lymph nodes, spreading further and further throughout the body);
• moderately differentiated gastric adenocarcinoma(the tumor does not grow too actively, so the patient's survival becomes quite high and completely depends on the methods of treatment used).

The lower the degree of differentiation of the oncological process, the less chance of prolonging the life of the patient.

Adenocarcinoma of the stomach develops in certain stages.

On the early of these, only the internal cavity of the organ is affected. A malignant neoplasm is not yet large in volume, therefore it does not have a very pronounced effect on the body as a whole. The symptomatology is erased and most often manifests itself in the form of a lack of desire to eat.

On the second stage occurs infiltration of the tumor into the muscular membrane of the stomach, from there it spreads through the lymphatic system. The clinical picture is not too pronounced. The patient refuses food and complains of a general decrease in well-being.

Third the stage is characterized by damage to the entire organ, as well as neighboring anatomical structures. Limofuzly covered completely.

On the fourth metastases spread throughout the patient's systems.

Symptoms of stomach adenocarcinoma

The clinical picture of oncology is not very obvious. The main signs of its development include:

Such non-specific symptoms as increased saliva production, slight hyperthermia, mood swings, lethargy can also indirectly indicate the formation of cancer.

Particular attention of the doctor is attracted by the patient's developed aversion to foods rich in protein, especially fish and meat.

Diagnosis of gastric adenocarcinoma

If a malignant tumor is suspected, an urgent thorough examination of the patient is necessary. To clarify the nature of the pathology, a number of measures must be taken.

The main tool for the rapid detection of a malignant neoplasm of the stomach is FGDS. The method allows you to carefully examine the internal cavity of the organ and take biomaterial for subsequent histology.

x-ray with the use of contrast, it helps to clearly establish the localization and boundaries of the tumor from the photographs taken.

Ultrasound Scan makes it possible to clarify the degree of formation of the oncological process and the spread of metastases.

Computed tomography used for a complete examination of the patient's body.

To check the general state of his health, a number of laboratory tests are carried out. They allow you to establish the degree of development of inflammation, changes that have occurred in the internal organs and the level of intoxication due to the growth of the pathological focus.

The data provided by biopsy and laparoscopic examination are also very important.

Treatment of adenocarcinoma

In the initial stage of the development of oncological disease, the patient undergoes an operation to excise the tissues affected by cancer.

With a significant development of the disease, complete removal of the stomach is used with simultaneous resection of regional lymph nodes.

In the later stages, surgical treatment is not used, since the pathology has already captured the entire body of the patient. Then radiation, analgesics, symptomatic and chemotherapy are prescribed.

If the digestive processes are sharply disturbed, anastomoses are created to facilitate their flow.

Metastasis and complications

As already mentioned, the biggest threat to the patient's body with adenocarcinoma of the stomach is rapidly spreading through his body metastases. It is they that entail a significant deterioration in the well-being of a person and bring his death closer.

The most affected are:

Metastasis and rapid progression of the disease leads to extremely negative consequences, most often manifested in the form of gastric perforation in the process of ulceration of a malignant neoplasm. Such processes can lead to the occurrence of severe bleeding and peritonitis.

The growth of cancer entails an irreversible narrowing of the lumen of the gastrointestinal tract. In addition, its effect on nearby tissues provokes vascular disorders and the development of abdominal edema in the form of ascites.

Usually, the oncological process is accompanied by the formation of anemia due to severe disorders in the hematopoietic system.

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Prognosis and survival in adenocarcinoma at different stages

If timely treatment was applied at the very beginning of the development of the tumor, then more than three-quarters of patients can live for at least five years. If the recurrence of the oncological process is not observed, then experts usually state that the cancer has been defeated.

The five-year survival rate in the second stage does not exceed forty percent. With the third degree of formation of a malignant neoplasm, only one in five survives after five years. At the end of the disease, only very few people manage to prolong their existence.

In general, if gastric adenocarcinoma is diagnosed, the prognosis of its development depends entirely on the timeliness of detection of the tumor, the treatment performed and the general health of people. Even at the fourth stage, it is often possible to help the patient's existence for up to ten years, with strict adherence to all the oncologist's prescriptions.

People under the age of fifty live on average ten percent longer than those of the elderly and senile age.

Prevention options

Any tumor is easier to prevent than after trying to cure it. Therefore, a number of rules must be strictly observed.

1. Eliminate foods that contain carcinogens from the diet.
2. Adhere to the principles of a healthy diet.
3. Get regular medical check-ups.
4. Timely cure any diseases of the digestive system.
5. Refrain from drinking alcohol.
6. Stop smoking.

Adenocarcinoma of the stomach, or as this disease is also called glandular cancer, is a malignant tumor that is formed from cells of the gastric mucosa.

This form of stomach cancer is the most common - the 4th place in the world among all oncological diseases and the 1st place among gastric malignant pathologies in the Russian Federation, Ukraine, Japan and Scandinavian countries.

According to statistics, the risk of encountering gastric adenocarcinoma is significantly higher in patients over the age of 45 in the third or fourth stage of cancer development.

Men are subject to adenosarcoma 3 times more often than women, while this disease is diagnosed extremely rarely in children.

Reasons for development

What causes stomach cancer? To date, the unambiguous etiology of the occurrence of glandular cancer in oncology has not been established, however, the fact that this pathological process develops as a result of various factors that cause persistent circulatory disorders in the walls of the stomach and inhibition of its secretory functions is recognized as absolutely accurate. What contributes to the development of this disease?

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Some of the most well-known causes of gastric adenocarcinoma include:

• nicotine and alcohol addiction. Tobacco tar and alcohol have a toxic effect on the walls of the gastric mucosa;
• unbalanced diet. Excessive consumption of fried, fatty and high-sodium foods increases the risk of developing this disease. This is due to the content of nitrites in such food, which, when mixed with hydrochloric acid in the stomach, are converted into enzymes that transform healthy cells into malignant ones;
• abuse of a diet low in fiber, vitamins and minerals;
• the presence of Helicobacter pylori bacteria, which provokes the appearance of infiltrative gastritis, accompanied by a violation of the mucous layer of the stomach. If the infection lasts for many years, then the likelihood of developing a tumor process is very high;
• hereditary factor;
• living in unfavorable ecological zones;
• work with harmful substances.

Oncologists believe that gastric adenocarcinoma never occurs in healthy cells and is necessarily preceded by:

How is gastric adenocarcinoma classified?

According to the classification of stomach cancer according to Bormann, there are 5 main varieties and 4 subspecies of adenocarcinoma.

So the five types are:

• polyposis - a clearly defined formation that appears in the lumen of the stomach;
• diffuse;
• infiltrative cancer with extended boundaries;
• unclassified group of formations;
• pseudoulcerative.

As subspecies stand out:

• papillary adenocarcinoma (from 1 to 10 percent of all types of adenocarcinomas) - a tumor that is formed from epithelial cells and grows inside the stomach. It looks like a finger.
• tubular form of cancer - a formation consisting of cystic and branched elements;
• mucous (mucinous) adenocarcinoma - a tumor that secretes a mucus-like fluid that is detected during the gastroscopy procedure;
• cancer with cricoid cells - a neoplasm that grows throughout the entire inner layer of the stomach.

Based on the differentiation of the structure of adenocarcinoma, it can be:

Symptoms of adenocarcinoma

Answering the question why this type of cancer is so difficult to treat, it should be noted that, given the germination of such a variety of adenoma as glandular cancer in the pyloric gastric region, it is practically not observed in the early stages of development. According to statistics, 40 percent of patients turn to a specialist already when the disease has “taken deep roots”. Tumor growth is very slow, and sometimes takes about 17-20 years. Characteristic for this type of tumor is the early appearance of metastases (in 82 percent of cases).

The earliest and sometimes not always clearly diagnosed sign of gastric adenocarcinoma is periodic and quickly passing indigestion, accompanied by nausea, belching, poor appetite, mild pain in the epigastric region and the formation of gases in the intestines. A frequent symptom is also a persistent reluctance to eat foods containing protein - fish and meat.

With the development of the disease and its transition to the next stage, symptoms such as:

• pain that is not associated with eating and radiates to the chest, shoulder blade or back;
• violations of the process of bowel movement - frequent constipation, or, conversely, loose stools;
• complete refusal to eat;
• weight loss;
• tarry consistency of the stool with bleeding that occurs in the gastrointestinal tract as a result of the collapse of the tumor;
• food or blood vomiting;
• weakness, fatigue and low performance;
• anemia and pallor of the skin and mucous membranes;
• an increase in body temperature above 37 degrees;
• irritability and depression.

Attention! The formation and development of adenocarcinoma of the stomach have no signs, up to the last stage. This is the most dangerous course of the disease, since in this case surgical removal of the tumor is impossible, given the spread of its cells to most of the nearest organs. In order to avoid such a development of the situation, it is necessary to contact a gastroenterologist at the very first signs.

Stages of development of glandular cancer

The development of adenocarcinoma of the stomach occurs in the following sequence:

First stage- the tumor is localized within the gastric mucosa, is small in size, does not intoxicate the body and does not cause external symptoms, except for a slight deterioration in appetite;

Second stage- the formation grows into muscle tissue and partly into the lymphatic system. Symptoms are mild, there is a violation of the digestive process, an increase in lymph nodes, muscle pain, poor appetite.

3 stage- neoplasia grows throughout the entire inner layer of the stomach, with simultaneous penetration into the abdominal cavity, liver, duodenum and pancreas. Metastases of atypical cells are found in distant lymph nodes;

4 stage- malignant formation begins to metastasize. In addition to the proliferation of cells in the organs indicated in the third stage, metastasis can also be observed in the navel and lung tissues, which causes a strong cough with sputum containing blood streaks.

Diagnosis of the disease

To diagnose this type of malignant neoplasia, the following types of examinations are shown:

Treatment of gastric adenocarcinoma

The choice of a method for treating cancer, including gastric adenocarcinoma, comes primarily from its localization and structure. In the early stages of the tumor process, surgery is almost always prescribed using the following methods:

• subtotal resection, in which a part of the gastric organ and tissues of neighboring organs affected by the tumor are cut out;
• gastrectomy method, when the entire stomach, part of the esophagus, small intestine and nearby lymph nodes are resected;

At the same time, on the eve and after the operation, the patient undergoes a course of radiobeam and, the purpose of which is to reduce the size of the formation and prevent its recurrence after surgery. Chemotherapeutic drugs include the cytotoxic agents found in Docetaxel, Oxaliplatin, Cisplatin, Epirubicin, and Irinotecan.

* Having received data on the patient's disease, a clinic representative will be able to calculate the exact price for treatment.

If the disease is detected at the very late stages of its development, then the surgical operation is not only ineffective, but also dangerous. According to statistics, the mortality rate of cancer patients with surgical intervention at advanced stages of gastric adenocarcinoma is 12 percent.

Based on this, doctors in such cases prescribe other methods of treatment, among which are:

• destruction of a malignant tumor with an endoluminal laser;
• elimination of cancer cells by endoluminal stenting, which expands the lumen of the stomach and allows the patient to swallow food on his own;
• taking anabolic drugs and medicines that improve stomach function.

Important: It is impossible to cure gastric adenocarcinoma using traditional medicine methods, its use is possible only as a maintenance therapy and only on the recommendation of a doctor.

What complications does it cause?

A tumor of the stomach can lead to the following complicated processes:

How long do people live with gastric adenocarcinoma?

The life expectancy of a patient with this form of cancer depends on many factors, the most important of which is the stage of gastric cancer. Based on practice, 20 percent of patients live for about 5 years, due to the late diagnosis of the tumor. In general, doctors cite the following data: in the first stage, the survival rate is 80 percent, in the second stage - 50 percent, in the third stage - from 15 to 38 percent; the fourth stage - no more than 5 percent. If gastric carcinoma is detected at the very last stage, life expectancy is no more than one year.

Prevention

To minimize the risk of stomach cancer, it is necessary to follow fairly simple rules, including quitting smoking and drinking alcoholic beverages, providing the body with a healthy and balanced diet, especially when. Also, constant monitoring of health, especially in the presence of chronic diseases associated with the gastrointestinal tract.

Gastric cancer is one of the most common oncological pathologies in the world. It accounts for about 30% of deaths in cancer patients. Adenocarcinoma, or glandular cancer, accounts for nearly 95% of all stomach cancers. For a long time, this disease is asymptomatic or “disguised” as other diseases (gastritis, duodenitis, ulcers).

What is gastric adenocarcinoma

Adenocarcinoma is a tumor that develops from the glandular cells of the inner lining of the stomach (mucosa). Under the influence of various factors, the cells of the mucous membrane are damaged, the protective layer that protects them is destroyed, and normal cells degenerate into tumor cells. The neoplasm is located more often in the antral and pyloric sections of the stomach.

One of the most common localizations of adenocarcinoma is the antrum of the stomach.

The main danger of this type of cancer is an asymptomatic course in the early stages, which greatly complicates the diagnosis and leads to a late visit to the doctor.

Classification of adenocarcinomas

When classifying cancer, the degree of differentiation is taken into account. The higher it is, the more the tumor cells look like normal, healthy epithelial cells. The lower the tumor is differentiated, the more dangerous and malignant it is. According to this classification, adenocarcinomas are divided as follows:

• highly differentiated;
• moderately differentiated;
• poorly differentiated (poorly differentiated).

According to the appearance and nature of growth, there are adenocarcinomas of the following types:

• ulcer-cancer - the tumor has a flat shape with an ulceration in the center;
• polypoid cancer - outwardly very similar to a stomach polyp, has clear boundaries;
• skirr - sprouts the wall of the stomach over a large extent, gives early metastases;
• ulcerated cancer - outwardly very similar to an ulcer, an accurate diagnosis can only be established after a biopsy;

There is also a gradation based on the histological picture of the tumor - tubular, papillary, mucous adenocarcinomas.

Causes

The development of adenocarcinoma is based on damage to the cells of the glandular epithelium of the stomach by various factors:

1. The role of the bacterium Helicobacter pylori in the pathogenesis of glandular cancer has been proven. This microorganism releases substances that break down the protective mucus layer in the stomach, damaging mucosal cells, and causing chronic inflammation. The presence of gastritis, ulcers with proven infection with Helicobacter pylori is an indication for regular preventive examinations with FGDS (fibrogastroduodenoscopy).
2. Foods rich in nitrites can also cause adenocarcinoma. These products include fried, smoked food, fast food, food with a high content of preservatives.
3. Lack of vitamins A, E, C in the body.
4. Smoking, alcohol abuse.
5. hereditary factor. The presence of any of the relatives of this disease is a reason to closely monitor the health of your stomach.
6. Duodeno-gastric reflux (reflux of food from the duodenum back into the stomach).

The following diseases predispose to the development of adenocarcinoma: gastritis, chronic gastric ulcer, polyposis, the presence of dysplasia of the stomach epithelium.

Symptoms

For a long time, adenocarcinoma is asymptomatic. The patient may be disturbed only by such general and non-specific manifestations as weakness, fatigue, gradual weight loss. Later, symptoms join that can easily be mistaken for signs of gastritis:

• pain in the abdomen, depending on food intake;
• heartburn, belching (if the tumor is located in the cardia of the stomach);
• decreased appetite.

In the later stages of the disease, specific symptoms occur, which, as a rule, force a person to see a doctor:

• when the tumor is located in the pyloric region, a clinic of pyloric stenosis occurs - a feeling of fullness in the stomach even after taking a small amount of food, stagnation of food in the stomach, nausea;
• due to microbleeding from the tumor, anemia develops in a person, tarry stools can be observed;
• eating habits change - there is an aversion to meat.

By this time, the tumor is usually quite neglected, which significantly reduces the chances of recovery.

Stages of development of the disease

Unfortunately, the initial stage is rarely diagnosed, most often it is a finding during routine diagnostic studies. Survival in the later stages is 5 years, but when this threshold is overcome, the prognosis rises to 10 years. In young (under 50 years old) patients, the chances of recovery are higher than in the elderly - 20–22% and 10–12%, respectively.

Diagnostics

The examination begins with the identification of the patient with the symptoms described above. A general blood test is prescribed, where there may be a decrease in the number of red blood cells (anemia) and an increase in white blood cells (a sign of inflammation).

The most informative and reliable diagnostic method is gastroscopy with biopsy. During this study, the doctor examines the gastric mucosa through the endoscope, and if there are focal changes, he takes a piece of the epithelium for analysis. Histological examination allows to determine cancer with 95% certainty.

An X-ray method of examination is also used. The patient drinks a special liquid - a barium-containing contrast; after some time, an x-ray of the stomach is performed, which reveals a filling defect or a niche. This is a sign of tumor growth in the lumen of the stomach or destruction of its wall.

Ultrasound is used to detect metastases in the abdominal organs. Most often, the first metastases are found in the liver, as well as in the lymph nodes of the stomach and intestines.

The patient also undergoes computed tomography of the whole body to exclude distant metastases (to the lungs, brain, bones).

Treatment

In the treatment of adenocarcinoma, several methods are used - this is surgery, chemotherapy, radiation therapy. There are also traditional medicine recipes, and there is active research into the possibility of using stem cells to treat cancer.

The type of treatment, its volume and duration are entirely determined by the type of tumor, the degree of its progression, the development of metastases, as well as the general condition of the patient and the presence of concomitant diseases. The range of applied methods varies from only surgical intervention to a combination of all types of treatment.

1. Surgery. It is the only type of therapy that allows (in the absence of metastases) to completely remove cancer cells from the body. It is used in almost all stages of cancer, with the exception of cases when the tumor has reached such a size or has sprouted so many structures in the abdominal cavity that it is not possible to remove it. Usually in this case, the changes in the body are so great that the patient is prescribed palliative therapy, i.e., treatment aimed at getting rid of pain and improving the quality of life.
2. Chemotherapy. Used to slow tumor progression, spread of metastases, relieve symptoms. It is prescribed after surgical treatment alone or together with radiation therapy. Even modern chemotherapy drugs are quite toxic, they have pronounced side effects in the form of nausea, vomiting, baldness, weight loss, but it should be remembered that this is a necessary stage of treatment, and the unpleasant consequences of their use are temporary.
3. Radiation therapy. This is a non-invasive (without physical intervention in the body), painless procedure. Certain parts of the body (stump of the stomach after surgery, lymph nodes, organs with metastases) receive radiation of a certain type. This allows you to destroy cancer cells that could remain in the stomach after surgery, relieves pain, reduces the risk of spread and growth of metastases, and reduces the likelihood of bleeding in the postoperative period.
4. Immunotherapy. The use of drugs that affect the human immune system in order to reduce the intensity of metastasis, activate the body's natural antitumor defense factors, and reduce the likelihood of tumor recurrence.
5. Stem cell treatment. A new, experimental, but promising method of treatment. Currently available only in the largest clinics in the country.
6. Treatment with folk remedies. There are several traditional medicine recipes used for stomach cancer:

• Aconite tincture. You need to take 100 gr. aconite root, wash and pour boiling water for an hour. Then grind and pour 60 degrees alcohol for 21 days. Take dissolved in 200 ml of warm water 30 minutes before meals for 10 days, starting with 1 drop, adding 1 drop daily.

• Decoction of potato color. Collect potato flowers and dry in a dark place, then chop. Pour 500 ml of boiling water over one tablespoon of raw materials, leave for 3 hours. Take 150 ml 3 times a day 30 minutes before meals for 2 weeks. After a week break, repeat the course. Treatment lasts 6 months.

• Chop 33 walnuts and pour vodka for 40 days. Strain the resulting tincture, take 1 teaspoon before meals 3 times a day. Store in a dark glass container in the refrigerator.

Folk remedies in the photo

Keep the finished nut tincture in the refrigerator Potato flowers should be harvested during the full flowering period. Ready-made tincture of aconite can be bought at a pharmacy

Remember that traditional medicines can relieve symptoms and improve the general condition of the body, but they are not a substitute for traditional cancer treatment!

Complications

The main complications of adenocarcinoma are associated either with a far advanced pathological process or with treatment.

• If the tumor grows into the wall of the stomach and damages large blood vessels, a person will experience periodic or constant bleeding of varying intensity, from drip to profuse (abundant).
• The presence of metastases in the liver, lungs and other organs disrupts their work and can lead to the development of insufficiency (hepatic, pulmonary).
• The location of the tumor in the region of the pylorus leads to its stenosis.
• When the tumor compresses the blood vessels, the venous circulation in the abdominal cavity is disturbed, which leads to the occurrence of ascites (accumulation of fluid in the abdominal cavity).

The main complication of surgical treatment of cancer is bleeding from the stomach stump, the formation of pronounced scars in the area of ​​the postoperative wound, and impaired passage of food through the stomach. In some cases, it may be necessary to impose a gastrostomy, i.e., the creation of a "bypass" for food.

Prevention

Preventive measures to reduce the risk of developing adenocarcinoma can be divided into several main groups:

1. Diet. Meals should be fractional (at least three meals a day), in small portions. Excessively hot food should be avoided. Exclude fast food, smoked meats, too salty or overcooked food from the diet. Eat foods rich in vitamins A, E, C (carrots, citrus fruits, black currants, sea fish).
2. Lifestyle correction. Quitting smoking and drinking will greatly reduce your risk of developing cancer and improve your overall well-being.
3. Regular examinations. Even in the absence of complaints of stomach problems, it is necessary to undergo an examination every 2 years - to perform EGD and analysis for Helicobacter pylori. In the presence of gastritis, ulcers, polyps of the stomach, this examination should be performed more often.
4. Timely visit to the doctor. You should not endure pain in the stomach to the last, especially if it is accompanied by other disturbing symptoms. A timely appeal to a gastroenterologist will allow timely detection of the disease.

Sea fish

Adenocarcinoma of the stomach is a serious disease. A long asymptomatic course makes it difficult to diagnose, and therefore attention to one's health and compliance with preventive measures is the main weapon in the fight against it.