Gastric Cancer

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Latest Edit: Iva Lloyd, ND 2014-01-31 (EDT)

Stomach cancer is medically termed Gastric Cancer. Death from gastric cancer has decreased to 20% of that recorded in the 1930's in the US but it remains the second leading cause of death from cancer worldwide. [1] Rates of gastric cancer have been decreasing in North America, and increasing in East Asia. Currently, gastric cancer is the most common form of cancer in Japan, spurring a screening program which has reduced mortality by up to 50%. Men are more affected by gastric cancer than women and it most often is diagnosed during the 6th decade in life. [2]

Gastric Cancer
Causes Infections, Dietary Factors, Medications
See Also Gastric Cancer Details, Oncology
Books Books on Digestive and Liver Conditions, Books on Oncology
Articles Articles on Digestion, Articles on Oncology (Cancer)

Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. Factors associated with Gastric Cancer include:

External

Article Mediterranean Diet Lowers Gastric Cancer Risk ,2010 September Natural Medicine [1]
  • Infection with H. pylori, the microbe associated with Peptic Ulcer Disease, is the strongest risk factor for gastric cancer.[4]

Lifestyle

  • A diet high in salt, and in particular salted or smoked meats, increases the risk of developing gastric cancer. Foods preserved with salt or by smoking increase the amount of N-nitroso compounds and benzopyrene in the diet.[5]
  • Increasing foods high in selenium may reduce the risk.[1]

Genetics

  • Family History
  • The majority of gastric cancers are not attributed to heredity, however several rare inherited genetic disorders confer a very high incidence of gastric cancer. There are other genetic variations that are associated with a higher risk of gastric cancers.[3]
  • Asian, African and Hispanic Americans have a higher risk than Caucasian or white Americans.[1]
  • People with a Type A blood group are also observed to get gastric cancer more than other blood types.[1]

Physiology

Medical Interventions

  • Proton Pump Inhibitors
  • Individuals colonized with H.Pylori who are put on proton pump inhibitors to treat Gastroesophageal reflux disease, are at increased risk of gastric cancer. H.pylori is a known risk factor for gastric cancer, and it is able to proliferate more abundantly when stomach acidity is reduced.[3]
  • Surgery
  • Prior gastric surgery is a risk factor for gastric cancer.[3]

Characteristics

  • The adenocarcinoma type comprises 95% of the gastric cancer types. The remaining are rare types such as leiomyosarcomas, lymphomas, carcinoids, squamous cancers, etc.
  • Gastric cancer often progresses to an advanced stage by the time it is diagnosed. This is largely due in part to the overwhelming recommendations for proton pump inhibitors and antacids for long term use, when their original approval by the FDA was for short term (less than 14 days) use. Extended use of these medications will mask more serious conditions from being diagnosed, because the common symptom of abdominal pain is most often diagnosed as reflux without further follow-up care.[1]

Diagnostic Tests

The diagnosis of gastric cancer is often made at an advanced stage due to its nonspecific symptom picture. The most commonly used and important diagnostic test to evaluate suspected gastric cancer is flexible endoscopy. Other testing that may be indicated include:[3]

  • ”Other Studies” that are routinely used to confirm diagnosis and guide treatment include endoscopy (Esophagogastroduodenoscopy (EGD)), endoscopic ultrasound, and laproscopy.

Common Symptoms

The symptoms commonly associated with gastric cancer are nonspecific and contribute to its frequently delayed diagnosis. Common symptoms include:[3]

  • Epigastric pain
  • Dysphagia
  • Early Satiety
  • Weight loss
  • Hematemesis
  • Anemia

Associated Conditions

Conditions associated with Gastric cancer risk include:[1]

  • Individuals with pernicious anemia are at an increased risk of gastric cancer. This is due to the achlorhydria associated with this condition, which causes the mucosa to become atrophic and at risk of metaplasia.[3]
  • mucosal dysplasia with grade III dysplasia having the most loss of cell regulation. Risk is proportionally correlated with mucosal dysplasia
  • gastric polyposis - hyperplastic polyps, familial adenomatous polyposis both require endoscopic surveillance for carcinomatous changes.

Naturopathic Treatment Strategy

Article Green Tea and Gastrointestinal Cancers , February 2013 Natural Medicine [2]

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body. A treatment strategy is the most effective when it addresses the underlying causal factors and when it follows the naturopathic therapeutic order. The treatment strategy for gastric cancer is first prevention, followed by treatments to address the cancer directly or to support conventional treatments and to improve overall quality of life.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Prevention

Persistent investigation of persistent GI symptoms is clearly improving the detection of gastric cancers at an earlier stage and thus offers a better prognosis for the patient. It also involves addressing any of the causal factors before they cause cancer, for example:[6]

  • Not smoking, smoking cessation, and avoiding second hand smoke inhalation are important in preventing gastric cancer (and several other cancers).
  • Avoiding foods preserved with salt or by smoking. It is thought that the drop in gastric cancer in North America in the last 50 years can be attributed to increased use of refrigerators and the corresponding decrease in preservation of meat by smoking and salting.
  • Increasing fruit and vegetable intake is important in the prevention of gastric cancer.
  • Identifying and treating H. pylori infection is advised, as H. pylori is strongly associated with gastric cancer.

Cancer Specific Treatments

Follow the general guidelines for cancer specific treatments. Additional treatments that are specific to gastric cancer include:

  • Supplementation including:[7], [1]
Article Survival Rates in Gastric Cancer Patients Using Lentinan, NMJ, [3], 2012 June

Herbs such as[6] Astragalus, Curcumin, Garlic, Ginkgo biloba, Ginsenosides, and Mushroom polysaccharides.

  • Acupuncture has benefit in reducing conventional therapy side effects. It also serves a multitude of other benefits including improved sleep, reducing anxiety and stress and improving quality of life.

Supportive Care

Follow the general guidelines for supportive care especially when conventional treatments such as surgery or radiation therapy are chosen.

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Casciato DA. Manual of Clinical Oncology 5th ed. Lippincott Williams & Wilkins 2004. PP 189-195
  2. Shah MA, Rathkopf,D, and Schwartz GK. (2007) Gastric Cancer. In Boyiadzis MM, Lebowitz PF, Frame JN, and Fojo T. Hematology - Oncology Therapy; (pp 135-143). New York, USA: McGraw-Hill Medical
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Mahvi DM, Krantz SB (2012) Townsend: Sabiston Textbook of Surgery 19th ed Chap 49 Stomach Saunders
  4. Piazuelo MB, Epplein M, Correa P (2010) Gastric Cancer: An Infectious Disease Infectious Disease Clinics of North America 24(4)
  5. 5.0 5.1 Turner JR (2009) Kumar: Robbins and Cotran Pathologic Basis of Disease, Professional Edition 8th ed Chap 17 The Gastrointestinal Tract Saunders
  6. 6.0 6.1 Alshuler L and Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing 2007 Ten Speed Press/Celestial Arts Publishing pp.187-212
  7. Prousky J (2008) Principles and Practices of Naturopathic Clinical Nutrition CCNM Press