symptoms, blood test, what prognosis?

The number of new cases of stomach cancer in France is estimated at 4,657, including 65% in men. The median ages at diagnosis are 71 years in men and 75 years in women. What signs should alert? When to consult a doctor ? What tests diagnose stomach cancer?

According to the latest stomach cancer figures published by theInca in 2019, the number of new cases of this cancer in France is estimated at 4 657dont 65% in men. The median ages at diagnosis are respectively 71 years for men and 75 years for women. The risk of being affected by this cancer between 0 and 74 years of age has decreased in men and in women, passing respectively for the cohort born in 1920 and that born in 1950 from 1.6% to 0.8% in men. and 0.6% to 0.3% in women. The main risk factors are infection with Helicobacter pyloritobacco, food.

Stomach cancer is characterized in 9 cases out of 10 by a adenocarcinoma that is, a cancer that develops from glandular cells in the stomach wall. It is manifested by common symptoms such as nausea, vomiting or stomach pain,

Several risk factors are well identified such as gastritis chronic due to infection with Helicobacter pylori bacteriasmoking, alcoholism, diet (excessive salt intake, diets low in fresh produce), family history of stomach cancer, and genetic predispositions (Biermer’s diseaseMenetrier’s disease, etc.).

Pain localized in the upper part of the abdomen, gastroesophageal reflux disease, nausea, repeated vomitingdeterioration of general condition (loss of appetite, fatigue, weight loss)gastrointestinal bleeding and/or anemia chronic are warning signs. Of the difficulty swallowing solid foods, especially meat, may show signs of stomach pathology. It is not not uncommon for stomach cancer to be discovered during an anemia test because the tumor can cause chronic micro-bleeding that goes unnoticed.

When we talk about stomach cancer, we first practice a blood test. This allows you to see the presence of chronic bleeding anemia, increased sedimentation rate, indicating the presence of an inflammatory syndrome. The gastroscopy shows the extent of the tumor malignant but also to perform a biopsy which determines what type of cancer the patient has. A ultrasound and/or CT scan of the abdomen complete the diagnosis by specifying the extension of the tumour, that is to say whether there are adenopathies (lymph node metastases), and the metastases affected by distant organs. This bilan d’extension can be supplemented by other examinations depending on symptoms leading to suspicion of another location.

The management of stomach cancer will depend on its type, its stage, the general condition of the patient and the tumor location.

Surgery. In all cases, recourse to surgery is preferred when possible. This reference treatment consists of performing a partial or total gastrectomy in order to remove the tumour. The cancerous area is removed, and the restoration of the continuity of the digestive tract is done by a technique called anastomosis. The operation is generally followed by chemotherapy sessions, more rarely radiotherapy.

Chemotherapy, radiotherapy. Chemotherapy can also be proposed, in addition to surgery or when the latter is contraindicated. Radiotherapy is rarer. Close monitoring is necessary after treatment, due to the risk of recurrence.

We know that several risk factors are linked to stomach cancer, particularly a diet too rich in salt, smoked fish and meat. Reducing the consumption of these products, and promoting that of fruits and vegetables is part of the prevention of stomach cancer. the smoking cessation is obviously essential, as well as stopping the consumption of alcoholic beverages.

Stomach cancer is a so-called cancer with a “poor” prognosis, but the survival rate depends on several factors: the early diagnosis, the extent of the tumour, etc. According to INCA figures, the mortality linked stomach cancer is constantly decreasing in France. the estimated number of deaths related to stomach cancer is 4,272, of which 65% in men.

Incidence and mortality rates by age group in France in 2018 (cross-sectional age curve) ‑ Stomach © Inca

Mortality rates are respectively 3.9 and 1.5 per 100,000. The median ages at death are respectively 73 years in male and of 79 years for women. The risk of dying from this cancer between 0 and 74 years decreases according to the birth cohort, dropping respectively from 1.2% for men born in 1920 to 0.5% for men born in 1950. In women, the risk decreases from 0.4% to 0.2% between the cohort born in 1920 and that born in 1950

Thanks to Dr Anne-Christine Della Valle, for her medical validation.

Source: Report – Volume 1 – Solid tumors – National estimates of cancer incidence and mortality in metropolitan France between 1990 and 2018. INCA.

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