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Stomach Cancer

Disease Details

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Description: Stomach cancer, also known as gastric cancer, is a type of cancer that begins in the mucus-producing cells of the stomach lining.
Type: Stomach cancer, also known as gastric cancer, is primarily a type of carcinoma.

Type of genetic transmission: While most cases of stomach cancer are sporadic and not due to inherited factors, a minority of cases can be linked to hereditary genetic syndromes. Examples include Hereditary Diffuse Gastric Cancer (HDGC) caused by mutations in the CDH1 gene, and Lynch syndrome, which is associated with mutations in mismatch repair genes. However, stomach cancer can also arise from a combination of genetic predisposition and environmental factors.
Signs And Symptoms: Stomach cancer is often either asymptomatic (producing no noticeable symptoms) or it may cause only nonspecific symptoms (which may also be present in other related or unrelated disorders) in its early stages. By the time symptoms are recognized, the cancer has often reached an advanced stage (see below) and may have metastasized (spread to other, perhaps distant, parts of the body), which is one of the main reasons for its relatively poor prognosis. Stomach cancer can cause the following signs and symptoms: Unexplained nausea, vomiting, diarrhoea and constipation. Patients also can experience unexplained weight loss.Early cancers may be associated with indigestion or a burning sensation (heartburn). However, fewer than one in every 50 people referred for endoscopy due to indigestion has cancer. Abdominal discomfort and loss of appetite can occur.Gastric cancers that have enlarged and invaded normal tissue can cause weakness, fatigue, bloating of the stomach after meals, abdominal pain in the upper abdomen, nausea and occasional vomiting. Further enlargement may cause weight loss or bleeding with vomiting blood or having blood in the stool, the latter apparent as black discolouration (melena) and sometimes leading to anemia. Dysphagia suggests a tumour in the cardia or extension of the gastric tumour into the esophagus.These can be symptoms of other problems such as a stomach virus, gastric ulcer, or tropical sprue.
Prognosis: The prognosis of stomach cancer is generally poor, because the tumor has often metastasized by the time of discovery, and most people with the condition are elderly (median age is between 70 and 75 years) at presentation. The average life expectancy after being diagnosed is around 24 months, and the five-year survival rate for stomach cancer is less than 10%.Almost 300 genes are related to outcomes in stomach cancer, with both unfavorable genes where high expression is related to poor survival and favorable genes where high expression is associated with longer survival times. Examples of poor prognosis genes include ITGAV, DUSP1 and P2RX7.
Onset: The onset of stomach cancer typically occurs in individuals aged 55 and older, though it can develop earlier. Early stages often do not present noticeable symptoms, making it challenging to detect in the initial phase. When symptoms do appear, they may include indigestion, stomach discomfort, bloating, nausea, and loss of appetite.
Prevalence: The prevalence of stomach cancer (gastric cancer) varies globally. It is more common in East Asia, particularly in countries like Japan, South Korea, and China. In contrast, prevalence is lower in Western countries. Factors influencing prevalence include dietary habits, Helicobacter pylori infection rates, and genetic predisposition. Please specify the data for a particular region or timeframe for more precise information.
Epidemiology: In 2018, stomach cancer was the fifth most frequently diagnosed cancer worldwide, representing 5.7% of all cancer cases, and the third leading cause of death from cancers, being responsible for 8.2% of all cancer deaths. Among men, 683 754 cases were diagnosed, accounting for 7.2% of all cancer cases, and among women, stomach cancer was diagnosed in 349 947 cases, accounting for 4.1% of all cancer cases.In 2012, stomach cancer was the fifth most-common cancer with 952,000 cases diagnosed. It is more common both in men and in developing countries. In 2012, it represented 8.5% of cancer cases in men, making it the fourth most-common cancer in men. Also in 2012, the number of deaths was 700,000, having decreased slightly from 774,000 in 1990, making it the third-leading cause of cancer-related death (after lung cancer and liver cancer).Less than 5% of stomach cancers occur in people under 40 years of age, with 81.1% of that 5% in the age-group of 30 to 39 and 18.9% in the age-group of 20 to 29.In 2014, stomach cancer resulted in 0.61% of deaths (13,303 cases) in the United States. In China, stomach cancer accounted for 3.56% of all deaths (324,439 cases). The highest rate of stomach cancer was in Mongolia, at 28 cases per 100,000 people.In the United Kingdom, stomach cancer is the 15th most-common cancer (around 7,100 people were diagnosed with stomach cancer in 2011), and it is the 10th most-common cause of cancer-related deaths (around 4,800 people died in 2012).Incidence and mortality rates of gastric cancer vary greatly in Africa. The GLOBOCAN system is currently the most widely used method to compare these rates between countries, but African incidence and mortality rates are seen to differ among countries, possibly due to the lack of universal access to a registry system for all countries. Variation as drastic as estimated rates from 0.3/100000 in Botswana to 20.3/100000 in Mali have been observed. In Uganda, the incidence of gastric cancer has increased from the 1960s measurement of 0.8/100000 to 5.6/100000. Gastric cancer, though present, is relatively low when compared to countries with high incidence like Japan and China. One suspected cause of the variation within Africa and between other countries is due to different strains of the H. pylori bacteria. The trend commonly seen is that H. pylori infection increases the risk for gastric cancer, but this is not the case in Africa, giving this phenomenon the name the "African enigma". Although this bacterial species is found in Africa, evidence has supported that different strains with mutations in the bacterial genotype may contribute to the difference in cancer development between African countries and others outside the continent. Increasing access to health care and treatment measures have been commonly associated with the rising incidence, though, particularly in Uganda.
Intractability: Stomach cancer, also known as gastric cancer, varies in intractability depending on several factors, such as the stage at diagnosis, the specific type of gastric cancer, the patient's overall health, and response to treatment. Early-stage stomach cancer can often be treated successfully with surgery, chemotherapy, radiation, or a combination of these treatments. However, advanced-stage stomach cancer can be more difficult to treat and may be considered intractable, especially if it has spread to other parts of the body. Early detection significantly improves the chances of successful treatment.
Disease Severity: Stomach cancer, also known as gastric cancer, can vary in severity based on the stage at diagnosis. In the early stages, the cancer is localized to the stomach lining and might be curable with surgery. As the disease progresses to more advanced stages, it can invade deeper layers of the stomach wall and spread to other organs, lymph nodes, or distant parts of the body. Advanced stages are more challenging to treat and often have a poorer prognosis. Early detection is crucial for better outcomes.
Healthcare Professionals: Disease Ontology ID - DOID:10534
Pathophysiology: Stomach cancer, also known as gastric cancer, typically begins in the cells lining the stomach. The pathophysiology involves several steps:

1. **Genetic Mutations**: Genetic alterations in the gastric epithelium lead to abnormal cell proliferation. Mutations in genes such as TP53, CDH1, ARID1A, and others are commonly implicated.

2. **Precancerous Changes**: Conditions such as chronic gastritis, intestinal metaplasia, and dysplasia may precede cancer development, with Helicobacter pylori infection often playing a significant role in these changes.

3. **Tumor Formation**: As mutated cells proliferate uncontrollably, they form a primary tumor. The cancer can be of different histological types including adenocarcinoma, the most common type, as well as rarer forms like lymphoma, carcinoid tumors, and gastrointestinal stromal tumors (GIST).

4. **Invasion and Metastasis**: The tumor can invade nearby tissues and spread (metastasize) to distant organs through the lymphatic system and blood vessels. Common metastatic sites include the liver, lungs, and peritoneum.

The progression from normal gastric mucosa to cancer usually occurs over many years and involves both genetic susceptibility and environmental factors such as diet, smoking, and infections like H. pylori.
Carrier Status: Stomach cancer is not typically described in terms of "carrier status" as it is usually not directly inherited in the way that some other cancers can be. However, certain genetic factors and family histories can increase an individual's risk. Specific hereditary conditions, such as Hereditary Diffuse Gastric Cancer (HDGC) caused by mutations in the CDH1 gene, can increase susceptibility to stomach cancer. Overall, the majority of stomach cancer cases are sporadic and influenced by a combination of genetic and environmental factors.
Mechanism: Stomach cancer, also known as gastric cancer, arises when malignant cells form in the lining of the stomach.

**Mechanism:**
The mechanism of stomach cancer typically involves the uncontrolled growth of abnormal cells in the stomach lining. This can progress through several stages, starting from chronic inflammation and atrophy, developing into intestinal metaplasia, dysplasia, and eventually adenocarcinoma.

**Molecular Mechanisms:**
1. **Genetic Mutations:** Mutations in specific genes such as TP53, CDH1 (E-cadherin), KRAS, HER2, and others contribute to the development and progression of gastric cancer. These mutations can lead to the loss of normal cell cycle control and apoptosis, enabling uncontrolled cell division.

2. **Epigenetic Alterations:** DNA methylation, histone modification, and alterations in non-coding RNAs (such as microRNAs) play critical roles in regulating gene expression without changing the DNA sequence, contributing to gastric tumorigenesis.

3. **Helicobacter pylori Infection:** Chronic infection with H. pylori leads to prolonged inflammation, which can cause genetic and epigenetic changes in the gastric epithelium. It increases the risk of developing atrophic gastritis, metaplasia, and eventually gastric cancer.

4. **Signaling Pathways:** Dysregulation of cellular signaling pathways, including Wnt/β-catenin, NF-κB, PI3K/AKT/mTOR, and TGF-β, contributes to gastric cancer development by promoting cell proliferation, migration, survival, and angiogenesis.

5. **Environmental and Lifestyle Factors:** Factors such as diet (high intake of smoked, salted, and pickled foods), smoking, and alcohol consumption can cause direct DNA damage or interact with genetic susceptibilities to promote cancerous changes.

Understanding these mechanisms is crucial for developing targeted therapies and improving the diagnosis and management of stomach cancer.
Treatment: Stomach cancer treatment options typically include:

1. **Surgery:** To remove part or all of the stomach.
2. **Chemotherapy:** Uses drugs to kill cancer cells, can be given before (neoadjuvant) or after (adjuvant) surgery.
3. **Radiation Therapy:** Uses high-energy rays to target and kill cancer cells.
4. **Targeted Therapy:** Uses drugs that specifically target cancer cell mechanisms.
5. **Immunotherapy:** Helps the immune system fight cancer.
6. **Palliative Care:** Relieves symptoms and improves quality of life.

The type of treatment chosen depends on factors like the cancer's stage, location, and patient's overall health.
Compassionate Use Treatment: Compassionate use treatment, which allows patients with serious or life-threatening conditions to access investigational drugs outside of clinical trials, may include several options for stomach cancer. These can involve medications that are still in the experimental stage or not yet approved by regulatory authorities for this cancer type.

Off-label treatments for stomach cancer involve using approved drugs in a manner not specified in the FDA's (or other regulatory body’s) approved packaging label. Some off-label treatments for stomach cancer may include:

1. **Trastuzumab (Herceptin)**: Originally approved for breast cancer, it can be used off-label for HER2-positive gastric cancer.
2. **Pembrolizumab (Keytruda)**: An immunotherapy drug used for other cancers; it may be prescribed for certain cases of advanced stomach cancer.
3. **Ramucirumab (Cyramza)**: Approved for advanced gastric cancer but may also be used off-label in various combinations with other therapies.

Experimental treatments in clinical trials for stomach cancer include:

1. **Immunotherapy**: Newer agents and combinations being studied for efficacy and safety.
2. **Targeted Therapy**: Investigating novel agents that target specific mutations or biomarkers associated with stomach cancer.
3. **Combination Regimens**: Combining existing drugs in novel ways to enhance efficacy and reduce resistance.

Patients interested in these treatments should discuss them thoroughly with their oncologists, who can provide guidance based on individual health conditions and suitability for clinical trials or compassionate use programs.
Lifestyle Recommendations: Lifestyle recommendations for stomach cancer include:

1. **Healthy Diet**: Consume a diet rich in fruits, vegetables, and whole grains while limiting processed and red meats, salty foods, and pickled foods.
2. **Avoid Smoking**: Smoking is a major risk factor for stomach cancer. Quitting smoking can significantly reduce the risk.
3. **Limit Alcohol**: Moderation in alcohol consumption can decrease the risk of developing stomach cancer.
4. **Maintain a Healthy Weight**: Obesity is linked to an increased risk, so maintaining a healthy weight through diet and exercise is beneficial.
5. **Regular Physical Activity**: Engage in regular physical activity to help maintain a healthy weight and improve overall health.
6. **Reduce Helicobacter pylori Infection Risk**: Seek treatment for Helicobacter pylori infection, which is a known risk factor for stomach cancer.
7. **Regular Medical Checkups**: Especially if you have risk factors like a family history of stomach cancer, regular checkups can help in early detection and prevention.
Medication: Medications for stomach cancer may include chemotherapy drugs such as fluorouracil (5-FU), capecitabine, cisplatin, oxaliplatin, and irinotecan. Targeted therapy drugs like trastuzumab can be used if the cancer cells have certain genetic markers. Immunotherapy, such as pembrolizumab, may also be considered in some cases.
Repurposable Drugs: Research in repurposing drugs for stomach cancer has shown promise in using medications originally developed for other conditions. Drugs such as metformin (used for diabetes), statins (used for high cholesterol), and aspirin (an anti-inflammatory) have been studied for their potential anticancer effects. Additionally, certain antidepressants and antihypertensives are being explored for their ability to inhibit cancer progression and improve treatment outcomes. Further clinical trials and research are necessary to establish the efficacy and safety of these repurposed drugs in the context of stomach cancer.
Metabolites: For stomach cancer, typical metabolite changes include alterations in amino acids, lipids, and glycolytic intermediates. Specifically, increased levels of lactate, pyruvate, and certain amino acids such as glutamate may be observed. Various lipid metabolism pathways can also be affected, leading to changes in the levels of fatty acids and phospholipids.
Nutraceuticals: Nutraceuticals are food-derived products that offer health and medical benefits, including the prevention and treatment of diseases. In the context of stomach cancer, various nutraceuticals have been studied for their potential therapeutic effects. Some of these include:

1. Curcumin: Found in turmeric, curcumin has anti-inflammatory and anticancer properties.
2. Resveratrol: A compound in grapes and red wine, known for its antioxidant effects.
3. Epigallocatechin gallate (EGCG): A type of catechin found in green tea, with potential anticancer properties.
4. Lycopene: Present in tomatoes and other red fruits and vegetables, lycopene has antioxidant and anti-proliferative effects.
5. Omega-3 fatty acids: Found in fish oil, these have been shown to possess anti-inflammatory and anticancer properties.

The term "nan" could be a reference to "nanotechnology" in cancer treatment or simply an unfinished thought. If referring to nanotechnology, this field involves the development of nanoparticles for targeted drug delivery, imaging, and diagnosis in cancer treatment. In stomach cancer, nanotechnology has the potential to improve the efficacy and reduce the side effects of conventional therapies by targeting cancer cells more precisely.

If "nan" refers to something else, please provide more context so I can assist you accurately.
Peptides: In the context of stomach cancer, peptides are short chains of amino acids that can be used in various therapeutic and diagnostic approaches. Peptides can help target specific proteins on cancer cells, potentially leading to more effective treatments. They are also being explored in vaccine development to stimulate the immune system to recognize and attack cancer cells.

Nanotechnology, or nanomedicine, involves designing nanoparticles for targeted drug delivery, imaging, and other therapeutic purposes. In stomach cancer, nanotechnology can be used to enhance the precision of drug delivery, reduce side effects, and improve the effectiveness of treatments. Nanoparticles can also be used for early detection and diagnosis through advanced imaging techniques.

Combining peptides and nanotechnology may offer synergistic benefits in treating stomach cancer, providing a promising area for ongoing research and development.