Tumor of the stomach treatment. What is a submucosal formation of the stomach? Laboratory and instrumental research

Tumor of the stomach is the most common and insidious oncological disease. Regarding statistics, cancer diseases stomach firmly entrenched in second position, losing first place to lung cancer.

Almost 95% of stomach tumors, the symptoms of which are on initial stage development are identical to gastritis, are malignant. In men, this disease occurs much more often than in women. The risk of getting this disease after 45 years is much greater than in other age categories.

Existing bases of a tumor of the stomach

A malignant tumor is formed from epithelial cells of the gastric mucosa. The disease can affect any part of the body:

• Main or middle section.
• External at the immediate boundary with the pharynx.
• The lower section is near the intestines.

Of course, in a healthy body, a tumor will not occur. The development of oncology happens if, for some reason, a completely healthy cell begins to change, gradually developing into a cancerous one. The direct causes of cell mutation have not been found. But the main reasons for the formation of tumors can be attributed to a number of reasons:

The risk group includes patients who are overweight.

Malignant and benign tumors of the stomach

Sarcoma is classified as a malignant neoplasm. This disease is observed mostly in young people. An essential distinguishing feature of sarcoma is that it rarely metastasizes to other organs. Immediate symptoms of the disease:

• Feverish state.
• Gastric disorders.
• Bleeding.

Diagnosis is made using radiography. Treatment is contained in the surgical elimination of the neoplasm, postoperative treatment is carried out with the help of radiation treatment and chemotherapy. There are also benign tumors of the stomach. As a rule, such neoplasms are:

1. Epithelial - These are polyp formations with a mushroom-like surface. Sometimes these neoplasms turn into ulcers.
2. Neurinomas, hemangiomas, fibromas are classified as non-epithelial. Such neoplasms, as a rule, mature in the submucosal or muscle tissues. Regarding their configuration, they can be quite large with a smooth surface.

Symptoms of the disease are almost not expressed. With gastritis, expressions in the form of belching, nausea, vomiting after eating, and pain are likely. If the neoplasms have taken the form of an ulcer, then in this case it can lead to gastric bleeding. Diagnosis of such neoplasms is performed using gastroscopy. At this disease the only treatment option is surgery.

Features of the expression of the tumor of the stomach

When gastric cancer is detected in the early stages of development, the probability of a complete cure is quite high, and the immediate five-year survival rate is about 90%. But, as a rule, gastric cancer is detected to a greater extent at the late stages of formation, which significantly reduces survival rates. Therefore, in order to detect a tumor of the stomach in time, it is necessary to know the symptoms and, with slight doubts, resort to the help of a specialist to undergo a more thorough examination.

You should be aware that the signs of a stomach tumor are not always the same in different patients. Since the symptoms depend on the immediate location of the growth, and its histological type. The development of a tumor in the cardinal area of ​​the stomach is indicated by difficulties that begin when swallowing coarse food or its large chunks. Also clear symptom is salivation. Naturally, with an increase in the neoplasm, the symptoms become more pronounced.

If the tumor is located in the lower region of the stomach, then the symptoms will be somewhat different. With such a focus of the disease, the patient has vomiting, one feels constant heaviness, halitosis. A number of symptoms indicate the presence of a tumor:

• Loss of appetite.
• Apathy.
• Dizziness.
• Mass loss.

Symptoms of stomach swelling

It should be noted that there are no pronounced symptoms with this type of stomach tumor. The initial stage of the development of oncology is quite difficult to identify. As a result, mistreatment occurs. Since most of the ailments of the gastrointestinal tract have similar symptoms, therefore, it is quite difficult to correctly diagnose the development of oncology from them. But still the most likely symptoms oncology can be distinguished:

Immediate expression malignant tumor, the presence of metastasis, the dimensions of the formation, the level of germination in the body - all these nuances affect the determination of the method of healing. Medicine, as a rule, offers 3 treatment options for this disease:

• Elimination of a neoplasm by the method of surgical treatment.
• Chemotherapy.
• Radiation healing.

The direct method of treatment is appointed by a specialist after a complete and thorough examination. If cancer is detected at the initial stages of development, therefore, there are no metastases, then it is possible complete healing patient. During surgical intervention, as a rule, the injured area of ​​​​the stomach lining, adjacent tissues and lymph nodes are cut out. Radiation therapy is performed to reduce the size of the tumor and prevent the subsequent growth of pathological cells. Chemotherapy is used to cure 4 periods of cancer, when metastases are already present in the body.

With such a diagnosis, special attention should be paid not only to therapeutic treatment, but also to the daily diet. Experts recommend avoiding foods containing nitrates. Since these substances have the ability to be modified into nitrins and form nitrosamines. Which sometimes act as the root cause of tumors in the stomach. Products with antioxidants, vitamins C and E can prevent the creation of nitrosamines. Experts note that the diet of patients diagnosed with oncology must include food with a little glycemic index. Since such food is not so quickly digested and is able to regulate the amount of sugar in the blood.

Such patients need to eat often, but in small portions. You should also drink more liquid before and after a meal. You should reduce the consumption of sweets, or completely eliminate from the diet. To avoid the occurrence of tumors in the stomach, you should eat the right, healthy and balanced food, be sure to refrain from smoking and drinking alcohol.

Excellent cancer prevention are fruits and vegetables, green tea. Experts recommend focusing on frozen foods, as they retain all useful material. But it is better to refuse canned foods, because they contain great amount carcinogens.

Today it is very difficult to find a person who does not suffer from stomach diseases, and gastritis is considered a normal part of the life of almost every person living in a metropolis. We are so accustomed to modern world very difficult to balance healthy eating that we let stomach problems take their course, which can subsequently lead to very sad consequences, because in almost 95% of the stomach tumor turns out to be malignant, and the disease itself is in second place after lung cancer.

In today's world, men are more exposed to this disease than women, especially the risk increases after reaching 45 years. Recently, there has been a small wave of decrease in the statistics of the disease, but it is still too early to talk about the complete absence of danger.

Classification of tumors of the stomach

Depending on the type of tissue from which the tumor originated, they are divided into benign and malignant - this classification not only tells us about the danger of the neoplasm, but also indicates the main site of inflammation.

A benign tumor of the stomach is a polyp, a glandular formation that has a round shape. There is also a quantitative classification:

• Single polyps;
• Multiple polyps;
• Polypos.

Classification of the structure of polyps:

• Adematous - with a size of more than fifteen millimeters, they are converted into a tumor.
• Hyperplastic - develop in connection with atrophic gastritis.
• Inflammatory connective tissue tumors are not.

There is also a classification of tissues from which a benign neoplasm can occur:

1. muscular (leiomyoma);
2. submucosal layer (lipoma);
3. blood vessels (angioma);
4. nerve fibers (neurinoma);
5. connective tissue (fibroma).

The classification of gastric tumors also includes malignant tumors. Most of these neoplasms are of epithelial origin. Gastrointestinal stromal tumor of the stomach is also a malignant tumor, although it accounts for only one percent of total cases. Other tumors include:

• carcinoid - a tumor capable of producing hormones;
• leiomyoblastic tumor - contains epithelial and smooth muscle cells;
• leiomyosarcoma - matted smooth muscle cells.

The main causes of occurrence

epithelial cells located on the inner wall gastric tract- a common site of tumor occurrence. Cancer can develop in any of the gastric regions:

1. main or middle departments;
2. on the border with the esophagus - the upper section;
3. on the border with the intestines - the lower section.

As in other areas of oncological abnormalities, scientists have not been able to identify exact time and the cause of a cell mutation that results in a tumor. However, scientists were able to find out what events precede the onset of tumor formation. In a healthy stomach, a neoplasm cannot develop, which means that there must be reasons that lead to a change in the gastric composition.

Out of everything known causes the following classification can be made:

• heredity: stomach ulcer, polyps, gastritis (with low acidity);
• the use of foods that provoke the appearance of gastric diseases: smoked, spicy, fried. This also includes drinking alcohol, smoking;
• the presence of the bacterium helicobacter pylori in the stomach;
• low levels of vitamins B12 and C can also cause stomach cancer.

Signs of a stomach tumor

The main problem of identifying this terrible disease is that on early stages appearance, the symptoms are very similar to ordinary gastritis, which pushes doctors to determine this particular diagnosis and prescribe the wrong treatment.

Sharp changes or pains at the initial stage of the tumor of the stomach are not observed, however, after a while the patient begins to experience all the signs of the tumor inherent in patients:

1. fatigue;
2. apathy;
3. lack of appetite;
4. depression;
5. pale skin;
6. sharp weight loss;
7. development of pernicious anemia is possible.

A tumor of the stomach, the symptoms of which are listed above, is also accompanied by unpleasant sensations in the esophagus itself: there is a feeling of overeating and heaviness even after a small portion of food, the patient experiences nausea, which is often accompanied by vomiting. In later stages, a person's skin acquires a grayish tint, back pain appears (if metastases also appear in the pancreas), bleeding is possible. Only non-epithelial tumors of the stomach are asymptomatic in the first stages and are mostly benign.

The internal development of a stomach tumor occurs as follows:

• the cancer cell grows to about 2 cm;
• then it begins to penetrate both deep into the tissues and spread over the surface, preventing food from entering the stomach or entering the intestines, depending on its location;
• then it spreads to the colon and pancreas, and metastases penetrate the peritoneum, ovaries and liver.
• cancer cells are separated and spread throughout the body with the help of the bloodstream and lymph.

Diagnosis and treatment

To correctly establish the diagnosis and determine the stage of the disease, the patient must undergo the appropriate tests:

1. x-ray of the pancreas;
2. Ultrasound of the abdominal cavity;
3. gastroscopy;
4. biopsy;
5. CT scan.

This stage is the most important - the fate of the patient will depend on the results of this range of studies. If a malignant tumor of the stomach was nevertheless found, then it is at this stage that its size, boundaries and stage of the disease itself are determined.

Most often, after the examination, a decision is made to remove part of the stomach or the entire stomach as a whole. If a tumor of the stomach, the treatment of which is no longer possible, has spread to other organs: the spleen, liver or intestines, then they must also be removed.

After the operation, in order to reduce the possibility of metastases and prolong remission, courses of chemotherapy and radiation therapy are carried out, and a course of drugs is prescribed to maintain and restore the body itself. great content vitamins and minerals.

The purpose of chemotherapy is to destroy cancer cells. Sometimes it is prescribed even before surgery and is an intravenous infusion of special drugs. Radiation therapy is carried out remotely and occurs due to the irradiation of the necessary organs, which slows down the process of tumor development.

Treatment with folk remedies

It is difficult to imagine that such a serious disease can be cured only by self-hypnosis or folk remedies. Modern medicine does not admit the possibility that this is possible and generally hardly recognizes alternative methods of treatment. Nevertheless, there are adherents of similar methods, and there are several reasons for this:

• More than once we have heard versions that a cure for any type of cancer has long been invented, but since the treatment in most cases costs the patient a tidy sum, any attempts to leave chemotherapy and other treatments in the past are cut off in the bud. Pharmacology is a huge business that dictates to doctors how and with what it is worth treating patients. No one claims that the known methods of cancer treatment are ineffective, however, there are already a lot of questions about them.
• Sometimes doctors refuse to treat a patient, promising only to "reduce pain" - this also pushes people to self-medicate.
• There are many additional methods of treatment to classical medicine - they do not run counter to the prescribed procedures and may well help the patient in maintaining immunity. We will discuss these methods below.

Treatment with oils and juices

This method of treatment is rather a panacea, officially recognized as a method of fighting cancer for weeks, however, it has also been widely used. The thing is that oils are saturated with useful substances and have enveloping properties that protect cells from damage. However, despite the general belief, the applicable oils directly into the body significantly reduces it. beneficial features- many substances are destroyed in the process of digestion. The surest way to absorb all the beneficial substances is to rub it into previously cleansed skin.

For the treatment of cancerous tumors, the most saturated oils are used: avocado, sea buckthorn, cedar, chestnut, lilac, flax, eucalyptus, chicory, etc.

Juice treatment is a worthy alternative to oil treatment. The fact is that natural juices saturated with vitamins and minerals, which are so needed by the body, invigorating with oncology. However, the weakened gastric compartment does not always cope with the digestion of food, and the consumption of juices significantly facilitates its work.

The most useful juices for gastric tumors are nettle and dandelion juice. They will bring especially many benefits in the spring season - at the beginning of ripening. The juice of these plants increases the immune properties of the body, saturates it with energy and increases efficiency, so do not neglect at least a few spoons a day. It is better to drink juice before meals to increase acidity and make food easier to digest, however, this advice is relevant only in the case of low stomach acidity.

Do not forget about the antioxidants that are found in juices in large quantities, and have antitumor activity. In the presence of tumors, doctors advise replacing early breakfast with juices, when the body is still saturated due to dinner.

Prevention of tumor development

Today, all the reasons for the appearance of a gastrointestinal stromal tumor of the stomach have not yet been fully studied, but we can already say that the basic patterns and risk zones have been identified, which allows us not only to fight its development, but also to carry out targeted prevention. Scientists have proven that the use of food certain products can significantly reduce the risk of the disease, while you should not look for a special diet, but it is enough to include only a few foods in the diet.

Do not neglect timely research, with the help of which it is possible to identify and remove the tumor even in the early stages of its development. It is worth taking a closer look at your body - do not postpone the examination with the following symptoms:

1. a high fever that doesn't go down without showing other flu or cold symptoms
2. rapid weight loss;
3. prostration;
4. change in taste habits;
5. bowel dysfunction.

It cannot be denied that the main thing on the way to recovery is the very desire of the patient to recover - in this case, any methods of treatment will acquire a completely different meaning. On the this moment does not exist right way prevent the development of a tumor, and each of us is more or less at risk. However, you can very well minimize the possibility of illness - watch your diet, give up bad habits and do not start stomach diseases. After 45 years, it is worth taking as a norm to come to an appointment with a gastroenterologist, so that, in the event of an inflammatory process, it should be immediately identified.

Crayfish- that this is a disease, or something unknown, scary word(disease), under which lies a hidden meaning, and even worse - sad consequences. Cancer, or as it is commonly called a malignant tumor, has the ability to grow, when faster, at other times slower. But, perhaps, the only thing that unites all malignant processes is dysfunction, destruction internal organs in which they grow and spread throughout the body.

Endoscopic diagnostic method is considered to be the most reliable method in identifying various pathologies. upper division gastrointestinal tract, including stomach cancer. With the help of this modern apparatus, the degree of damage to the mucous membrane, the presence of scars, and improperly located folds are visualized. If necessary, in doubtful cases, it is also possible to take a piece of tissue from the affected area for microscopic examination. The presence of a cancerous process is confirmed by the presence of atypical malignant cells.

Laboratory research
Laboratory diagnostic methods are not widely used in the detection of tumor-like processes of the stomach and duodenum. An indirect confirmation of the pathological process (the appearance of ulcers on the mucous membrane of the stomach and duodenum) is positive reaction analysis of feces for occult blood (Gregersen reaction).

Treatment of cancerous tumors of the stomach

Radiological method as independent method treatment, due to the possible risk of irradiation of neighboring healthy organs not produced. In some cases, if the necessary equipment is present, the stomach is irradiated already during the operation. Wherein X-rays penetrate directly into the cells affected by the cancerous tumor.

Chemotherapy, as well as the radiation method, has an indirect value, which consists in the fact that the patient takes special chemotherapy drugs. medicines courses before and after the operation.
Application question helper methods treatment is decided in each individual case individually. It all depends on the availability of the necessary equipment and the qualifications of the staff. In any case, gastric cancer is a curable disease if detected early. But if the cancerous process is quite common and detected in the later stages of development, the question is raised about the so-called palliative operations, in which it is impossible to remove tumor-affected organs from the body without causing significant harm to health or simply without death. Palliative surgery involves reducing the suffering of the patient and the temporary extension of life.

Prevention of stomach cancer

• Prevention of the occurrence of stomach cancer involves actions aimed at preventing the occurrence of chronic diseases gastrointestinal tract. Throughout life, it is necessary to follow the general rules of the sanitary and hygienic regime, eat right, and, if possible, exclude the occurrence of stressful situations that can lead to the appearance of a stomach ulcer.
• Prevention of such precancerous diseases like pernicious anemia, chronic gastric and duodenal ulcers are of exceptional importance in preventive measures aimed at preventing the development of malignant neoplasms of these organs.
• Reducing the influence of harmful factors environment such as automotive traffic fumes, industrial waste.
• Nitrates, nitrites, contained in large quantities in greenhouse plants (tomatoes, cucumbers), smoked meats, also need to be limited in nutrition, since these products are dangerous from the point of view of a carcinogenic effect on the body.
• Observe moderation in the use of various medications.
• Fresh fruits and vegetables rich in vitamins, macro and microelements will balance the diet. also fresh vegetables and fruits are a good source of antioxidants, which are effective in the fight against the appearance of cancer cells.

What are the stages of development of stomach cancer?

Suggested below clinical classification gastric cancer, in addition to the four main stages, includes substages for a more accurate description of each tumor process.

Stomach cancer stages

What are the first symptoms of stomach cancer?

The first symptoms of stomach cancer

It is worth noting that the symptoms of stomach cancer may resemble such diseases of the gastrointestinal tract as peptic ulcer, gastritis, and some benign tumors. That is why when the above symptoms appear, it is necessary to carry out endoscopic diagnostics in a timely manner ( gastroscopy) or radiography of the stomach with contrast ( using a suspension of barium), since the earlier cancer is detected, the more likely it is to be completely cured.

How long do people live with stomach cancer?

It is worth noting that the earlier this oncological disease was detected, the greater the likelihood of a complete cure.

Prognosis and Survival in Gastric Cancer

What should be the diet for stomach cancer?

The diet has the following tasks:

• provides the human body with all the necessary macronutrients ( proteins, fats and carbohydrates) and trace elements ( vitamins and minerals);
• normalizes metabolism;
• improves the results of anticancer treatment;
• reduces the likelihood of postoperative complications;
• helps to strengthen the immune system;
• improves the quality of life before and after surgery.

Proper nutrition for stomach cancer includes the following:

• Complete nutrition. The human body must receive required amount proteins, lipids, carbohydrates, vitamins and minerals every day. The recommended ratio of macronutrients is as follows - 55% carbohydrates, 30% lipids and 15% proteins. It is also worth noting that in each individual case, this ratio must be adjusted. It is necessary to fully cover the needs of the body in all nutrients, as this helps to strengthen and restore the compensatory functions of the body. It is worth noting that with malnutrition, the chances of a successful cure are significantly reduced.
• Fractional nutrition. It is extremely important not to overload the stomach too much. To do this, you need to eat in small portions from 4 to 8 times a day. In this case, the load on the gastrointestinal tract will be reduced to a minimum. You should also chew food thoroughly, since when large food particles enter the stomach, more hydrochloric acid and digestive enzymes should be produced ( pepsin, gelatinase).
• Exclusion from the diet of all irritating substances. It is necessary to exclude excessively sweet, salty, spicy, fatty and smoked dishes from eating, as they can greatly irritate the organs of the gastrointestinal tract. It is worth significantly reducing the intake of vegetables that can cause bloating, namely beans, peas, soybeans, cabbage and onions. It is not recommended to eat fruits that contain a lot of acid - lemons, oranges, grapefruits, plums, currants. Contraindicated in the use of any products that contain a large amount of preservatives and food additives. Also, often with stomach cancer, a change in taste habits occurs. Most often, patients develop intolerance to meat products. In this case, it is necessary to exclude meat from the diet and find an alternative. protein nutrition. It is worth noting that food should be at the optimum temperature, that is, neither hot nor cold, so as not to irritate the gastric mucosa.
• Complete failure from alcohol. Ethyl alcohol, which is contained in alcoholic beverages, has an extremely adverse effect on the mucous membrane of the entire gastrointestinal tract and on the stomach in particular. Alcohol increases the secretion of hydrochloric acid, and also violates the integrity of the gastric mucosa. That is why the intake of any alcoholic products should be completely excluded.

For parenteral nutrition, solutions of amino acids, fat emulsions ( solution of fats in water), glucose solution, multivitamin complexes and trace elements, as well as combined preparations, which may include several of the above-mentioned solutions at once.

Is it possible to treat stomach cancer with folk remedies?

Traditional medicine is by no means an alternative to the above methods of treatment, since no medicinal tincture or a decoction will not be able to protect against tumor growth and its metastasis ( penetration of cancer cells into other organs and tissues). However, traditional medicine may be effective already in the postoperative period, when the general condition is stabilized and the risk of recurrence ( recurrence of the disease) is significantly reduced. The folk remedies described below normalize metabolism, increase immunity, and also help to speed up the recovery period.

During the recovery period(completion of illness)You can use the following folk remedies:

• Tincture of celandine. Take 1 kilogram of celandine root and dry it well for 6 hours. Then you need to scroll this root in a meat grinder. Add 0.5 liters of vodka to 0.5 liters of the resulting juice. Should insist 3 weeks. It is necessary to apply the tincture one tablespoon 4-5 times a day before meals. The course of treatment lasts from 1 to 3 months.
• Black radish tincture. It is necessary to grate 1 kilogram of washed radish ( along with skin) and pour 1 liter of vodka. In the future, the tincture is kept for 14-15 days in a dark and warm place, while periodically shaking. Take the tincture should be 50 milliliters 3-4 times a day for half an hour before meals.
• A decoction of potato flowers. You should brew 10 grams of dried potato flowers in a liter of boiling water. Then the broth should be placed in a thermos and infused for 4 to 5 hours. A decoction is taken daily, 100 milliliters after each meal.
• Tincture of pelargonium leaves and aloe. Dilute 20 grams of aloe juice with 0.5 liters of vodka. Pour 4 sheets of pelargonium with 50 milliliters of boiling water and place in a thermos for 12 hours. Pelargonium tincture is mixed with aloe with vodka and 3-4 drops of iodine are added. This tincture should be taken 50 grams 15 to 20 minutes before breakfast.
• Propolis pills. Melt 400 grams of butter and 100 grams of propolis. After the mixture has cooled, add 2 tablespoons of honey to it. This mixture is then rolled in cornmeal and made into pea-sized pills. It is necessary to take pills in the amount of three pieces 3 times a day 15-20 minutes before meals.

What is ring cell carcinoma of the stomach?

Most often, ring cell carcinoma affects young and middle-aged people, mainly women. On cytological and histological examination ( examination of tissue taken after a biopsy) altered flat cells of the stomach in the microscope resemble rings ( from which this form got its name).

Ring cell carcinoma of the stomach has the following features:

• It is a hormone dependent tumor. In the majority of male patients with ring cell carcinoma of the stomach, an increase in blood testosterone was detected ( main male sex hormone), while the patients had increased levels of estrogens - female sex hormones. This proves that this tumor most often occurs against the background of hormonal disorders.
• It occurs more often in women than in men. Various studies have shown that in women, ring cell carcinoma of the stomach is diagnosed slightly more often than in men. Average, this form cancer is detected in 55% of cases in women, while in men - in 45% of cases.
• More often detected in young people. It was noticed that this species Gastric cancer in most cases is detected in people whose age does not exceed 35 - 40 years.
• High degree of aggressiveness. Ring cell carcinoma is characterized rapid growth and aggressive flow. Often, this type of cancer is diagnosed already in the later stages, when the tumor has already metastasized to other organs.
• There is no connection with the occurrence of this form of cancer on the background of malnutrition. It has been found that people who eat a balanced diet and limit themselves to eating excessively fatty, salty and spicy foods are diagnosed with ring cell cancer with the same frequency as people who do not follow a diet.

Can stomach cancer be cured?

The most favorable prognosis is observed when the cancer is at the first or second stage of its development. In this case, the tumor grows only in the mucous and muscular layer of the stomach wall, is characterized by relatively small size ( up to 5 centimeters in diameter), and also does not give distant metastases to other organs ( kidneys, liver, bones, brain, lungs). The only problem is that at these stages of gastric cancer, the tumor, as a rule, does not manifest itself, which greatly complicates its detection. Treatment of stage III gastric cancer, when the tumor affects the entire wall of the stomach and is large ( more than 6 - 10 centimeters) presents a significant challenge. The prognosis in this case is unfavorable, and the five-year survival ( percentage of people who survive five years after cancer is diagnosed) after surgical treatment is, on average, 15 - 40% of all patients. The worst prognosis is observed when diagnosing the fourth degree of gastric cancer. In this case, the five-year survival rate is less than 3-5%.

Treatment of stomach cancer is carried out by the following methods:

• Surgical method is the gold standard treatment for stomach cancer. If the tumor is relatively small and does not metastasize, then only partial removal of the stomach is performed. At the same time, the tumor and part of the nearby healthy tissue are removed along with regional ( local) lymph nodes. This operation is currently performed laparoscopically, in which access to the stomach is through small openings in the upper part. abdominal wall. In one of the holes, the surgeon inserts a laparoscope containing an optical system that transmits an image to a screen. For more massive tumors, complete removal stomach ( resection) followed by restoration of the continuity of the digestive tract ( perform abdominal surgery). If the tumor grows into neighboring organs, the surgeon decides whether to remove these affected tissues. With multiple metastasis of a cancerous tumor, a palliative operation can be performed, in which the main task is to improve the patient's quality of life, since a cure is no longer possible.
• Chemotherapy. Chemotherapy is often used in combination with surgical treatment. This method treatment is based on the use of highly toxic and poisonous substances that stop the growth of tumor cells. Chemotherapy drugs can be taken by mouth or intravenously. They can be prescribed both before surgery, in order to stop the growth of the tumor and reduce its size, and after the intervention to reduce the likelihood of metastases. In some cases, not one, but several types of chemotherapy drugs are used at once ( polychemotherapy). It is worth noting that these chemotherapy drugs affect not only tumor cells, but also healthy cells, which can cause various side effects ( bone marrow depression, hair loss, damage to the gastrointestinal tract, heart, liver, skin, etc.).
• Radiotherapy rarely used in the treatment of stomach cancer. The fact is that exposure to ionizing radiation ( x-rays, gamma radiation, beta radiation, and neutron radiation) in the case of stomach cancer has more disadvantages than advantages. Radiotherapy can only be used in the postoperative period to prevent tumor recurrence ( relapse). As a rule, radiotherapy is part of complex treatment regimens that include surgical removal and chemotherapy.

Is Chemotherapy Necessary for Stomach Cancer?

Chemotherapy may be taken different ways. Most often they are taken orally ( orally) or intravenously. Depending on the type of chemotherapy, treatment can be done in a hospital or at home.

There are several types of chemotherapy:

• adjuvant chemotherapy used in the postoperative period. The main goal of adjuvant or additional chemotherapy is to reduce the likelihood of metastases ( spread of tumor cells to other tissues and organs). It was previously believed that this type of chemotherapy is ineffective, but recently many oncologists are reconsidering this point of view. It is also possible to use neoadjuvant chemotherapy, when drugs are taken before surgery in order to slow down the growth and reduce the size of the tumor.
• Palliative chemotherapy It is used when the cancer has already metastasized to other organs and surgical treatment is not possible. In fact, palliative chemotherapy is used only to improve the quality of life and cannot affect the outcome of malignant cancer.
• Polychemotherapy represents complex treatment, in which several types of chemotherapy drugs are used at once. As a rule, such medicines are selected that block the growth of tumor cells in various ways. Unlike monochemotherapy ( single drug treatment), polychemotherapy is more likely to be successful, although it causes more complications.

Since toxic and highly toxic substances are used during chemotherapy, various side effects often occur after a course of treatment.

The most common complications after chemotherapy are:

• Inhibition of hematopoiesis. Chemotherapy drugs have a depressing effect not only on cancer cells, but on absolutely all cells of the human body. Bone marrow cells, which are responsible for hematopoiesis, are very sensitive to this effect. The most commonly damaged white blood cell precursors ( leukocytes), as well as platelets ( platelets). Inhibition of hematopoiesis is maximally manifested 1-2 weeks after the start of the course of treatment with chemotherapy drugs.
• Hair loss ( alopecia) is also quite common side effect occurring during chemotherapy. Some chemotherapy drugs can adversely affect and damage the hair follicle ( pouch), leading to hair loss. This complication is a significant psychological trauma for young people, especially girls and women. It is worth noting that hair loss is a temporary phenomenon and after 4-6 months the hair begins to grow again.
• Decreased local and general immunity. Chemotherapy drugs can significantly reduce immunity by suppressing cells of the immune system ( lymphocytes). This can lead to the fact that the human body becomes extremely sensitive to various kinds of infectious diseases.
• Damage to the gastrointestinal tract. While taking certain chemotherapy drugs by mouth ( in tablet form) often there are various symptoms of damage to the mucous membrane of the digestive tract. This is most often manifested by the appearance of nausea, vomiting, diarrhea or stomatitis ( mucosal inflammation oral cavity ). Liver cells can also be damaged. In this case, an increase in liver tests will be detected in the blood ( aminotransferases) and bilirubin ( hyperbilirubinemia).

Is surgery necessary for stomach cancer?

The amount of surgery depends on various factors. First, the size of the tumor itself is taken into account. Secondly, the number of affected local ( regional) lymph nodes. Thirdly, how deep the tumor has grown into the wall of the stomach. And fourthly, the presence or absence of distant metastases ( spread of tumor cells) in tissues and organs. Also an important factor is the general state of health and the presence of concomitant diseases.

Most often, patients must undergo chemotherapy before surgery. Chemotherapy drugs, which are toxic and poisonous medicines, stop the growth of a cancerous tumor and also reduce its size.

If a cancerous tumor of a small size was detected, in which tumor cells grow only into the mucous and muscle layers, then surgical operation laparoscopic method. This method is minimally invasive ( less traumatic) and involves making several small incisions in the upper part of the abdominal wall. A laparoscope is inserted through one of these holes - a special instrument that has an optical system and transmits an image to the monitor, and other holes are injected surgical instruments. Removal requires not only the tumor itself, but also nearby healthy tissues, as well as local lymph nodes, since they may contain tumor cells.

With larger malignant processes when the tumor affects the entire or almost the entire stomach, the question arises of the complete removal of the stomach ( total resection of the stomach). In this case, resort to abdominal operations. During this operation, the surgeon makes a wide incision through which access to the stomach is made. After gastric resection, the surgeon also examines nearby organs for the presence of metastases in them. After a gastrectomy removal of the stomach) the continuity of the digestive tract is restored by stitching the stomach stump with a loop of the small intestine.

After the operation, it is also necessary to undergo a course of chemotherapy. In this case, chemotherapy drugs reduce the likelihood of recurrence ( relapse) cancerous tumor.

In addition to the above operations, there is also a palliative operation. This operation is performed when stage 4 stomach cancer is diagnosed with metastasis to various organs ( lungs, kidneys, liver, bones, brain). The bottom line is to alleviate the suffering of the patient, improve nutrition and slightly improve the quality of life. There are two types of palliative surgery for stomach cancer. The first type of operation is aimed at creating anastomoses ( anastomosis) between the stomach and small intestine. The second type of palliative surgery involves the complete removal of the tumor along with all metastases to slow down the spread of cancer cells in the body.

The choice of a particular surgical technique depends on many factors and should be carried out by an experienced oncologist. It is worth noting the fact that today surgical treatment there are no alternatives for gastric cancer.

- a polymorphic group of neoplasms affecting all layers of the stomach, having a different degree of proliferative activity and impact on the health and life of the patient. The main signs of gastric cancer include weakness, emaciation, digestive discomfort, loss of appetite, anemia, depression, and loss of interest in life. To detect tumors, X-ray and endoscopic techniques, ultrasound, CT and MRI of the abdominal organs are used. The treatment of this pathology is mainly surgical; if a malignant neoplasm is detected, combined therapy also includes radiation and polychemotherapy.

General information

Tumors of the stomach may differ in the nature of tumor growth, origin, degree of differentiation. Among all neoplasms of the stomach, benign tumors occur in no more than 4% of cases, the vast majority of them are gastric polyps. Among malignant tumors, gastric cancer is most often detected; other types of malignant neoplasms account for no more than 5%. The ratio of men and women among patients with oncopathology of the stomach is 3:2. The age bar is shifted towards the elderly: more than two-thirds are patients over 50 years old. AT last years the incidence of stomach cancer has decreased significantly, and gastroenterologists attribute this to the timely detection and eradication of Helicobacter pylori infection. It is known that it is H.pylori that plays a leading role in the formation of gastric ulcer and duodenal ulcer, and a long-term ulcer can become malignant and lead to the development of gastric cancer.

Classification of tumors of the stomach

According to the degree of differentiation, gastric tumors are divided into benign and malignant. Further division within these groups is carried out according to the type of tissue from which this tumor formation originates. Among benign gastric tumors most of represented by polyps - glandular neoplasms growing into the lumen of the stomach, having round shape, thin leg or wide base. According to the quantitative criterion, a single polyp, multiple polyps, polyposis of the stomach are distinguished ( hereditary disease characterized by damage to the mucous membrane of the digestive tract).

By structure, polyps are adenomatous (originate from the glandular epithelium of the stomach, in 20% of cases they transform into cancer, especially when the polyp is larger than 15 mm); hyperplastic (develop against the background of atrophic gastritis, make up more than 80% of all polyps, very rarely malignant); inflammatory-connective tissue (infiltrated by eosinophils, are not true tumors, but outwardly very similar to the oncological process). Separately, Menetrier's disease is distinguished - a precancerous condition, which is described as polyadenomatous gastritis. Benign tumors of the stomach can originate from various tissues: muscular (leiomyoma), submucosal layer (lipoma), blood vessels (angioma), nerve fibers(neurinoma), connective tissue(fibroma), etc.

Most malignant tumors of the stomach (more than 95% of cases) are represented by adenocarcinoma (gastric cancer of epithelial origin). Other tumors include carcinoid (has a neuroendocrine origin, the tumor is capable of producing hormones), leiomyoblastoma (contains cells resembling both epithelioid and smooth muscle), leiomyosarcoma (consists of transformed smooth muscle cells), malignant lymphoma (comes from degenerated lymphoid tissue) . Less commonly, gastric tumors such as fibroplastic and angioplastic sarcoma, retinosarcoma, and malignant neurinoma can be detected.

Causes of stomach tumors

To date, the exact causes of the transformation of normal tissues into a stomach tumor have not yet been identified. However, in gastroenterology, the main predisposing factors and conditions have been identified, which, with highly likely lead to the formation of oncopathology.

Predisposing factors are basically the same for both malignant and benign neoplasms. These include chronic Helicobacter pylori infection, atrophic gastritis, genetic predisposition(presence of oncopathology of the stomach in relatives, detection of the IL-1 gene), malnutrition, smoking and alcoholism , living in an ecological disaster zone, immunosuppression. The presence of gastric polyps (adenomatous), resection of a part of the stomach, pernicious anemia, and Menetrier's disease also predispose to malignant transformation.

Symptoms of stomach tumors

benign tumors of the stomach most often do not manifest themselves in any way and are discovered by chance during an examination for another pathology. Large polyps can manifest as aching pain in the epigastric region after eating; nausea and vomiting with streaks of blood; heartburn and belching; weakness; dizziness (against the background of anemia, gastric bleeding); frequent change constipation and diarrhea. Symptoms of leiomyomas appear in case of necrosis of the tumor node and internal bleeding. In this situation, the patient is concerned about weakness, pallor, dizziness.

Signs of malignant tumors of the stomach can occur both against the background of complete health, and accompany the symptoms of peptic ulcer, chronic gastritis. In the early stages of gastric cancer, the patient notes a decrease in appetite, pain and a feeling of fullness in the stomach after eating, progressive emaciation, taste perversion and rejection of certain foods because of this. In the later stages of the disease, cancerous intoxication develops; there is an increase in abdominal pain against the background of tumor germination of neighboring organs; vomiting of food eaten the day before; melena (stool with altered blood); enlargement of regional lymph nodes.

Complications of a benign oncoprocess include malignancy; germination of the tumor wall of the stomach with perforation and the development of peritonitis; overlapping of the lumen of the stomach with a tumor conglomerate with a violation of the passage of the food bolus; ulceration of the tumor with disintegration and bleeding from the tumor node; migration of a polyp on a leg into the duodenum with infringement and necrosis of the polyp.

Malignant tumors of the stomach are also complicated by narrowing of the stomach cavity, ulceration and bleeding, and gastric perforation. In addition, metastasis, rapid emaciation with the development of cancer cachexia are characteristic of malignant tumors.

Diagnosis of tumors of the stomach

In previous years, the main method for diagnosing a tumor of the stomach was radiography, but today endoscopic studies come to the fore. Nevertheless, one cannot deny the informativeness and wide possibilities of radiography - in some clinics it still remains the main diagnostic technique. Panoramic radiography of the abdominal organs allows suspecting a tumor due to deformation of the contours of the stomach, displacement of neighboring organs. For more accurate diagnosis are used contrast studies(radiography of the stomach with double contrasting) - during such a study, various filling defects are detected, indicating the presence of a tumor growing in the cavity of the organ, or defects in the mucous membrane, indicating malignancy and decay of the neoplasm.

A consultation with an endoscopist is needed to visualize the tumor process and prescribe esophagogastroduodenoscopy and endoscopic biopsy. Holding morphological study allows you to establish the correct diagnosis and start timely treatment in 95% of cases. To clarify the prevalence of the tumor conglomerate, the degree of involvement of surrounding organs and the presence of metastases, it is possible to perform ultrasound, CT and MSCT of the abdominal organs. Clinical and biochemical analyzes make it possible to assess the general condition of the patient, the degree of tumor intoxication.

Treatment of stomach tumors

Tactics in relation to the treatment of benign and malignant tumors of the stomach are somewhat different. Removal of benign tumors of the stomach is usually carried out surgically. With regard to gastric polyps, gastroenterologists can take a wait-and-see approach, although more often a decision is made to remove gastric polyps during endoscopy with simultaneous intraoperative histological examination. Finding out the morphological characteristics of the removed benign tumor allows you to make a decision - to resect only the polyp or also the adjacent mucosa. If during endoscopic examination total polyposis of the stomach is detected, gastrectomy is performed. After removal of a benign tumor, a course of treatment with proton pump inhibitors, anti-Helicobacter drugs is prescribed.

Treatment of malignant neoplasms of the stomach is usually complex, including surgery, radiation and polychemotherapy. To date, the most effective method therapy is considered surgery. Volume surgical intervention depends on many factors: the type and size of the tumor, the prevalence of the oncological process, the presence and number of metastases, the involvement of surrounding organs, the general condition of the patient.

In the presence of a malignant neoplasm, a radical operation or palliative intervention can be performed. Radical surgery implies removal of the tumor, total gastrectomy, resection of the omentum (omentectomy) and the surrounding organs involved in the process, the lymph nodes. Palliative operations are aimed at alleviating the general condition and providing enteral nutrition for the patient. The complex treatment of malignant neoplasms usually includes radiation, chemotherapy to achieve the best result, to prevent tumor recurrence.

Forecast and prevention of tumors of the stomach

The prognosis for the detection of benign neoplasms is favorable; however, because these tumors are prone to recurrence, patients are on dispensary observation throughout life. Establishing the malignant nature of the tumor significantly worsens the prognosis. The chances of recovery are much higher with timely diagnosis and initiation of cancer treatment. When metastases are detected, germination of neighboring organs, the prognosis for life worsens significantly.

There is no specific prevention of stomach tumors. To prevent the formation of an oncological process, provoking factors should be excluded: establish a diet, give up bad habits, promptly identify and treat inflammatory diseases of the stomach, regularly undergo endoscopic examination in the presence of a family predisposition to oncopathology. Upon reaching the age of 50, you should undergo an annual examination by a gastroenterologist.

A benign form of a tumor in the stomach is a neoplasm that is included in the group of histogenesis processes (epithelial and non-epithelial).

These processes come from different gastric layers. They develop slowly and with adequate treatment have a favorable prognosis.

The tumor appears pain syndrome in the epigastric region stomach bleeding, often the feeling of nausea is accompanied by vomiting.

To make a diagnosis, the patient must undergo a series of studies in the form of radiography of the stomach, fibrogastroscopy and histological examination of tumor tissues.

Remove the neoplasm using surgery or endoscopic method.

A benign tumor is diagnosed in 5% of cases of gastroenterological tumors. Neoplasms come from the mucous, submucosal, muscular layers of the stomach, as well as from the epithelial, nervous, vascular and fatty structures.

By growth, the neoplasm is divided into:

• endogastric, growing towards the gastric lumen;
• exogastric, growing towards nearby organs;
• intramural, grows into the walls of the stomach.

Types of benign neoplasms in the stomach

A benign neoplasm can be epithelial or non-epithelial, depending on its origin.

Epithelial formations of the gastric walls include single or multiple adenomatous and hyperplastic polyposis, diffuse polyposis. The growths look like a tumor-like epithelial neoplasm in the gastric lumen.

They have a leg with an elongated base. They are spherical or oval in shape. The surface plane of the polyps has a smooth or granulation structure, and inside them is a dense content.

Diagnosed in men aged 42 to 65 years in the pyloroanthral region. The tissues of the growths consist of growing tectorial epithelium, glandular elements and tissue consisting of connective cells. Benign tumors of the stomach are equipped with vessels.

Adenomatous polyp of the stomach is a direct benign tumor of the glandular epithelium, which consists of a papillary or tubular structure. Pronounced cellular dysplasia and metaplasia.

Adenomas are dangerous because benign cells develop into malignant ones, which leads to stomach cancer.

More than half of benign tumors epithelial tissue of the stomach are polyps similar to tumors (hyperplastic).

They develop due to the increase structural elements in the covering epithelium. In isolated cases, a hyperplastic polyp can turn into a malignant tumor.

Diffuse polyposis may consist of hyperplastic and adenomatous polyps.

Nonepithelial neoplasms are less common. They develop inside the gastric walls in the submucosal, muscular or subserous layers.

They are formed from muscle, fat, connective tissues, vessels and nerves, it can be: myoma, neurinoma, fibroma, lipoma, lymphangioma, hemangioma, endothelioma.

Tissues of the pancreas and duodenal glands can form dermoid, osteoma, chondroma, hamartoma and heterotopia.

Non-epithelial benign formations in the stomach are diagnosed in female representatives. In rare cases, they can be of considerable size with a clear outline, they round shape with a smooth surface.

Leiomyoma is one of the most common benign tumors of the stomach. It develops in the muscle layers, grows towards serous membrane and grows into the gastric mucosa. This may lead to bleeding. Non-epithelial benign tumors of the stomach can develop into cancer.

Causes of a stomach tumor

The doctors did not determine exact reasons, due to which a benign tumor of the stomach can occur. But there are factors that predispose to this disease.

1. Chronic inflammatory process mucous membrane of the inner lining of the stomach (gastritis), leading to impaired regeneration. It atrophies epithelial cells and replaces normal glands with fibrous tissue.
2. Infection with spiral bacteria ( Helicobacter pylori). Bacteria contribute to increased release of hydrochloric acid, which eventually reduces the properties of the inner lining of the gastric walls.
3. genetic predisposition. If there were such diseases in the family, then the risk increases by 70%.
4. Abuse alcoholic drinks and smoking.
5. Wrong nutrition. The diet should be balanced and rich in vitamins. Salty, fried, smoked foods irritate the stomach walls. Fresh vegetables and fruits should be on the menu every day.
6. Reduced immunity.
7. Bad ecology.

Symptoms

The main feature of a benign tumor of the stomach is that it does not have pronounced symptoms.

The disease can proceed for a long time and does not give itself away.

Over time, the patient begins to complain of aching or dull pain in the stomach. When the tumor becomes significant, the patient feels heaviness in the stomach and this does not depend on food intake.

Often there is an eructation, nausea with a gag reflex. The patient loses his appetite, he noticeably loses weight. The body is weakened, constantly dizzy and I want to sleep.

One of the symptoms is vomiting and tarry stools.

Symptoms of polyps:

• pain syndrome with a pulling and pressing character in the epigastric region. May last several hours after a meal;
• frequent belching;
• in the sternum, a constant burning sensation;
• regular diarrhea or constipation.

Polyposis gives itself out as a hemorrhage. Bleeding is determined by laboratory research that define occult blood.

Bleeding chronic form can lead to anemia.

Leiomyomas do not show any symptoms. The only time when a necrotic change in muscle tissue begins is that internal bleeding can begin. The patient experiences weakness, loses weight and is diagnosed with iron deficiency anemia.

Diagnosis of a tumor of the stomach

To make a final diagnosis to specialists of insufficiently pronounced symptoms, he needs to conduct laboratory tests.

Therefore, the symptoms of a benign tumor of the stomach are similar to peptic ulcers, cholelithiasis and colitis.

For an accurate diagnosis, doctors examine the stomach with an endoscope and x-ray. Radiography allows you to determine the number of neoplasms, their size and localization.

In the pictures, the polyps have the correct shape and smooth outlines. The mucous membrane surrounding the stomach remains unchanged.

Gastroscopy allows you to notice neoplasms of small sizes that were not seen on x-rays.

The main feature of endoscopy is that it is possible to take biomaterial with the help of a biopsy and conduct a morphological study.

The final diagnosis can be made after a comprehensive examination, including radiography, endoscopy, targeted biopsy and cytological examination.

Treatment of a benign neoplasm in the stomach

Benign neoplasms in the stomach are removed only by surgery. If doctors find polyps in the stomach, then a gastroscopy is performed. When esophagogastroduodenoscopy is performed, all neoplasms are removed with a flexible tube.

Esophagogastroduodenoscopy is a diagnostic examination, including examination and assessment of the condition of the internal surfaces of the esophagus, gastric walls and duodenum. Inspection is carried out with an optical instrument (endoscope).

If there are few neoplasms, then they are removed, otherwise a part of the gastric wall is removed. After removal of the tumor, a small part of it is taken for histological examination to determine the presence of malignant cells in it.

If doctors diagnosed diffuse polyposis, then the stomach is removed completely. After removal of the tumor, the patient must undergo a course of drug therapy.

The doctor prescribes:

1. A drug that allows you to produce hydrochloric acid in a smaller amount.
2. If the secretion of hydrochloric acid has been increased as a result of infection with pathogenic microbes that have reduced the protective properties of the inner lining of the gastric wall, then an antibiotic is prescribed that will destroy and slow down the growth of bacteria.

Forecast

After adequate treatment doctors put a favorable prognosis. But there are exceptions in the form of relapses.

Therefore, patients with such a diagnosis are under the strict supervision of doctors.

The main consequences of a benign tumor in the stomach:

• benign neoplasms can develop into stomach cancer;
• a hole may form in the gastric walls, as a result of which severe inflammation of nearby organs begins;
• the gastric lumen decreases or narrows. Basically, this is due to the large size of the tumor;
• deep defects of the inner surface of the neoplasm appear, ulcers form;
• stomach tumor is bleeding.

If you follow your diet and lead a healthy lifestyle, you can avoid a benign tumor of the stomach.