Stomach cancer is a malignant tumour of the stomach. It usually starts developing from the gland cells that form gastric juice. The disease is often detected late. However, the earlier stomach cancer is detected, the better the chances of recovery.
Stomach cancer is classified according to its malignancy and the spread of cancer cells in the stomach, as well as in the lymph nodes or other organs. If gastric cancer is suspected (e.g. due to bloody vomiting or blood in the stool- black, tarry stool, severe weight loss and loss of appetite), gastroscopy should first be performed.
In the gastroscopy, not only can the stomach be examined from the inside, tissue samples (biopsies) can also be taken. The pathologist examines these for the presence of gastric cancer cells. A blood test can show an iron-deficiency anaemia (decrease in the number of red blood cells caused by a lack of iron) in stomach cancer. Iron-deficiency anaemia can have many other causes, however, and is not specific to stomach cancer.
In contrast to other cancers, in stomach cancer no suitable tumour marker can be detected in blood. The tumour markers (CEA, CA-19/9 and CA-72/4) are used only for monitoring the course of stomach cancer.
Every tumour patient, including a patient with stomach cancer, is presented preoperatively to a tumour board. At least one oncologist, and also a radiologist etc. are part of this committee. The various therapy options are discussed in accordance with international guidelines and standards, and finally a therapy concept suited for the respective patient, possibly with pre- or postoperative chemotherapy, is created.
Administration of Vit. B12 is necessary postoperatively. In order to be able to absorb this from food, the body needs a sugar-protein complex (intrinsic factor) produced in the gastric mucosa. This is why Vit. B12 deficiency usually occurs after stomach resection.
Antibody therapy can be used as a newer treatment approach for stomach carcinomas that are no longer radically operable. In about 20 percent of all stomach cancer patients, so-called HER2 receptors are increasingly found on the surface of the cancer cells. These are docking points for growth factors that are important for tumour growth. In HER2-positive gastric carcinomas, HER2 antibodies can be useful. These occupy the HER2 receptors to impair tumour growth. The antibodies are given as an infusion every 3 weeks. In addition, the patients receive chemotherapy.
If stomach cancer is detected very early, we perform a minimally invasive operation. This procedure is also called keyhole surgery. A partial to complete removal of the stomach (gastric resection) is carried out. To ensure the passage of food, the remaining parts of the stomach and the oesophagus (in case of complete stomach removal) are connected directly to the small intestine. It is also important, however, that all lymph nodes where the metastases can spread are removed during the operation.
In some cases, stomach cancer can spread so much that it is no longer possible to cure it. We then sometimes have to perform an operation that restores the passage for food. We perform a gastrojejunostomy. Palliative measures are also used in these patients to prolong the life of the patient.
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