Gastric Cancer
Original Editors -Nick Goulooze & Corey Malone from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
Definition
Stomach cancer (also known as gastric cancer) is a disease in which the cells forming the inner lining of the stomach become abnormal and start to divide uncontrollably, forming a mass called a tumor. (http://medical-dictionary.thefreedictionary.com/stomach+cancer)
Prevalence[edit | edit source]
Estimated new cases and deaths from stomach cancer in the United States in 2012:
New cases: 21,320
Deaths: 10,540
(http://cancer.gov/cancertopics/types/stomach)
Characteristics/Clinical Presentation[edit | edit source]
In the United States, about 25% of stomach cancer patients present with localized disease, 31% present with regional disease, and 32% present with distant metastatic disease; the remainder of cases surveyed were listed as unstaged.
Early disease has no associated symptoms; however, some patients with incidental complaints are diagnosed with early gastric cancer. Most symptoms of gastric cancer reflect advanced disease. Patients may complain of indigestion, nausea or vomiting, dysphagia, postprandial fullness, loss of appetite, melena, hematemesis, and weight loss.
Late complications include pathologic peritoneal and pleural effusions; obstruction of the gastric outlet, gastroesophageal junction, or small bowel; bleeding in the stomach from esophageal varices or at the anastomosis after surgery; intrahepatic jaundice caused by hepatomegaly; extrahepatic jaundice; and inanition resulting from starvation or cachexia of tumor origin.
All physical signs are late events. By the time they develop, the disease is almost invariably too far advanced for curative procedures.
Signs may include a palpable enlarged stomach with succussion splash; hepatomegaly; periumbilical metastasis (Sister Mary Joseph nodule); and enlarged lymph nodes such as Virchow nodes (ie, left supraclavicular) and Irish node (anterior axillary). Blumer shelf (ie, shelflike tumor of the anterior rectal wall) may also be present. Some patients experience weight loss, and others may present with melena or pallor from anemia.
Paraneoplastic syndromes such as dermatomyositis, acanthosis nigricans, and circinate erythemas are poor prognostic features.
Other associated abnormalities also include peripheral thrombophlebitis and microangiopathic hemolytic anemia.
http://emedicine.medscape.com/article/278744-clinical#a0217
Associated Co-morbidities[edit | edit source]
http://wjso.com/content/pdf/1477-7819-5-81.pdf
Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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References[edit | edit source]
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