Stomach Cancer

Stomach cancer, also known as gastric cancer, is a significant global health concern, claiming the lives of hundreds of thousands of individuals annually. While well-established risk factors for stomach cancer include infection with Helicobacter pylori, dietary habits, smoking, and genetic predisposition, compelling evidence suggests that asbestos exposure also plays a role in its development. Asbestos, a fibrous mineral once widely used in construction, shipbuilding, and various manufacturing industries, is a known carcinogen linked to diseases such as mesothelioma, lung cancer, and asbestosis. Increasingly, researchers are exploring its potential contribution to cancers of the gastrointestinal tract, including stomach cancer.

The relationship between asbestos and stomach cancer has been studied for decades, with researchers identifying increased rates of gastrointestinal cancers among asbestos-exposed workers. Occupational exposure to asbestos was widespread in industries such as construction, shipbuilding, and manufacturing, raising concerns about long-term health effects. Though research is still evolving, understanding the potential connection between asbestos exposure and stomach cancer is essential for those with a history of occupational or environmental exposure.

How Asbestos Fibers Reach the Stomach

Asbestos fibers are microscopic and highly durable, making them resistant to breakdown inside the body. There are two primary pathways through which asbestos fibers can reach the stomach: inhalation and ingestion.

Inhalation of Asbestos: When asbestos fibers are inhaled, they enter the lungs and can become trapped in lung tissue. Over time, some fibers may migrate through the lymphatic system or be cleared by mucociliary action, which moves particles upward toward the throat, where they can be swallowed. Once swallowed, these fibers enter the digestive tract and may become embedded in the stomach lining.

Ingestion of Asbestos: Asbestos fibers can also be directly ingested through contaminated food, beverages, or dust particles that settle on hands, utensils, or cooking surfaces. Workers exposed to asbestos in occupational settings may inadvertently swallow fibers while eating or drinking. Once in the digestive system, asbestos fibers can lodge in the stomach lining, potentially causing inflammation and cellular damage that could lead to cancer over time.

Common Sources of Asbestos Exposure Related to Stomach Cancer

Occupational Exposure: Asbestos exposure has been associated with an increased risk of stomach cancer, particularly for workers in industries where asbestos was heavily utilized. Construction workers often encountered asbestos in materials such as cement, insulation, and tiles, while shipyard workers were exposed through insulation and fireproofing products. Auto mechanics faced risks when handling asbestos-containing components like brake pads and clutches. These occupational exposures highlight the dangers asbestos posed to workers, many of whom unknowingly inhaled or ingested fibers during their careers, potentially leading to stomach cancer. Learn more about asbestos exposure in the workplace →

Secondary (Take-Home) Exposure: Family members of asbestos-exposed workers are also at risk due to secondary exposure. Asbestos fibers brought home on work clothes, shoes, or hair can contaminate living spaces, where they may be inhaled or ingested by family members, including children. This indirect exposure has been linked to asbestos-related illnesses, including stomach cancer. Learn more about secondary exposure →

Product Use Exposure: Household products containing asbestos have also been identified as sources of exposure. Items such as asbestos-insulated ironing boards, oven mitts, and ceiling tiles were common in many homes. Additionally, contaminated products like Kent cigarettes (with asbestos filters) and Zippo lighter wicks further demonstrate how asbestos infiltrated daily life, exposing consumers to harmful fibers that could be ingested, potentially increasing the risk of stomach cancer. Learn more about asbestos-containing products →

Protect Yourself and Your Family

Stomach cancer linked to asbestos exposure is often the result of significant or prolonged contact with asbestos fibers, whether through occupational, secondary, or consumer product exposure. Asbestos fibers brought into the home on clothing or other items can unknowingly put family members at risk. If you or someone you love has been diagnosed with stomach cancer and has a history of asbestos exposure, call us at 833-4-ASBESTOS to explore your options for free health screenings and to take proactive steps to protect your family.

Symptoms of Stomach Cancer Related to Asbestos Exposure

Stomach cancer, including cases potentially linked to asbestos exposure, often develops gradually over many years. In its early stages, it may not present noticeable symptoms, making early detection challenging. However, as the disease progresses, several symptoms may arise. Below is an expanded list of common symptoms, along with explanations of why stomach cancer causes them:

Persistent Indigestion or Heartburn: Frequent discomfort, acid reflux, or a burning sensation in the chest or upper abdomen can occur due to the tumor irritating the stomach lining or disrupting normal digestive processes. As the cancer grows, it may interfere with the stomach’s ability to properly process food, leading to these symptoms.

Abdominal Pain or Bloating: Pain or a feeling of fullness in the stomach region, especially after meals, is common. This occurs because the tumor can obstruct the stomach or press against surrounding tissues, causing discomfort. Bloating may result from the stomach’s inability to empty properly or from fluid buildup in the abdominal cavity.

Unexplained Weight Loss: Sudden loss of appetite and unintended weight loss are often signs of advanced stomach cancer. Tumors can alter the body’s metabolism, suppress appetite, or physically obstruct the stomach, making it difficult to eat or digest food properly.

Nausea and Vomiting: Nausea and vomiting, sometimes with blood, can occur as the tumor irritates the stomach lining or blocks the passage of food. Blood in vomit (hematemesis) may appear as bright red or resemble coffee grounds, indicating bleeding from the stomach lining or tumor.

Difficulty Swallowing (Dysphagia): A sensation of food getting stuck or painful swallowing may occur if the cancer spreads to the esophagus or if the tumor grows near the stomach’s opening, narrowing the passage for food.

Blood in Stool: Dark, tarry stools (melena) are a sign of internal bleeding in the stomach. As the tumor erodes blood vessels in the stomach lining, blood may pass through the digestive tract and appear in the stool.

Fatigue and Weakness: Chronic fatigue and weakness often result from anemia caused by internal bleeding. The loss of blood reduces the number of red blood cells, which carry oxygen throughout the body, leading to feelings of exhaustion and weakness.

Why Asbestos Exposure Contributes to Stomach Cancer

Asbestos fibers, when ingested or inhaled, can become lodged in various tissues, including the stomach lining or gastrointestinal tract. These fibers are highly durable and resistant to breakdown by the body, which allows them to persist in tissues for extended periods. Over time, their presence can lead to chronic inflammation, a key factor in carcinogenesis. Chronic inflammation caused by asbestos fibers can result in the release of reactive oxygen species (ROS) and other inflammatory mediators, which can damage cellular DNA. This damage may lead to genetic mutations, chromosomal aberrations, and epigenetic changes, all of which disrupt normal cellular processes and promote uncontrolled cell growth.

In addition to inflammation, asbestos fibers can physically interact with cells, causing mechanical damage to the epithelial lining of the stomach or gastrointestinal tract. This damage may create an environment conducive to tumor development, particularly in areas of mucosal injury or ulceration. Furthermore, asbestos fibers have been shown to interfere with mitosis, leading to abnormal cell division and further increasing the risk of cancer.

While the association between asbestos exposure and stomach cancer is not as definitive as its link to mesothelioma or lung cancer, studies have identified asbestos fibers and asbestos bodies in the gastrointestinal tract of exposed individuals. Epidemiological research has suggested modest increases in the risk of stomach and colorectal cancers among asbestos-exposed populations, particularly those with significant occupational exposure. However, the evidence remains suggestive rather than conclusive, as experimental studies have not consistently demonstrated a direct causal relationship.

Despite the uncertainties, individuals with significant occupational or secondary exposure to asbestos are often eligible for compensation through asbestos trust claims and lawsuits. These legal avenues recognize the potential health risks associated with asbestos exposure, even in cases where the scientific evidence for specific cancers, such as stomach cancer, is less robust than for mesothelioma or lung cancer.

Diagnosing Stomach Cancer

Diagnosing stomach cancer involves a combination of procedures and tests designed to confirm the presence of cancer, determine its stage, and guide treatment planning. Below is an explanation of the diagnostic process:

Endoscopy (Gastroscopy): A gastroscopy is often the first step in diagnosing stomach cancer. During this procedure, a thin, flexible tube with a camera and light (gastroscope) is inserted through the mouth and into the stomach. This allows doctors to visually examine the stomach lining for abnormalities, such as ulcers, tumors, or suspicious lesions. If any irregularities are detected, the doctor can collect tissue samples (biopsy) during the same procedure for further analysis. Endoscopy is particularly effective for identifying early-stage stomach cancer, which may not be visible on imaging tests.

Biopsy: Tissue samples collected during an endoscopy are sent to a pathology lab for microscopic examination. Pathologists analyze the samples to determine whether cancerous cells are present, the type of cancer (e.g., adenocarcinoma, lymphoma), and the grade of the tumor (how aggressive it is). A biopsy is the definitive method for diagnosing stomach cancer, as it provides direct evidence of malignancy.

Imaging Tests: Imaging tests are used to assess the extent of the cancer and whether it has spread (metastasized) to other parts of the body. Common imaging techniques include:

• CT (Computed Tomography) Scans: Provide detailed cross-sectional images of the stomach and surrounding organs, helping to identify the size and location of the tumor and any potential spread to lymph nodes or distant organs.

• MRI (Magnetic Resonance Imaging): Offers high-resolution images of soft tissues and is particularly useful for evaluating the spread of cancer to nearby structures.

• PET (Positron Emission Tomography) Scans: Detect areas of high metabolic activity, which may indicate cancerous growths. PET scans are often combined with CT scans (PET-CT) for more precise staging.

• X-rays with Barium Swallow: In some cases, patients may be asked to swallow a barium solution before undergoing X-rays. The barium coats the stomach lining, making abnormalities more visible on the X-ray.

Blood Tests: While blood tests alone cannot diagnose stomach cancer, they can provide valuable information about a patient’s overall health and potential cancer markers. Common blood tests include:

Tumor Markers: Elevated levels of markers such as carcinoembryonic antigen (CEA) or CA 19-9 may indicate stomach cancer, although these markers are not specific and can be elevated in other conditions.

Complete Blood Count (CBC): May reveal anemia, which could result from chronic internal bleeding caused by the tumor.

Liver Function Tests: Help assess whether the cancer has spread to the liver.

Staging Procedures

Once stomach cancer is confirmed, additional tests may be performed to determine the stage of the disease. Staging is critical for treatment planning and prognosis. These procedures may include:

Endoscopic Ultrasound (EUS): Combines endoscopy with ultrasound to provide detailed images of the stomach wall and nearby lymph nodes. EUS is particularly useful for determining the depth of tumor invasion and whether nearby lymph nodes are affected.

Laparoscopy: A minimally invasive surgical procedure in which a small camera is inserted into the abdomen to directly visualize the stomach and surrounding organs. Laparoscopy can help detect small metastases that may not be visible on imaging tests.

Molecular and Genetic Testing: In some cases, molecular testing of the tumor tissue may be performed to identify specific genetic mutations or biomarkers. For example, testing for HER2 (human epidermal growth factor receptor 2) overexpression can help determine whether targeted therapies, such as trastuzumab, may be effective.

The Importance of Early Diagnosis

Early diagnosis of stomach cancer significantly improves treatment outcomes and survival rates. Unfortunately, stomach cancer often does not cause noticeable symptoms in its early stages, leading to delayed diagnosis. For individuals at high risk—such as those with a history of asbestos exposure, a family history of stomach cancer, or chronic conditions like gastritis or Helicobacter pylori infection—regular screenings and prompt evaluation of symptoms are essential.

By combining advanced diagnostic tools with a thorough medical evaluation, healthcare providers can accurately diagnose stomach cancer, determine its stage, and develop an effective treatment plan tailored to the patient’s needs.

Types of Stomach Cancer Linked to Asbestos Exposure

Stomach cancer has been investigated as a potential consequence of asbestos exposure, particularly in individuals diagnosed with asbestosis. For these individuals, stomach cancer is considered to be associated with asbestos exposure. Below, we explore the types of stomach cancer potentially linked to asbestos exposure and the evidence supporting this association.

Adenocarcinoma - The Most Common Subtype: Adenocarcinoma, which originates in the glandular cells lining the stomach, is the most prevalent form of stomach cancer, accounting for 90-95% of cases. In individuals with asbestosis, asbestos fibers have been identified in the stomach tissue, suggesting a possible link between occupational asbestos exposure and the development of adenocarcinoma. The presence of asbestosis strengthens the potential association, as asbestos-related lung disease often coexists with asbestos fiber deposition in other tissues, including the stomach.

Mucinous Adenocarcinoma: This subtype of adenocarcinoma is characterized by the production of mucus and is less common in the stomach than in the colon. However, studies have noted the potential for asbestos fibers to accumulate at sites of mucosal injury, which could contribute to the development of mucinous adenocarcinoma in individuals with significant asbestos exposure. This warrants further investigation to clarify the relationship.

Signet Ring Cell Carcinoma: A rare and aggressive form of stomach cancer, signet ring cell carcinoma spreads more quickly and has a poorer prognosis than other subtypes. While asbestos exposure has not been definitively linked to this specific subtype, the ability of asbestos fibers to embed in stomach tissue and cause cellular damage suggests a potential association. This is particularly relevant in individuals with asbestosis, where asbestos fibers are more likely to be found in gastrointestinal tissues.

Other Rare Subtypes: Asbestos exposure may also contribute to the development of rarer forms of stomach cancer, particularly in individuals with documented asbestos-related disease. These include:

• Lymphoma: A cancer of the immune system that can occur in the stomach wall, accounting for about 4% of stomach cancers. While not directly linked to asbestos exposure, the role of asbestos in immune system disruption could be a factor.

• Mixed Tumors: Tumors exhibiting features of multiple subtypes, such as adenocarcinoma and signet ring cell carcinoma.

• Carcinoid Tumors: These are slow-growing, hormone-producing tumors that can develop in the stomach and other parts of the gastrointestinal tract. While carcinoid tumors are not commonly associated with asbestos exposure, the potential for asbestos fibers to accumulate in the stomach lining and contribute to cellular changes may play a role in their development.

Asbestos and Histological Subtypes of Stomach Cancer

The identification of asbestos fibers in the stomach tissue of individuals with asbestosis provides suggestive evidence of asbestos’s role in stomach cancer. Although a definitive dose-response relationship has not been established, the potential for asbestos fibers to accumulate at sites of mucosal injury or ulceration lends mechanistic support to the hypothesis. This highlights that asbestos exposure may contribute to the development of stomach cancer across various histological subtypes, particularly in individuals with pre-existing asbestos-related conditions.

How Stomach Cancer is Staged

Stomach cancer staging is a critical process used to determine the extent of the disease and guide treatment decisions. Staging provides information about the size of the tumor, its spread to nearby lymph nodes, and whether it has metastasized (spread) to distant parts of the body. The most widely used system for staging stomach cancer is the TNM system, developed by the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC). This system evaluates three key factors:

Tumor (T): The “T” category describes the size and extent of the primary tumor. It ranges from T1 (tumor confined to the inner layers of the stomach) to T4 (tumor has grown through the stomach wall and may invade nearby organs or structures). For example:

• T1: The tumor is limited to the submucosa (the layer beneath the stomach lining).

• T2: The tumor has invaded the muscular layer of the stomach.

• T3: The tumor has grown through the outer layer of the stomach but has not invaded nearby structures.

• T4: The tumor has penetrated the stomach wall and may involve adjacent tissues or organs, such as the pancreas or spleen.

Node (N): The “N” category assesses whether the cancer has spread to nearby lymph nodes. It ranges from N0 (no lymph node involvement) to N3 (cancer has spread to seven or more regional lymph nodes). Lymph node involvement is a critical factor in determining the likelihood of metastasis and the overall prognosis.

Metastasis (M): The “M” category indicates whether the cancer has spread to distant organs or tissues.

• M0: No distant metastasis.

• M1: The cancer has spread to other parts of the body, such as the liver, lungs, or peritoneum. M1 may be further divided into subcategories based on the number and location of metastases.

Hypothetical Example of Staging with the TNM System:

John, a 62-year-old construction worker with a history of asbestos exposure, has recently been diagnosed with stomach cancer. Using the TNM staging system, his cancer is classified as T3N2M0. This means that the primary tumor (T3) has grown through the outer layer of the stomach but has not invaded nearby organs. The cancer has spread to four to six nearby lymph nodes (N2), but there is no evidence of distant metastasis (M0). John’s staging highlights the regional progression of his disease, and his treatment plan will likely involve a combination of surgery and systemic therapies.

Staging of Stomach Cancer – From a TNM Rating to Stage I-IV.

Once the TNM categories are determined, they are combined into an overall stage grouping, which ranges from Stage I to Stage IV:

• Stage I: The cancer is localized to the stomach and has not spread to lymph nodes or distant sites. It is often curable with surgery alone.

• Stage II: The cancer has grown larger or penetrated deeper into the stomach wall and may involve a small number of nearby lymph nodes but has not spread to distant sites. Treatment may involve surgery and, in some cases, chemotherapy.

• Stage III: The cancer has spread to regional lymph nodes but not to distant organs. This stage often requires a combination of surgery and systemic therapies, such as chemotherapy.

• Stage IV: The cancer has metastasized to distant organs or tissues. Treatment focuses on managing symptoms and prolonging survival, often through systemic therapies like chemotherapy, targeted therapy, or immunotherapy.

To illustrate how TNM staging applies in real-world cases, consider John, a patient diagnosed with stomach cancer.

• John’s stomach cancer, classified as T3N2M0, corresponds to Stage III under the overall stage grouping system. This stage indicates that his cancer has advanced locally, involving several nearby lymph nodes (N2) and penetrating through the stomach wall (T3), but it has not metastasized to distant organs (M0). As a Stage III patient, John’s treatment options will likely involve surgery to remove the tumor and affected lymph nodes, followed by chemotherapy to address any remaining cancer cells and reduce the risk of recurrence. Depending on his overall health and the specific characteristics of his cancer, targeted therapies or immunotherapy may also be considered. John’s care team will tailor his treatment plan to maximize effectiveness while prioritizing his quality of life.

Treatment Options for Stomach Cancer

Treatment for stomach cancer depends on the stage of the disease, the patient’s overall health, and specific characteristics of the tumor. A multidisciplinary approach is often used, combining surgery, chemotherapy, radiation therapy, and newer targeted therapies to achieve the best possible outcomes. Below is an expanded and improved overview of the treatment options for stomach cancer:

Surgical Treatments for Stomach Cancer

Surgery is a critical component in the treatment of stomach cancer, particularly for patients with localized disease. The primary goal of surgery is to remove the cancer entirely, along with any affected surrounding tissues, to achieve a cure. In cases where a cure is not possible, surgery may still play a role in alleviating symptoms and improving quality of life. The type of surgery performed depends on the tumor’s size, location, stage, and the patient’s overall health.

Subtotal Gastrectomy (Partial Stomach Removal):

A subtotal gastrectomy, or partial stomach removal, is a surgical procedure that involves removing the portion of the stomach affected by the tumor, along with nearby lymph nodes and surrounding tissues. The remaining part of the stomach is then reconnected to the esophagus or small intestine to maintain digestive function. This procedure is typically recommended for cancers located in the lower or middle part of the stomach, particularly in cases where the cancer has not spread extensively and can be completely removed while preserving a portion of the stomach. One of the key benefits of a subtotal gastrectomy is that it allows for better digestive function compared to a total gastrectomy, potentially reducing long-term nutritional challenges such as severe weight loss or vitamin deficiencies. However, post-surgical adjustments are necessary, as patients often need to adopt smaller, more frequent meals to accommodate the reduced stomach capacity. Nutritional support and monitoring are essential to prevent deficiencies in key vitamins such as B12, iron, and calcium, ensuring overall health and recovery.

Total Gastrectomy (Complete Stomach Removal):

A total gastrectomy, or complete stomach removal, is a surgical procedure in which the entire stomach, nearby lymph nodes, and, in some cases, parts of adjacent organs such as the spleen, pancreas, esophagus, or small intestine are removed if the cancer has spread. To maintain digestive function, the esophagus is directly connected to the small intestine. This procedure is typically necessary for cancers located in the upper part of the stomach or those that have spread extensively, making subtotal gastrectomy insufficient for complete tumor removal. The primary benefit of a total gastrectomy is that it offers the best chance of eliminating cancer in cases of widespread or upper stomach tumors while significantly reducing the risk of recurrence. However, post-surgical adjustments are substantial, as the stomach plays a crucial role in digestion and nutrient absorption. Patients will need to adopt a specialized diet, consuming small, frequent meals, and may require lifelong vitamin B12 injections due to the loss of the stomach’s role in vitamin absorption. Additionally, close monitoring is essential to manage potential complications such as dumping syndrome, a condition where food moves too quickly into the small intestine, causing nausea, dizziness, and other digestive issues.

Lymph Node Removal (Lymphadenectomy):

Lymph node removal, or lymphadenectomy, is an essential component of stomach cancer surgery, performed during both subtotal and total gastrectomies. This procedure involves removing nearby lymph nodes to assess whether the cancer has spread, helping to accurately stage the disease and determine the extent of its progression. By removing these potential sites of cancerous cells, lymphadenectomy also reduces the risk of recurrence. There are two primary types of lymphadenectomy: D1 lymphadenectomy, which involves the removal of lymph nodes immediately surrounding the stomach, and D2 lymphadenectomy, a more extensive procedure that includes the removal of additional lymph nodes along the major blood vessels supplying the stomach. D2 lymphadenectomy has been associated with improved survival rates in some cases, but it may also carry a higher risk of complications. The decision between D1 and D2 lymphadenectomy depends on several factors, including the patient’s condition, the expertise of the surgeon, and the specific characteristics of the cancer.

Palliative Surgery:

Palliative surgery is performed in advanced cases of stomach cancer where the tumor cannot be completely removed, focusing on relieving symptoms and improving the patient’s quality of life rather than curing the disease. Several palliative procedures can help manage complications and enhance comfort. A gastrojejunostomy may be performed to bypass a blocked portion of the stomach, restoring the ability to eat and digest food. Tumor debulking involves removing as much of the tumor as possible to reduce symptoms such as pain or bleeding, while surgical control of bleeding can help prevent complications like anemia caused by tumor-related hemorrhaging. The primary benefits of palliative surgery include alleviating severe symptoms such as obstruction, bleeding, and pain, improving the patient’s ability to eat and maintain proper nutrition, and ultimately enhancing their overall quality of life, even when a cure is not possible.

Minimally Invasive Surgical Techniques:

Minimally invasive surgical techniques, such as laparoscopic or robotic-assisted surgery, have become increasingly common in the treatment of stomach cancer, offering several advantages over traditional open procedures. These techniques involve smaller incisions, which result in reduced pain, faster recovery times, and a lower risk of infection or other complications. Patients undergoing minimally invasive surgery often experience shorter hospital stays, allowing them to return to normal activities more quickly. However, these techniques are not suitable for all cases, particularly for patients with advanced or complex tumors that require more extensive surgical intervention. Additionally, the success of these procedures depends on the expertise and specialized training of the surgical team, making them available only in centers with experienced surgeons.

Post-Surgical Recovery and Follow-Up:

Recovery from stomach cancer surgery can be challenging and requires careful management of nutrition, hydration, and overall health. Patients may need to work with a dietitian to develop a tailored eating plan that meets their nutritional needs while accommodating changes in digestion. Regular follow-up appointments are essential to monitor for signs of recurrence, manage any complications, and provide ongoing support.

Chemotherapy Treatment for Stomach Cancer

Chemotherapy is a systemic treatment that uses powerful drugs to kill cancer cells or inhibit their growth and division. It plays a crucial role in the management of stomach cancer, often in combination with other treatment modalities such as surgery and radiation therapy. The specific approach to chemotherapy depends on the stage of the cancer, the patient’s overall health, and the treatment goals.

Neoadjuvant Chemotherapy (Before Surgery):

• Neoadjuvant chemotherapy is administered before surgery to shrink tumors, making them easier to remove completely and improving the likelihood of a successful surgical outcome. This approach offers several benefits, including reducing tumor size to facilitate complete resection, targeting microscopic cancer cells that may have already spread beyond the stomach, and lowering the risk of recurrence. Additionally, it allows clinicians to assess the tumor’s response to chemotherapy, providing valuable insights for tailoring further treatment. Neoadjuvant chemotherapy is particularly beneficial for patients with locally advanced stomach cancer or those with bulky tumors that may be difficult to remove surgically, helping to optimize their chances for a better prognosis.

Adjuvant Chemotherapy (After Surgery):

• Adjuvant chemotherapy, administered after surgery, plays a crucial role in eliminating any remaining cancer cells that could not be removed during the operation. These residual cells, though microscopic and undetectable, pose a risk of recurrence if left untreated. By targeting these cancer cells, adjuvant chemotherapy helps reduce the likelihood of relapse and improves long-term survival rates, particularly for patients with high-risk factors such as lymph node involvement or incomplete tumor removal. It is often recommended for patients with stage II or III stomach cancer or those with other indications of aggressive disease.

For patients with advanced or metastatic stomach cancer, where the cancer has spread beyond the stomach and surgery is not a viable option, chemotherapy serves as the primary treatment. The primary goals of chemotherapy in these cases are to slow disease progression, alleviate symptoms such as pain, difficulty eating, or bleeding, and improve quality of life while potentially extending survival. Several drugs are commonly used, including fluorouracil (5-FU), which interferes with cancer cell DNA synthesis, and capecitabine, an oral drug that converts to 5-FU in the body for easier administration. Platinum-based drugs like cisplatin and oxaliplatin disrupt cancer cell DNA, preventing their replication, while docetaxel, a taxane drug, targets microtubules to inhibit cancer cell division. These drugs are often used in combination regimens such as FOLFOX (5-FU, leucovorin, and oxaliplatin) or DCF (docetaxel, cisplatin, and 5-FU) to maximize treatment effectiveness.

While chemotherapy is a powerful tool against stomach cancer, it can also affect healthy cells, leading to side effects such as nausea, vomiting, fatigue, hair loss, and increased susceptibility to infections. The severity of these side effects varies depending on the drugs used and the patient’s overall health. However, advances in supportive care, including anti-nausea medications and growth factors to boost blood cell counts, have significantly improved the tolerability of chemotherapy. Treatment plans are carefully tailored to balance the benefits of chemotherapy with potential risks and side effects.

Radiation Therapy for Stomach Cancer

Radiation therapy is a localized treatment that uses high-energy rays or particles to destroy cancer cells. It plays a significant role in the management of stomach cancer, either as part of a curative approach or to alleviate symptoms in advanced cases. Radiation therapy is often combined with chemotherapy, a combination known as chemoradiation, to enhance its effectiveness by making cancer cells more sensitive to radiation.

Preoperative Radiation Therapy (Neoadjuvant Radiation):

This approach is used to shrink tumors before surgery, making it easier for surgeons to remove the cancer completely. By reducing the size of the tumor, preoperative radiation can also help preserve more of the stomach and surrounding structures, improving the patient’s quality of life after surgery. Preoperative radiation is often combined with chemotherapy to maximize tumor shrinkage and improve surgical outcomes.

Postoperative Radiation Therapy (Adjuvant Radiation):

Administered after surgery, this type of radiation therapy targets any remaining cancer cells in the stomach area or nearby lymph nodes. It is particularly useful in cases where the surgical margins are positive (cancer cells are found at the edges of the removed tissue) or when there is a high risk of recurrence.  Postoperative radiation is often combined with chemotherapy to reduce the likelihood of cancer returning.

Palliative Radiation Therapy: In advanced or metastatic stomach cancer, radiation therapy is used to relieve symptoms rather than cure the disease. This is known as palliative radiation therapy. It can help manage symptoms such as:

• Pain: Caused by tumor growth pressing on nearby organs or nerves.

• Bleeding: From the tumor itself or surrounding tissues.

• Obstruction: Radiation can help reduce blockages in the stomach or intestines caused by tumor growth, improving the patient’s ability to eat and digest food.

Planning and Delivery of Radiation Therapy

Radiation therapy for stomach cancer is carefully planned to maximize its effectiveness while minimizing damage to surrounding healthy tissues. The stomach is located near several critical organs, including the liver, pancreas, intestines, and kidneys, which makes precision in radiation delivery essential. Advanced techniques are used to ensure that the radiation dose is concentrated on the tumor while sparing nearby healthy tissues.

• External Beam Radiation Therapy (EBRT): The most common form of radiation therapy for stomach cancer. Delivered from outside the body using a machine called a linear accelerator (LINAC).

Techniques such as 3D conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) are often used to shape the radiation beams to the tumor’s exact size and shape, reducing exposure to healthy tissues.

Brachytherapy (Internal Radiation Therapy): In rare cases, brachytherapy may be used. This involves placing a radioactive source inside or near the tumor. However, it is less commonly used for stomach cancer compared to EBRT.

Image-Guided Radiation Therapy (IGRT): Advanced imaging techniques are used to guide the delivery of radiation, ensuring that the tumor is accurately targeted even if the patient’s position shifts slightly during treatment.

Side Effects of Radiation Therapy

While radiation therapy is an effective treatment option, it can cause side effects due to its impact on both cancerous and healthy cells. Common side effects include:

• Fatigue: A common side effect of radiation therapy, often due to the body’s effort to repair radiation-induced damage.

• Nausea and Vomiting: Radiation to the stomach area can irritate the digestive system.

• Diarrhea: Caused by radiation affecting the intestines.

• Skin Changes: Redness, irritation, or peeling of the skin in the treated area.

• Loss of Appetite: Due to nausea or changes in taste.

Most side effects are temporary and can be managed with supportive care. The radiation oncology team works closely with patients to monitor and address any side effects during and after treatment.

Radiation therapy is a versatile and effective tool in the treatment of stomach cancer. Whether used before surgery to shrink tumors, after surgery to eliminate residual cancer cells, or in advanced cases to relieve symptoms, it plays a vital role in improving patient outcomes. With careful planning and advanced techniques, radiation therapy can be delivered safely and effectively, minimizing harm to surrounding healthy tissues and enhancing the patient’s quality of life.

Targeted Therapy Treatments for Stomach Cancer

Targeted therapy uses drugs that specifically attack cancer cells by focusing on unique molecules or pathways that contribute to their growth and survival. This approach is particularly beneficial for patients with advanced or metastatic stomach cancer, especially when traditional treatments are less effective.

One common targeted approach is HER2-targeted therapy, which is used for tumors that overexpress the HER2 protein. Drugs like trastuzumab (Herceptin) work by blocking this protein, slowing cancer growth and improving patient outcomes. To determine eligibility for this treatment, HER2 testing is performed on tumor samples.

Another targeted approach focuses on the vascular endothelial growth factor (VEGF) pathway, which plays a crucial role in tumor blood vessel formation. Drugs like ramucirumab (Cyramza) block VEGF, effectively starving the tumor of essential nutrients and oxygen needed for its growth.

Immunotherapy has also emerged as a promising treatment for certain patients with advanced stomach cancer by leveraging the body’s immune system to recognize and attack cancer cells. Immune checkpoint inhibitors, such as pembrolizumab (Keytruda), target proteins like PD-1/PD-L1, which cancer cells use to evade detection by the immune system. By blocking these proteins, immunotherapy enhances the immune system’s ability to destroy cancer cells.

This approach has been particularly effective for patients whose tumors exhibit high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR). In some cases, immunotherapy is combined with chemotherapy or targeted therapy to enhance treatment effectiveness, offering a broader and more aggressive approach to controlling cancer growth.

Palliative Care: For patients with advanced or incurable stomach cancer, palliative care focuses on improving quality of life by managing symptoms such as pain, nausea, and difficulty eating. Palliative treatments may include:

• Endoscopic procedures to relieve blockages or bleeding.

• Nutritional support, such as feeding tubes or dietary modifications.

• Medications to control pain, nausea, and other symptoms.

Emerging Therapies and Clinical Trials

Ongoing research is exploring new and innovative treatment options for stomach cancer, aiming to improve outcomes and provide more personalized approaches to care. These include:

• Precision Medicine: This approach involves tailoring treatments based on the genetic and molecular profile of the tumor. By identifying specific genetic mutations or biomarkers driving the cancer, doctors can select targeted therapies that are more likely to be effective for an individual patient. For example, therapies targeting HER2 (a protein overexpressed in some stomach cancers) or PD-L1 (a protein involved in immune evasion) are being used and further refined through research.l

• CAR-T Cell Therapy: Chimeric Antigen Receptor T-cell (CAR-T) therapy is a groundbreaking form of immunotherapy that involves engineering a patient’s T-cells to recognize and attack cancer cells. While CAR-T therapy has shown significant success in treating blood cancers, researchers are actively investigating its potential for solid tumors like stomach cancer. Challenges such as the tumor microenvironment and immune suppression are being addressed to make this therapy more effective for gastrointestinal cancers.

• Novel Drug Combinations: Researchers are testing new combinations of chemotherapy, targeted therapy, and immunotherapy to enhance treatment efficacy. For instance, combining immune checkpoint inhibitors (like pembrolizumab) with traditional chemotherapy or targeted drugs is being studied to improve response rates and survival outcomes. These combinations aim to attack the cancer from multiple angles, reducing the likelihood of resistance and improving overall effectiveness.

• Epigenetic Therapies: Emerging research is also focusing on drugs that target epigenetic changes—alterations in gene expression without changes to the DNA sequence—that play a role in cancer progression. These therapies aim to reverse abnormal gene expression patterns and restore normal cellular function.

Patients are strongly encouraged to discuss clinical trial opportunities with their healthcare team. Clinical trials often provide access to cutting-edge treatments that are not yet widely available, offering hope for improved outcomes. These trials also contribute to advancing medical knowledge, helping to refine existing therapies and develop new ones. By participating in a clinical trial, patients may benefit from innovative approaches while playing a vital role in the fight against stomach cancer.

Legal Options for Stomach Cancer Patients Exposed to Asbestos

Asbestos Trust Fund Claims: Many companies responsible for asbestos exposure have established trust funds to compensate affected individuals. Those diagnosed with stomach cancer linked to asbestos exposure may be eligible for financial assistance.

Lawsuits for Compensation: Victims of asbestos-related stomach cancer can file lawsuits against manufacturers or employers who failed to protect them from asbestos exposure. Compensation can help cover medical expenses, lost wages, and pain and suffering.

Disability Benefits: The Social Security Agency offers benefits for individuals unable to work due to their stomach cancer.  Veterans exposed to asbestos during military service may qualify for benefits through the VA, including disability compensation and healthcare coverage.

If you or a loved one has been diagnosed with stomach cancer and has a history of asbestos exposure, you may be entitled to compensation. Our team is here to help you navigate your legal options and secure the financial support you deserve.

Call us today at 833-4-ASBESTOS to learn more about your rights and options.