The stomach is a hollow organ in the upper abdomen, under the ribs. It is an essential part of the digestive tract and helps in the proper digestion of the food we eat. The churning action of the stomach makes the food semi-liquid in nature. The glands embedded in the lining of the stomach produce a strong acid to help break down the food and protect us from harmful bacteria. The semi-digested food then passes off to the small intestine for further digestion and absorption of the nutrients.

Stomach cancer is also called "gastric cancer". It is the most common cancer in Asia; associated with a diet high in smoked and pickled foods that contain certain toxins like nitrates. Stomach cancer mostly affects older people - majority of cases reported are over age 65. It usually begins in cells in the inner layer of the stomach. The most common type of stomach cancer is adenocarcinoma, which starts in the mucous producing cells of the inner lining of the stomach and accounts for 90% to 95% of all stomach cancers.

Risk factors and causes:

Helicobacter pylori (H. pylori) infection of the stomach: Helicobacter pylori are a certain type of bacteria that causes inflammation of the lining of the stomach and thus leads to gastritis and ulcers.

A diet high in salty, pickled and smoked food is also said to be a leading cause of stomach cancer. These products are high in nitrates which get converted into toxic compounds by H. Pylori.

A very important but preventable cause of gastric cancer is tobacco smoking. Smokers are at double risk than non-smokers in developing stomach cancer.

Males are more commonly affected than females. The ratio of male to female risk is almost 3:1.

Family history: close relatives of a person suffering from gastric cancer increases their risk of developing stomach cancer as well.

Ongoing inflammation in the stomach for long: Certain diseases like atrophic gastritis (an autoimmune condition) and GERD (Gastric reflux problem) also carry a relatively high risk of culminating into stomach cancer.

Symptoms

It is hard to diagnose stomach cancer in its early stage since there are hardly any symptoms at an initial level of disease. It is mainly in the advanced stage that the symptoms begin to appear which makes its diagnosis and treatment very difficult.

Symptoms may include:

- Indigestion and stomach discomfort

- Nausea and vomiting

- Bloated feeling after eating

- Loss of appetite

In advanced cases, additional symptoms can be seen like:

- Discomfort in the upper or middle part of the abdomen

- Blood either in vomit or in stool. This leads to anaemia.

- Weight loss

- Diarrhoea or constipation

- Weakness and fatigue

- Occasionally, difficulty in swallowing which usually points towards advanced stage of the disease. Diagnosis

The earlier stomach cancer is diagnosed, the better the prognosis. The doctor will perform several tests for the confirmation of the disease, starting with:

- Physical examination: The doctor feels the fluid in abdomen, checks for enlarged lymph nodes and also estimates the sizes of liver and spleen.

- Endoscopy: this is a procedure in which a camera attached to a tiny tube is inserted into the stomach via throat. anaesthesia is given prior to the procedure. This provides direct visibility to the doctor and the camera also records and captures the images of the stomach from the inside and provided valuable information on the presence and absence of lesions or for that matter any changes in the wall of the stomach.

- Biopsy: In case of changes in the stomach wall, a sample of the tissue is withdrawn during endoscopy. This sample tissue is sent for cytological study which actually reveals the cancer cells, if any. Biopsy is the only sure shot way of confirming cancer.

- Imaging studies: Sometimes, CT, PET ( positron emission tomography) and barium x-ray are also done.

Treatment

Prior to the treatment, staging of the cancer for the convenience of choosing treatment options is done. Treatment depends on the kind of cancer and its spread to other localizations.

Since the diagnosis of stomach cancer is usually late, treatment becomes even more difficult.

Surgery is the preferred therapy for respectable tumours. Usually part or all of the stomach is removed, as well as the surrounding lymph nodes, with the basic goal of removing all cancer and a margin of normal tissue.

Chemotherapy ( drug treatment that uses chemical compounds to kill cancer cells) is also almost always given. It is either given before or after surgery to reduce the size of the cancer mass.

Radiation therapy is also used to kill cancer cells. Just like chemotherapy, it can also be used before or after surgery as and how the need arises. Radiation is often combined with chemotherapy.

Prevention

Although we do not exactly know the cause of stomach cancer, some steps can definitely be taken to reduce the risk of its occurrence like maintaining a healthy diet consisting of fruits and vegetables, staying away from tobacco of any form and maintain a healthy lifestyle in general. It is always better to prevent something from happening than to treat it once it has developed.