Advanced Gastric Cancer Essay

Stomach cancer, also known as gastric cancer, is a type of cancer that develops slowly over many years. Most frequently, stomach cancer starts in the lining of the stomach otherwise knows as the mucosa, and then develops into the other layers of the stomach. There are many ways in which stomach cancer spreads. In some cases it invades near by organs or it can also travel through the bloodstream to for cancer in other organs. There are many statistics and organizations of support for stomach cancer, as well as, symptoms, risk factors, screening and diagnosis’ and, treatments. Like all cancers, stomach cancer is a deathly disease and one of the major leading causes of cancer deaths in countries other than the U.S.

In our study: statistically, the extent of agreement between dynamic contrast MRI and histopathological staging was almost perfect (κ =0.880) and highly significant (P = 0.001), which is higher compared to the study done by Gupta N. and his colleagues on 60 patients, that resulted in good agreement equals (κ =0.690) and

Staging is the process of finding out how much cancer there is in the body and where it is located. It is how the doctor learns the stage of a person's cancer. Doctors use this information to plan treatment and to help predict a person's outlook (prognosis). Cancers with the same stage tend to have similar outlooks and are often treated the same way. The cancer stage is also a way for doctors to describe the extent of the cancer when they talk with each other about a person’s case.

Esophageal carcinoma, the eighth most common cancer in the world, includes squamous cell carcinoma and adenocarcinoma (Sun, Lin, Chen, Liang, &Hsieh, 2015; American Cancer Society, 2015). Squamous cell carcinoma is simply damaged esophageal cells; however, adenocarcinoma occurs when glandular cells replace squamous cells in the esophagus (American Cancer Society, 2015). While squamous cell carcinoma was once the most common form of esophageal carcinoma in the United States, adenocarcinoma has taken its place with speculation placed towards the increase of gastroesophageal reflux disease (GERD) (Baldwin, 2015). These two manifestations of cancer account for approximately 90% of diagnosed esophageal cancers, while the remaining 10% of esophageal

(a) Grading of the tumor: is very important prognostic factor, well differentiated tumors are associated with better OAS than poorly differentiated tumors (Wasif et al.,

For one, gastric cancer affects many people. In 2011, an estimated 74,035 people in the US had been inflicted with gastric cancer ("SEER Stat Fact," 2013). Additionally, this year, an estimated 22,220 additional people will receive the diagnosis of the stomach cancer ("Stomach (Gastric Cancer)," 2014). Though these numbers may not seem to indicate much of a problem in the United States when compared to prostate cancer's 233,000 estimated new cases and breast cancer's 232,670 estimated new cases, gastric cancer has a significant impact worldwide, being the cancer with the second highest mortality rate ("New Targeted Drug," 2014; "SEER Stat Fact," 2013).

Various investigators have found cellular pleomorphic, stromal elements or the combination of histologous stromal elements or the combination of histological features to be prognostically useful [1,8,10,11]. According to Hawkins et al. Four features-high mitotic count, stromal overgrowth, severe nuclear pleomorphism and infiltrating margins were useful predictors for the development of metastases [8]. They also showed that the most reliable predictor for metastasis was the presence of stromal overgrowth, and a primary tumor with stromal overgrowth had a 72% risk of metastatic spread [8]. Here patients need a close follow up with a CT scan of the bones and lungs.

In vitro: Dacomitinib could reduce the phosphorylation of EGFR, HER2, and HER4 in various sensitive cancer cell lines through a combined G0–G1 arrest and an induction of apoptosis. In addition, dacomitinib inhibited growth in several HER2-amplified lines with resistance to trastuzumab. Moreover, dacomitinib

Cancer is defined by the National Cancer Institute as “the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.” Cancer can develop at almost any part of the human body and anyone can develop cancer, although risk typically increases with age because most cancers tend to require many years to develop. “Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place. When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors” (cancer.gov). Cancerous tumors are defined as malignant meaning that they can spread to nearby tissues or metastasize to distant places in places within the body and form new cancerous tumors. There are over 100 forms of cancer and they are usually named after the organs or tissues where the cancers originate. Staging of cancer is used to “describe the severity of a person’s cancer based on the size and/or extent (reach) of the original (primary) tumor and whether or not cancer has spread in the body” (cancer.gov). The importance’s of staging cancer is to assist the doctor with planning appropriate treatments to fight the cancer

A histologically confirmed metastasis in the absence of a detectable primary cancer (after investigation) is termed cancer of unknown primary or CUP (1). CUP comprises 2-6% of all malignancies (1), and is generally divided further based on the site of the metastasis and prognosis (2). Most cases are carcinomas with adenocarcinomas (undifferentiated to well differentiated) accounting for 90%, squamous cell carcinomas (SCC) making up 5% and undifferentiated neoplasm accounting for the remainder (3). In post-mortem studies, the primary tumor was discovered in 73% of patients with the most common site being: lung (27%), pancreas (24%), liver or bile duct (8%), kidney or adrenals (8%), colon or rectum (7%), genital system (7%), and stomach (6%)

The evaluation looks at these factors in relationship to the cancer’s invasion of other organs, metastases to lymph nodes or beyond and the persistence or recurrence of the cancer

Esophageal cancer, or oesophageal cancer, is a lethal variation of cancer globally ranking sixth as the leading cause of cancer-associated deaths and eighth as the most common type of cancer (Pennathur et al. 2013). In contrast to other parts of the world, the United States has experienced a decrease in esophageal squamous cell carcinoma incidence rates and a distinct increase in esophageal adenocarcinoma, which corresponds to increased obesity and gastroesophageal reflux rates over the years (Simard et al. 2012). Along with increasing incidence rates, esophageal cancer is associated with a 15-25% survival rate of five years regardless of treatment, poor prognosis due to diagnosis during the cancer’s later stages, and predisposition to metastases regardless of tumor type (Pennathur et al. 2013, Chen et al. 2013). In addition, patients who have been treated are at risk for high incidences of recurrence and approximately 90% of patients are faced with mortality from esophageal cancer (Lou et al. 2013), all of which contributes to the poor prognosis associated with the disease. With increasing incidence rates and poor prognosis, esophageal cancer poses challenges to healthcare providers in finding effective and standardized guidelines with respect to screening, treatment, and surveillance.

In-situ carcinomas were divided into three grades; Solid, cribriform and micropapillary carcinomas were designated as grade I and classified as grade II if they had intermediate cytomorphology. While Comedo-carcinoma has been placed in grade III. (54)

One of the leading causes of death in the world is cancer. There are various types of cancers but the one that will be discussed is gastric cancer, also referred to as stomach cancer. Gastric cancer is difficult to diagnose at an early stage due to the fact that the symptoms of the disease are quite similar to the symptoms of every day stomach issues such as indigestion, loss of appetite, and heart burn, just to name a few (Gastric Cancer Treatment 2015). In most cases, the cancer is not discovered until it is in a more advanced stage and as a result oncologists find it extremely difficult to cure it. Gastric cancer is a complex disease that is categorized in four different stages and that have many different treatments for it.

The American Joint Committee on Cancer developed the TNM staging system. The T classification measures the scope of the primary tumor; the N classification measures how much the lymph nodes are affected; and the M classification evaluates metastasis. The T category characterizes the primary tumor as: TX-undefinable, T0-no evidence, Tis- carcinoma in situ, and T1-T4- the measurable scope of the tumor with T4 being the largest. The N category is defined as: NX- not evaluated, N0-no involvement, and N1-N3-regional lymph node involvement measuring the extent with N3 being the worst. The M category is listed as: M0- no metastasis and M1- metastasis. The T, N, and M classifications are then added together to get the more commonly known 0-IV staging. (AJCC,