4. INCIDENCE
• According to the National
Cancer Institute (NCI, 2008),
approximately 760,000 cases of
stomach cancer are diagnosed
worldwide.
• New cases: 21,000 in United
States (NCI, 2010); 13,000 men
and 8,000 women
Created by: Katherine L. Laud, SN
5. INCIDENCE
• In Philippines, cancer of
the stomach is the 8th
leading site of cancer
overall. According to
Department of Health
(DOH), it is 6th among
males and 10th among
females
Created by: Katherine L. Laud, SN
6. INCIDENCE
• New cases: 2,563 in
Philippines; 1,511
among males and
1,052 among
females (DOH, 1998)
Created by: Katherine L. Laud, SN
7. INCIDENCE
• Most (85%) cases of gastric cancer are
adenocarcinomas that occur in the
lining of the stomach (mucosa).
Approximately 40% of cases develop
in the lower part of the stomach
(pylorus); 40% develop in the middle
part (body); and 15% develop in the
upper part (cardia). In about 10% of
cases, cancer develops in more than
one part of by: Katherine L. Laud, SN
Created the organ.
9. MORTALITY
• Stomach cancer is the second leading
cause of cancer death worldwide
(737, 000 deaths, 10% of the total).
The highest mortality rates are in
Eastern Asia and the lowest in
Northern America (World Cancer
Research Fund International, 2008).
• Deaths: 10,570 in United States (NCI,
2010)
• Deaths: 1,484 in Philippines (DOH,
1998) Created by: Katherine L. Laud, SN
11. ETIOLOGY/RISK FACTORS
• Family history of gastric cancer
• Helicobacter pylori infection (a
common bacteria that can also
cause stomach ulcers)
• History of an adenomatous gastric
polyp larger than 2 centimeters
• Common in men
• Smoking
Created by: Katherine L. Laud, SN
12. ETIOLOGY/RISK FACTORS
• Risk increases after age 50
• History of chronic atrophic gastritis
• Previous stomach injury
• History of pernicious anemia
• Evidence suggest that gastric cancer may
be linked to diet, such as salty food,
smoked fish, preserved meats, and low in
fresh fruits and vegetables.
Created by: Katherine L. Laud, SN
13. ETIOLOGY/RISK FACTORS
• Some studies have found that a diet
high in red meat is another possible
risk factor. Eating red meat an
average of about twice a day seems
to raise the risk of stomach cancer.
This risk is increased even more if the
meat is barbecued and well done.
• Workers in the coal, metal, and
rubber industries
Created by: Katherine L. Laud, SN
15. PREVENTION, SCREENING,
DETECTION
• Changing lifestyle or eating
habits (balanced diet)
• Avoiding things known to
cause cancer
• Taking medicines to treat a
precancerous condition or to
keep cancer from starting
Created by: Katherine L. Laud, SN
16. PREVENTION, SCREENING,
DETECTION
• There is no standard or
routine screening test for
stomach cancer. However,
upper endoscopy has been
studied as a screening test
to find stomach cancer at an
early stage.
Created by: Katherine L. Laud, SN
17. PREVENTION, SCREENING,
DETECTION
• Scans - these may include
ultrasound, MRI or CT scans
• Complete blood count (CBC) to
check for anemia
• Esophagogastroduodenoscopy
(EGD) with biopsy
• Stool test to check for blood in
the stools
Created by: Katherine L. Laud, SN
19. CLASSIFICATION
• T Stage for Gastric Cancer
- Tis (Carcinoma in situ),
T1, T2, T3, T4
• N Stage of Gastric Cancer
- N0, N1, N2, N3
• M Stage for Gastric Cancer
- M0, M1
Created by: Katherine L. Laud, SN
21. CLINICAL FEATURES
• Weight loss and persistent
abdominal pain, Dysphagia
• Feeling bloated after eating
only a small meal
• Nausea and vomiting,
Hematemesis
• Melena
Created by: Katherine L. Laud, SN
23. DIAGNOSIS AND STAGING
• Thorough history and
physical examination
• MRI, CT Scan, Upper
Endoscopy
• Biopsies
Created by: Katherine L. Laud, SN
24. DIAGNOSIS AND STAGING
*STAGING
• Stage 0: Tis, N0, M0
• Stage IA: T1, N0, M0
• Stage IB: Any of the ff: T1,N1,M0;
T2,N0,M0
• Stage IIA: Any of the ff: T1,N2,M0;
T2,N1,M0; T3,N0,M0
• Stage IIB: Any of the ff: T1,N3,M0;
T2,N2,M0; T3,N1 SN T4a,N0,M0
Created by: Katherine L. Laud, M0;
25. DIAGNOSIS AND STAGING
• Stage IIIA: Any of the ff:
T2,N3,M0; T3,N2,M0; T4a,N1,M0
• Stage IIIB: Any of the ff:
T3,N3,M0; T4a,N2,M0; T4b,N0 or
N1,M0
• Stage IIIC: Any of the ff:
T4a,N3,M0; T4b,N2 or N3,M0
• Stage IV: Any T,any N,M1
Created by: Katherine L. Laud, SN
27. METASTASIS
• Stomach cancer usually begins
in cells in the inner layer of the
stomach. Over time, the cancer
may invade more deeply into the
stomach wall. A stomach tumor
can grow through the stomach's
outer layer into nearby organs,
such as the liver, pancreas,
esophagus, or intestine.
Created by: Katherine L. Laud, SN
28. METASTASIS
• Stomach cancer cells can spread by
breaking away from the original tumor.
They enter blood vessels or lymph
vessels, which branch into all the
tissues of the body. The cancer cells
may be found in lymph nodes near the
stomach. The cancer cells may attach
to other tissues and grow to form new
tumors that may damage those
tissues. by: Katherine L. Laud, SN
Created
30. SURVIVAL The overall 5-year
relative survival rate of
Stage IA 71% people with stomach
Stage IB 57% cancer in the United
States is about 28%. One
Stage IIA 45%
reason for this is that
Stage IIB 33% most stomach cancers
Stage IIIA 20% are found at an advanced
Stage IIIB 14% stage. The outlook for
survival is better if the
Stage IIIC 9%
cancer is in the lower part
Stage IV 4% of the stomach than if it is
*The survival rates above come from the
National Cancer Institute's SEER database.
in the upper part
They are based on people diagnosed with (American Cancer
stomach cancer and treated with surgery Created by: Katherine L. Laud, SN
between 1991 and 2000 Society).
