Early Gastric Cancer: Symptoms, Diagnosis, and Treatment Options

Gastric cancer is one of the most common types of cancer worldwide and holds a significant position among cancer-related deaths. However, in cases of early gastric cancer (EGC), when diagnosed at an early stage, the success rate of treatment is remarkably high. Therefore, early detection and treatment play a crucial role in the management of the disease.

What is Early Gastric Cancer?

Early gastric cancer refers to the stage of stomach cancer where the tumor is confined to the mucosa or submucosa of the stomach, with minimal or no lymph node involvement. At this stage, the cancer is typically localized and can be completely treated through surgical or endoscopic interventions.
 
Symptoms of Early Gastric Cancer

Symptoms of early gastric cancer are often vague or mild, making it difficult for patients to notice them. In most cases, EGC is diagnosed incidentally during investigations for other conditions. However, the following symptoms may warrant attention:

1.    Mild Stomach Discomfort
o    Temporary indigestion, bloating, or heartburn may occur.

2.    Mild Abdominal Pain
o    A mild, often non-distressing pain in the upper abdomen may be felt.

3.    Loss of Appetite and Early Satiety
o    Patients may feel full even after consuming small amounts of food.

4.    Nausea and Vomiting
o    Although rare in early stages, nausea can sometimes occur.

5.    Unexplained Weight Losso Patients may notice weight loss despite not being on a diet.

6.    Occult Blood in Stool
o    Usually invisible, this condition can be detected through stool tests and may lead to iron deficiency anemia.

These symptoms are non-specific and can be mistaken for other digestive disorders. However, persistent symptoms should be medically evaluated. It is also important to note that early gastric cancer can sometimes be asymptomatic.
 
Risk Factors for Early Gastric Cancer

Certain individuals are at higher risk of developing gastric cancer due to genetic and environmental factors. The following are key risk factors:

1.    Helicobacter pylori Infection
o    Causes chronic inflammation of the stomach lining, increasing the risk of gastric cancer.

2.    Genetic Predisposition
o    Individuals with a family history of gastric cancer have a higher risk.
o    Conditions like hereditary diffuse gastric cancer syndrome also elevate the risk.

3.    Dietary Habits
o    A diet high in salty, smoked, and processed foods raises the risk of gastric cancer.

4.    Smoking and Alcohol Consumption
o    Long-term use, especially of tobacco, damages the stomach lining.

5.    Age and Gender
o    More common in individuals over 50 and in males.

6.    Other Factors
o    Conditions such as chronic gastritis, pernicious anemia, and gastric polyps increase the risk.

 

How is Early Gastric Cancer Diagnosed?

Early diagnosis is critical in the treatment of gastric cancer. Several diagnostic methods are utilized for detecting the disease:

1. Gastroscopy (Endoscopy)
•    The Most Effective Method: It is the most commonly used tool for early diagnosis of gastric cancer.
•    A thin, flexible tube called an endoscope is used to examine the stomach.
•    Biopsies can be taken from suspicious lesions.
•    Identifying early gastric cancer during endoscopy can be challenging, requiring skilled endoscopists and advanced equipment.

2. Histopathological Examination
•    Tissue samples obtained during gastroscopy are analyzed pathologically.
•    This determines the type and stage of the cancer.

3. Fecal Occult Blood Test
•    Patients with early gastric cancer may experience hidden blood loss in their stool.
•    This test helps detect occult bleeding.

4. Blood Tests
•    Hemoglobin levels are checked for anemia.
•    Tumor markers (CEA, CA 19-9) are rarely elevated in early stages but may aid in further investigations.

5. Imaging Techniques
•    While not commonly used for EGC diagnosis, CT or MRI may help evaluate the cancer’s spread.

6. Screening Programs
•    Regular endoscopic screenings are conducted in high-risk populations, particularly in Asian countries.

 

Treatment of Early Gastric Cancer

When gastric cancer is diagnosed at an early stage, the likelihood of complete recovery is high with appropriate treatment. Treatment options depend on the extent of the disease, the location of the tumor, and the patient’s overall health.

1. Endoscopic Treatments
•    Endoscopic Mucosal Resection (EMR):
Cancers confined to the gastric mucosa can be removed through an endoscope.
•    Endoscopic Submucosal Dissection (ESD):
Used for larger lesions. This method preserves the stomach tissue.

2. Surgical Treatments
•    Partial Gastrectomy: Performed when cancer affects only part of the stomach.
•    Total Gastrectomy: Required when cancer has spread, involving the removal of the entire stomach.
•    Nearby lymph nodes are also removed during surgery to reduce the risk of metastasis.

3. Chemotherapy
•    Generally not required in early stages but may be used post-surgery depending on risk factors.
•    Chemotherapy helps shrink tumors or control metastasis.

4. Immunotherapy and Targeted Therapies
•    Newer treatments include immunotherapies and HER2-targeted therapies, typically used in advanced stages.

 

Lifestyle Changes and Prevention of Early Gastric Cancer

Making healthy lifestyle changes is essential to reducing the risk of gastric cancer:

1.    Treatment of Helicobacter pylori Infection:
o    H. pylori infection should be treated if detected.

2.    Healthy Diet:
o    Consume a diet rich in vegetables, fruits, and whole grains.
o    Limit the intake of salty, smoked, and processed foods.

3.    Quit Smoking and Alcohol Consumption:
o    Both smoking and excessive alcohol use harm the stomach lining.

4.    Regular Exercise:
o    Strengthens the immune system and lowers the risk of obesity.

5.    Routine Check-Ups:
o    High-risk individuals should undergo regular screenings for early detection.

 

Conclusion

Early gastric cancer is challenging to detect due to mild and non-specific symptoms. However, regular screenings and early diagnostic methods significantly improve the success rate of treatment. Diagnostic tools such as gastroscopy enable the early identification and management of the disease before progression.
Treatment options include endoscopic methods, surgical interventions, and, if necessary, chemotherapy. Early diagnosis dramatically increases long-term survival rates. Embracing a healthy lifestyle and managing risk factors are the most effective strategies for reducing the likelihood of gastric cancer.