More and more people are facing the diagnosis of cancer. One of the most common tumors worldwide is considered to be stomach cancer. Gastric tumor ranks third after lung and breast cancer. The disease occurs most often in men over 60-70 years of age. In Germany, the percentage of cured cases is one of the highest in Europe. This is due to the development of the latest methods of diagnosing and treating stomach disease.
Reasons
Unfortunately, a huge number of both external and internal causes contribute to the development of the disease. External factors include poor ecology, polluted air.
The others constitute the main group of causes:
- Genetics. If there were relatives with stomach pathology in the family, the likelihood of developing it is almost doubled.
- Diet. Expressed errors in diet also contribute to the deformation of cells into atypical cells due to the influence of temperature, increased fat content of food.
- Bad habits. Smoking, alcohol abuse, especially vodka, has a direct deleterious effect on tissues, causing changes in DNA structure and stimulating the growth of masses.
- Associated diseases of the gastrointestinal tract. Ulcers, duodenogastric reflux, and chronic gastritis may subsequently malignize. This occurs due to the constant exposure of acidic contents to the stomach wall, causing the destruction of normal cells. Surgery on the gastrointestinal tract also contributes to the development of the formation, as a frequent side effect of such operations is the throwing of acidic contents.
- German oncology research centers are constantly conducting studies to determine the relationship between the medications taken and the development of cancer. It has been proven that an insufficient amount of vitamin C in the body can be a prerequisite for the development of the disease.
- A real breakthrough in gastroenterology was the discovery of Helicobacter pylori. As early as 1994, the International Agency for Research on Cancer classified the bacterium as a Group 1 carcinogen. Prevention of cancer in this case is eradication of the bacterium, however, if there are already initial signs of cancer, eradication will not improve the outcome of the disease and will not stop the process.
Types of cancer
Specialists use a large number of different classifications to determine the different forms of cancer. The type of mass will help in determining further treatment tactics and prognosis.
All types of oncology are divided according to:
- Macroscopic picture
- Histologic analysis
- Localization of the process.
Macroscopic picture
- Polypoid cancer. The tumor grows into the gastric lumen and has clear margins with normal tissue. There is no evidence of ulceration. The prognosis is quite favorable.
- «Cancer ulcer.» This type is characterized by ulceration, the edges of the formation are raised and clear. Usually this form of formation develops against the background of an existing gastric ulcer, so it is quite difficult to diagnose it. To correctly diagnose the disease, a biopsy from several sites is performed, since a single biopsy can give a negative result.
- Ulcerated carcinoma. The tumor grows through all tissues, there are no clear boundaries. It grows quite quickly and metastasizes very early.
- Skirr. Specially aggressive form, another name is diffuse-infiltrative. It is poorly visible on gastroscopy, but it grows through the submucosa. It also grows rapidly and metastasizes early.
Histologic analysis
According to histological analysis, 6 types of tumors are distinguished:
- Adenocarcinoma — develops from the glandular tissue of the organ.
- Pistillate cell
- Glandular squamous cell
- Squamous cell
- Small cell
- Undifferentiated
This classification gives some information to the doctor about the structure of the mass. However, its rate of growth and metastasis is not always determined by its type.
Another important information for tumor treatment is the localization of the tumor. In most cases, the tumor grows in the antral and pyloric regions — about 70%. Tumors of the small curvature of the stomach body and cardia are equally common — about 10% of cases. And approximately 5% each occupy the anterior and posterior wall of the body.
In addition to the above classifications, there are many others that describe the structure and position of the tumor in more detail.
Stages
In worldwide practice, 5 stages of the disease are distinguished.
- stage zero. At this stage, there are almost no symptoms, the carcinoma grows in the inner layer of the mucosa, so it can not be detected by conventional methods.
- stage 1. The carcinoma has already invaded the mucosa and affected the muscular layer. In addition, already at this stage the tumor can be detected in single lymph nodes. However, diagnosis and treatment at this stage gives a positive outcome in 95% of cases.
- stage 2. Carcinoma grows into the outer layers. 10 to 15 lymph nodes are affected. At this stage, a positive outcome is observed in 50% of patients.
- stage 3. The mass has sprouted all the walls of the organ and affected surrounding tissues and organs. From 15 to 50% have a favorable outcome of the disease.
- stage 4. At this stage, metastases have spread throughout the body.
Symptoms
Unfortunately, in the early stages there are practically no symptoms. The patient may feel a slight discomfort in the stomach, stool disorders. However, for a long time may not pay attention to this. When there is frequent vomiting and constant constipation or diarrhea, vomiting with blood or blood in the stool, the patient turns to the doctor. Most often this is already the 3rd or 4th stage of the process. In addition to symptoms associated with the disruption of the organ, there are general complaints:
- increased fatigue
- reduced performance
- skin pallor
- weight loss, etc.
The appearance of severe pain indicates the growth of carcinoma into other organs.
Diagnostics
It is quite difficult to make a diagnosis, as the doctor is required to rule out a large number of other diseases of the gastrointestinal tract that are in any way similar to the symptoms of cancer. For this purpose, the doctor has a whole arsenal of techniques.
The peculiarity of diagnostics in German clinics is the availability of high-class equipment and individual approach to each patient. The patient is consulted not only by a gastroenterologist, but also by related specialists.
First of all, the doctor assesses the patient’s symptoms and complaints, conducts a complete examination and then prescribes the necessary tests. Cancer most often develops against the background of chronic inflammatory diseases of the stomach. Therefore, the specialist prescribes tests:
- general blood test (will show signs of inflammation, anemia).
- biochemical analysis (will show changes in liver, kidney function, which may accompany the growth of the mass)
- coagulogram (evaluation of the blood coagulation system), abnormalities indicate a problem with liver function, as well as a neglected process
- oncomarkers (elevated values indicate a large volume of mass or tumor decay).
After evaluation of laboratory data, the patient is performed instrumental diagnostic methods.
The first and most common diagnostic method is gastroscopy. In German clinics, it can be performed in two ways:
- classic gastroscopy, when an endoscope is inserted through the mouth under short-term general propofol anesthesia (the anesthesia is withdrawn after 15 minutes). This provides detailed information about the presence of pathology in the stomach.
- «virtual» capsule gastroscopy. In this case, the patient swallows a miniature camera that takes pictures every second. They are received by the doctor and analyzed for the presence of pathology. This method has a certain disadvantage. In the process of taking pictures, the camera can not be turned to all parts of the stomach, that is, during its passage through the stomach, not all parts will be examined thoroughly. However, if the carcinoma is located in the submucosa, it may not be noticed.
Ultrasound is then performed, however, for clearer visualization, prior preparation in the form of avoiding foods that cause fermentation and gas formation is required. In Germany, ultrasound equipment is at the highest level, as it is in Germany that it is developed and perfected.
On a side note! For better diagnosis of the disease, when ultrasound or gastroscopy does not reveal any pathology, ultrasound endoscopy is used. At the end of the gastroscope, an ultrasound transducer is installed, which allows you to see the pathology in the depth of the tissue.
Computed tomography and magnetic resonance imaging are used to further evaluate the size, location, and malignancy of the tumor. It is performed with or without contrast.
In addition, ultrasound, CT scanning and endoscopy are used to perform biopsy pathologic material. German specialists use mainly fine-needle biopsy, and the number of complications is much lower than in other variants.
Radioisotope scintigraphy (distant metastases: bones, organs) and laparoscopic intervention (to assess the peritoneum) are used to evaluate metastases.
Cancer treatment in Germany
The main treatment is removal of the carcinoma. In many cases, chemotherapy and radiation therapy are given before and after surgery. Depending on the volume of the process, its stage, and the concomitant pathology, chemotherapy is first performed to reduce the volume of the carcinoma, and then surgery is performed.
There are quite a few resection options:
- in case of a tumor with clear boundaries, doctors remove a section of the stomach. Thus, if it grows closer to the esophagus — it is a proximal resection, if to the intestine — distal.
- if the stage of the process is zero or first, the operation can be performed using endoscopic techniques. That is, the gastric mucosa is removed during endoscopy.
- If the tumor grows further, a gastrectomy is performed. This is the complete removal of the stomach. In this case, surgeons use loops of intestine to form a new stomach.
Chemotherapy is performed to reduce the volume of the mass and prevent the spread of metastases. German specialists continue to develop new drugs for chemotherapy. In addition, a patient with stage 3 or 4 of the process can participate in clinical trials of a drug, which gives a chance to stop the process.
It’s gaining momentum in all of medicine. targeted therapy. Drugs are injected into physiological carriers (liposomes) and delivered by the carrier directly to the tumor. The malignant cells are destroyed without affecting normal tissues.
Palliative therapy is used when other treatments are not possible. It is usually aimed at eliminating symptoms and alleviating the patient’s condition.
How much does it cost to treat cancer in clinics in Germany?
The cost of treatment depends on many components, such as:
- formation size
- process stage
- concomitant pathology
- therapy regimen
- patient’s wishes
Prices for gastric cancer treatment are summarized in the table below.
| Name of service | Price, € | Optional |
|---|---|---|
| Diagnostics | 2100 | 3 days, outpatient |
| Complete gastricresection | 18000 | 5 days inpatient |
| Partial gastric resection | 10000 | 5 days inpatient |
| Chemotherapy | от 1200 | over a cycle |
How do I choose a clinic?
Many patients turn to foreign clinics in order to receive advice from an experienced specialist and quality treatment. Germany is one of the most demanded countries for treatment of any cancer diseases. In the clinics of Germany, in particular Munich, work highly qualified doctors, doctors of science, with experience of work in different countries, as well as engaged in scientific developments in the field of oncology. The head of the center «Clinics of Germany» will help to orient on clinics and specialists in Germany Maxim Sergeevich Rykov. He has been organizing diagnosis and treatment with leading specialists for many years, and the quality of his work is determined by a huge number of positive reviews from patients.
It’s very important! Treatment of gastric cancer is complex, complex, requires the involvement of many specialists. Only early diagnosis and early treatment will ensure a high chance of victory with this disease.