If it is stomach cancer, it will be bad!
Gastric ulcer-gastric perforation-gastric cancer
clinical picture
(1) symptoms
More than 1.70% of early gastric cancer has no obvious symptoms. With the development of the disease, nonspecific symptoms similar to gastritis or gastric ulcer may gradually appear, including fullness and discomfort or dull pain in the upper abdomen, pantothenic acid, belching, nausea, occasional vomiting, loss of appetite, black stool and so on.
2. The symptoms of advanced gastric cancer are pain in the stomach area, frequent biting, which has no obvious relationship with eating, and also has pain similar to peptic ulcer, which can be relieved after eating. Abdominal fullness, heaviness, anorexia, abdominal pain, nausea, vomiting, diarrhea, emaciation, anemia, edema, fever, etc.
The main manifestations of cardiac cancer are subaxiphoid discomfort, pain or retrosternal pain, accompanied by eating obstruction or dysphagia; Cancer of the fundus of stomach and lower cardia often has no obvious symptoms, and it does not attract attention until the tumor is huge and necrotic, causing upper gastrointestinal bleeding, or until the tumor infiltrates into the cardia and causes dysphagia. Tumors in the body of stomach are mostly swollen, and pain and discomfort appear later. Ulcer cancer is the most common form of gastric antrum, so the symptoms of upper abdominal pain appear earlier. When the tumor extends to the secluded doorway, it can cause symptoms of pyloric obstruction such as nausea and vomiting.
The spread and metastasis of cancer can cause ascites, hepatomegaly, jaundice and metastasis of lung, brain, heart, prostate, ovary and bone marrow, and produce corresponding symptoms.
(2) signs
Most patients with gastric cancer have no obvious signs, and some patients have mild tenderness in the upper abdomen. Advanced gastric cancer located in pyloric sinus or stomach body can sometimes be palpated as a mass, which is often nodular and hard. When the tumor infiltrates into adjacent organs or tissues, the mass is often fixed and cannot be pushed. When a female patient palpates a mass in the middle and lower abdomen, it is often suggested that it is Crockenbeier tumor. When gastric cancer has liver metastasis, nodular masses can be touched in the swollen liver. Obstructive jaundice can occur when abdominal metastatic masses compress the common bile duct. In patients with pyloric obstruction, the enlarged stomach type can be seen in the upper abdomen, and the sound of shock can be heard. When cancer metastasizes through the thoracic duct, the left supraclavicular lymph nodes can be enlarged. When there is pelvic implantation in advanced gastric cancer, rectal digital examination can palpate bladder (uterus) rectal fossa nodules. Ascites can occur when there is peritoneal metastasis. Intestinal stricture caused by small intestine or mesenteric metastasis can lead to partial or complete intestinal obstruction. Diffuse peritonitis caused by cancer perforation can cause symptoms of peritoneal irritation such as plate-like stiffness and abdominal tenderness in supine position, and can also infiltrate organs adjacent to the cavity to form internal fistula.
(3) Common complications
1, combined with gastrointestinal bleeding, dizziness, palpitation, tarry stool and vomiting of brown substances may occur.
2. When the abdominal metastasis of gastric cancer oppresses the common bile duct, jaundice and stool clay color may appear.
3, combined with pyloric obstruction, vomiting may occur, and increased stomach type, odor and shock sound can be seen in the upper abdomen.
4, diffuse peritonitis caused by cancerous perforation, can appear supine plate stiffness, abdominal tenderness and other peritoneal irritation symptoms.
5, the formation of gastrointestinal fistula, see the discharge of indigestible food.
Traditional therapy
Surgical treatment plays an important role in the treatment of gastric cancer, and it is the main treatment method that can achieve the cure goal at present. For those who can't do radical resection, palliative resection of the primary focus should be done as far as possible according to the specific situation of the patient. In addition, according to the staging of gastric cancer, the biological characteristics of the tumor and the patient's physical condition, chemotherapy, radiotherapy, traditional Chinese medicine treatment and immunotherapy are selected.
(1) surgical treatment
If the clinical examination shows no obvious signs of metastasis and there are no serious organic lesions in all important organs, if it is estimated that the general nutritional status and immune function can withstand surgery, laparotomy should be given. Sometimes, even if there is distant metastasis or serious complications such as pyloric obstruction and puncture, and the operation is generally tolerable, palliative surgery should be given to relieve symptoms and pain.
The effect of surgical treatment of gastric cancer is closely related to early diagnosis, pathological morphology and the choice of surgical scheme. According to the research on the biological behavior of gastric cancer, the surgical prognosis of upper gastric cancer is worse than that of middle and lower gastric cancer, because there are more patients with lumps in middle and lower gastric cancer and more patients with yayoi in upper gastric cancer. There is no significant relationship between tumor size and prognosis. Because of its unclear margin, it is difficult to determine the scope of surgical resection, and this type of gastric cancer has many and extensive metastases, so it is difficult to completely remove it by surgery. So the annual survival rate is low. However, the perigastric lymph nodes of mass gastric cancer are mostly mild metastasis and located near the cancer focus, which is easy to be completely removed by surgery, so the prognosis is good. The 5-year survival rate of gastric cancer surgery in recent 30 years at home and abroad is 20%-30%.
(2) Chemotherapy
Chemotherapy for gastric cancer is inefficient, so it can only be used as adjuvant therapy, that is, it is generally used as adjuvant therapy before, during and after surgery, which can achieve the following purposes: (1) Locate the focus and improve the surgical resection rate. (2) Reduce the chance of tumor cell diffusion and implantation during operation. (3) Adjuvant chemotherapy after radical operation to eliminate possible residual lesions and prevent metastasis and recurrence. (4) Palliative surgical treatment can control the development of the disease and prolong the survival time.
(3) radiotherapy
Undifferentiated cancer, poorly differentiated cancer, tubular adenocarcinoma and papillary adenocarcinoma are sensitive to radiotherapy, and those with small and shallow cancer focus and no ulcer have the best effect, which can make the tumor disappear completely. Mucinous adenocarcinoma and signet ring cell carcinoma are taboo because of their poor radiotherapy effect.
Preoperative radiotherapy for gastric cancer can shrink the primary tumor of more than 60% patients in different degrees, the resection rate is 5.3%-20% higher than that of the simple operation group, and the 5-year survival rate can be improved by 1 1.9%. Intraoperative radiotherapy is feasible for patients whose primary focus has been resected, lymph nodes have metastasized in two groups, or whose primary focus has invaded the serosal surface and involved the pancreas, without peritoneal and liver metastasis. Those who cannot be removed during operation should be marked with silver pods on the residual cancer, and the histological type can be confirmed as non-mucinous cancer or signet ring cell cancer by postoperative pathology.
(4) immunotherapy
The indications of immunotherapy include: ① systemic application of immunostimulants after radical gastrectomy for early gastric cancer; ② In the case of unresectable or palliative resection, immunostimulants can be directly injected into the residual cancer; ③ Patients with advanced ascites are suitable for intraperitoneal injection of immunopotentiators.
(5) Endoscopic therapy
If patients with early gastric cancer have systemic diseases that are not suitable for surgical resection, endoscopic treatment can be used. In addition, laser, microwave and injection of anhydrous alcohol can also achieve radical effect through endoscope.
Gastric cancer is a common malignant tumor originating from the stomach. This disease is mainly caused by eating carcinogenic food containing ammonium nitrite, such as smoked food, pickled vegetables and moldy food. Chronic atrophic gastritis is closely related to the occurrence of gastric cancer, intestinal metaplasia is related to gastrointestinal cancer, and digestive tract ulcer is related to early gastric cancer. There are three forms of diffusion and metastasis of gastric cancer:
① The tumor spread directly and invaded the tissues around the stomach, such as liver, diaphragm, colon, pancreas and omentum.
② Lymph node metastasis is the most common metastasis of gastric cancer. With the increase of the depth and breadth of cancer invasion, the lymph node metastasis rate of each station gradually increases, and it can reach the left supraclavicular lymph node along the thoracic duct, and even the bilateral supraclavicular lymph nodes can be metastasized.
③ Gastric cancer cells often enter the liver from the portal vein to form liver metastasis, in addition, it can also cause the metastasis of lung, bone, brain, ovary and periumbilical skin along the blood passage. Cancer cells will fall off after invading gastric serosa and spread in abdominal cavity and pelvic cavity, causing ascites and implantation metastasis around the wound.
Upper abdominal discomfort, pain, stomach pain on an empty stomach or after meals, loss of appetite, vomiting, nausea, frequent diarrhea, black stool, weight loss and sudden change of food preference are all common symptoms of early gastric cancer. If the following symptoms appear, you should go to the hospital for further examination in time.
① General symptoms of the upper digestive tract, even if the symptoms are mild, if they persist or break out intermittently for more than 3 to 6 months.
(2) Those who have a history of "stomach trouble" and their symptoms have been obviously aggravated recently.
③ Patients with chronic gastritis or multiple gastric polyps have been diagnosed.
④ The regularity of typical ulcer history has changed.
⑤ Stool occult blood test is positive for a long time.
Diagnosis:
Fiberoptic gastroscopy and cytological diagnosis of gastric exfoliation are the most important methods to diagnose gastric cancer. HCD 1ca 13； X-ray barium meal examination is one of the indispensable methods to diagnose gastric cancer. HCD 1ca 05； Gastric juice analysis, tetracycline fluorescence test and immunological diagnosis of gastric cancer have certain value in the diagnosis of gastric cancer.
Treatment:
After the diagnosis of gastric cancer, you should go to a specialized hospital for treatment in time. Radical resection is the main method for stage ⅰ and ⅱ gastric cancer, and postoperative stage ⅱ gastric cancer can be treated with chemotherapy and traditional Chinese medicine. Stage Ⅲ gastric cancer should also undergo radical resection. If it really can't be cured, palliative resection can be done, and chemotherapy and traditional Chinese medicine should be considered after operation. For patients with stage Ⅳ gastric cancer without obvious distant metastasis, radical surgery or palliative resection is feasible in some cases, and short-circuit surgery is feasible in those who cannot be resected, and chemotherapy and traditional Chinese medicine should be combined after operation.
Prevention:
① Eat fresh food and have a moderate diet.
② Maintain psychological balance and emotional stability.
③ To actively treat chronic diseases, we should first actively prevent and treat oral diseases and chronic upper respiratory diseases, and actively cure chronic stomach diseases.
Pathogenic factors and prevention of "gastric cancer"
What are the possible factors of gastric cancer? Although many medical experts have done a lot of work on the etiology of gastric cancer, it is still unclear. Now we can only introduce the pathogenic factors related to gastric cancer as follows: (1) nitrosamines and gastric cancer: the carcinogenic problem of nitrosamines has been widely concerned. At present, animal experiments have proved that nitramine compounds can cause gastric cancer in animals. In nature, the precursors of nitrosamines-secondary amine and nitrite are widely distributed. These substances enter the stomach with food, and can be converted into nitrosamines under the action of high acid environment (PH 13) and/or bacteria in the stomach, thus inducing gastric cancer. (2) Relationship between gastropathy and gastric cancer: ① Chronic gastritis and intestinal metaplasia: Chronic gastritis, especially chronic atrophic gastritis, can develop into gastric cancer. The incidence of gastric cancer caused by gastritis in antrum of stomach is high. According to statistics, about 10% gastritis in gastric antrum may cause gastric cancer. Gastric cancer occurs in chronic atrophic gastritis because the lesion is often accompanied by intestinal metaplasia and continues to develop into atypical hyperplasia, which is considered as the early stage of gastric cancer. ② Gastric polyp: Gastric polyp is an adenoma and a benign tumor. When the diameter of the polyp exceeds 2 cm, it means that there is a possibility of malignant transformation. A total of 83 cases of gastric adenomatous polyp/kloc-0 were examined, of which 35 cases were malignant (18%). ③ Peptic ulcer: Whether gastric ulcer can become cancerous has been a big debate. Most clinical and pathological workers believe that; Part of the stomach may become cancerous due to gastric ulcer. The main reason is that the incidence of gastric cancer in patients with chronic gastric ulcer is high; In addition, some patients with gastric ulcer are often signs of malignancy when their clinical symptoms change significantly. Pathologically, according to the reports of pathology departments of some hospitals in Shanghai and Beijing, the rate of gastric cancer from gastric ulcer to malignant transformation is 5-0%. However, some people think that less than 1% of gastric cancer is accompanied by malignant transformation of gastric ulcer. ④ Genetic factors: The incidence of gastric cancer in relatives is 4 times higher than that in normal people. The incidence of gastric cancer in Sujiaren with type A blood is also higher than that in normal people. The difference between these phenomena and the incidence of ethnic groups in Yun Chi by the Institute of Epidemiology indicates heredity. One of the races has a certain relationship with the incidence of gastric cancer. How to prevent gastric cancer (1) Do not eat or eat less foods containing nitrosamines such as salted fish, sausages and sauerkraut. I eat fresh vegetables and avoid eating too many irritating diets. Quit smoking and drinking, and eat regularly. Eat moderately to prevent overeating, so as to reduce the occurrence of gastritis and gastric ulcer. ⑶ Actively treat atrophic gastritis, gastric ulcer and other diseases, and check them regularly. (4) Once diagnosed as multiple polyps or single polyps with a diameter greater than 2 cm, surgical treatment should be taken in time. 5] People with tar-like stools should go to the hospital for further examination regardless of whether they have stomach symptoms.
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Example of one-day recipes for gastric cancer
Breakfast: milk (250g of fresh milk), boiled eggs (50g of eggs), cake (50g) and rice porridge (50g of rice).
Lunch: soft rice (75g of rice), steamed meat pie (50g of lean meat), fried shredded carrots (200g of carrots).
Meals: boiled fruit water (peach 150g) and baked steamed bread (flour 25g).
Dinner: noodle soup (minced meat 25g, rapeseed 75g, dried noodles 50.
G), flower rolls (75g flour), steamed fish (carp 100g).
Extra meal: milk (250 grams of fresh milk)
All-day cooking oil 10g.
Dietotherapy prescription for gastric cancer
(1) Sugarcane and ginger drink: appropriate amount of sugarcane and ginger. Take half a cup of sugarcane juice, 1 tablespoon of ginger juice, and stew well. Take it twice a week after stewing. Has the effects of harmonizing middle energizer and invigorating stomach, and is suitable for early gastric cancer.
(2) Brown sugar tofu: tofu 100g, brown sugar 60g, clear water 1 bowl. Wash brown sugar with clear water, add tofu and cook for 10 minutes. If you take it regularly, you can choose this dietotherapy prescription for those who have obvious effects of regulating stomach to stop bleeding and vomiting blood.
(3) Drinks of dried tangerine peel and red dates: 65438+ 0 dried tangerine peel and 3 red dates. Remove the core from red dates, and decoct dried tangerine peel in water. 65438+ 0 times a day, this dietotherapy prescription can promote qi and strengthen the spleen, reduce adverse reactions and stop vomiting, and is suitable for deficiency-cold vomiting.
(4) Radish porridge: 30 grams of radish seeds and appropriate amount of japonica rice. Stir-fry radish seeds first, and then cook porridge with japonica rice. Take 65438+ 0 times a day at breakfast. This prescription can be used to eliminate food retention and abdominal distension, and can be used for patients with obvious abdominal distension.
(5) Pericarpium Citri Tangerinae lean porridge: 9g Pericarpium Citri Tangerinae, 0/2g squid bone, 50g lean pork and appropriate amount of japonica rice. Cook porridge with dried tangerine peel, fishbone and rice. After cooking, remove dried tangerine peel and cuttlefish bone, add lean meat slices and cook again, and season with a little salt. Take it twice a day at breakfast and dinner. This slimming porridge can reduce adverse reactions, stop vomiting, strengthen the spleen and smooth qi, and people with abdominal distension can choose this meal first.
(6) Lettuce: 250g of lettuce, 250g of jujube and 500g of flour. Chop lettuce, cook jujube, remove the core, mix with flour and make a cake. When eaten as a snack, it can strengthen the spleen and stomach, dispel dampness and promote diuresis; You can choose loose stools or diarrhea.
(7) Six Precious Cake of Euryale ferox: 30g of Euryale ferox, 30g of yam, 30g of poria cocos, 30g of lotus seeds, 30g of coix seed, 30g of lentils and 500g of rice flour. All the above materials are processed into powder and mixed with rice flour. 6 grams, two or three times a day, flavored with sugar, taken with boiling water, or as a cake. This prescription has a good effect of strengthening the spleen and stopping diarrhea.
(8) Longan Peanut Soup: 250g peanuts in red, 5 jujubes, longan meat12g. Remove the core of jujube and cook it with peanuts and longan in water. 65438+ 0 times a day, nourishing blood and strengthening the spleen, this prescription can be used for those with obvious anemia.
(9) ebony porridge: ebony 20g, japonica rice 100g, and appropriate amount of rock sugar. First, stir-fry dark plum juice to remove residue, and then cook glutinous rice into porridge. Add a little rock sugar to the porridge after it is cooked, and then cook it a little. 1 once a day, this prescription has astringent and hemostatic effects.
(10) Sesame porridge: 20g sesame, 20g peach kernel and 80g japonica rice. Cook porridge with sesame, peach kernel and glutinous rice. 1 every other day, used for people with loose bowels and dry stools.
(1 1) Sesame porridge: 6 grams of sesame, 30 grams of japonica rice, and appropriate amount of honey. Stir-fry sesame seeds until rice porridge is almost cooked, then add honey and mix well. 65438+ 0 times a day, this medicated diet nourishes blood and moistens intestines.
(12) Fish maw crisp: Fish maw (the swim bladder of large yellow croaker, carp, yellow-lipped fish and eel can be used as raw materials), sesame oil. Fried fish maw with sesame seeds. Take10g three times a day with warm water. This medicated diet can tonify kidney, replenish essence, nourish tendons, dredge veins, stop bleeding, remove blood stasis and reduce swelling.
(13) stomach-invigorating and cancer-preventing tea: sunflower stalk or sunflower plate 30g. Boil the above raw materials into soup. Decoction instead of tea, long-term drinking, has anti-cancer, anti-cancer and anti-inflammatory effects. Patients with anastomotic inflammation after gastric cancer surgery can choose this meal. (
1) Some trace elements can prevent cancer. Foods containing more molybdenum are radish, cabbage, lentils and bean sprouts; Pumpkin and dried sweet potato contain more selenium; The food containing more germanium is asparagus.
(2) Eating more vegetables and fruits with high vitamin C content can block nitrosamines and prevent cancer.
(3) Some vegetables contain lignin, which can promote macrophages to devour cancer cells, such as asparagus, shepherd's purse, taro, lotus root, water chestnut and carrot.
(4) Eating foods with high calcium content can prevent cancer, such as fish, soybeans, chlorophyll and sesame seeds.
(5) The foods that increase the anti-cancer ability are carrots, tomatoes, red sweet potatoes, dark green vegetables and garlic.
(6) Tea has a good anti-cancer effect, especially green tea. It is necessary to advocate drinking more green tea.