- partial GASTRECTOMY, in which the surgeon
removes the section of stomach containing the
tumor - total gastrectomy, in which the surgeon
removes the entire stomach and an area of sur-
rounding adipose (fatty) tissue called the
omentum - lymphadenectomy, in which the surgeon
removes the adjacent lymph nodes
Few lifestyle modifications beyond those to
decrease the risk for recurrent or other cancers,
are necessary for people who have endoscopic
resections. Partial gastrectomy requires moderate
changes in diet and EATING HABITSto accommodate
the reduced size of the stomach, primarily a shift
to eating smaller meals more frequently and
reducing the amount of carbohydrates in the diet.
Total gastrectomy requires significant modifica-
tions in eating habits as the surgery connects the
lower end of the ESOPHAGUSto the start of the DUO-
DENUM, leaving no reservoir for ingested food.
Most people can eat only a few bites of food at a
time after total gastrectomy, making eating
enough to meet the body’s nutritional needs a
fairly continuous process. As well, because the
stomach produces the substances that make it pos-
sible for the body to absorb vitamins such as vita-
min B 12 , people who undergo total gastrectomy
need NUTRITIONAL SUPPLEMENTS.
The outlook for stage 0 stomach cancer is excel-
lent, with a 90 percent of people who undergo
surgery reaching the five-year survival mark. The
outlook remains very good for stage 1 stomach
cancer, with about a 70 percent five-year survival
rate. More advanced stages of stomach cancer, in
which the cancer spreads to involve other tissues
and organs, remain difficult to treat successfully.
Clinical research studies may offer the opportunity
to participate in investigational treatments that
extend life as well as improve QUALITY OF LIFE.Risk Factors and Preventive Measures
As is the case with many kinds of cancer, age is
the most significant risk factor. Most stomach can-
cers occur in people over age 60. Family history of
stomach cancer or COLORECTAL CANCER (which is
also an ADENOCARCINOMA of the gastrointestinal
tract), long-term cigarette smoking (particularly in
combination with excessive alcohol consumption)
and OBESITYalso raise the risk for stomach cancer.
The most valuable preventive measure is FOBT to
screen for the presence of blood in the gastroin-
testinal tract. Bleeding raises suspicion for several
kinds of cancer that are highly treatable with early
detection and intervention. People who have pep-
tic ulcer disease should be tested and treated for H.
pyloriinfection. A diet high in vegetables and low
in smoked or preserved foods seems to lower the
risk for stomach cancer.
See also ADENOCARCINOMA; ADENOMA-TO-ADENO-
CARCINOMA TRANSITION; CANCER RISK FACTORS; CANCER
PREVENTION; CANCER TREATMENT OPTIONS AND DECI-
SIONS; END OF LIFE CONCERNS; INFLAMMATORY BOWEL
DISEASE(IBD); INTESTINAL POLYP; LIVER CANCER; LY M-
PHEDEMA; PANCREATIC CANCER; SMOKING AND CANCER;
STAGING AND GRADING OF CANCER; SURGERY BENEFIT
AND RISK ASSESSMENT.92 The Gastrointestinal System