How common and dangerous is stomach cancer?

Stomach cancer is a common oncological entity, both in men and women in today’s era. It is a cancer with increased mortality and specifically is the second most frequent cause of death from oncological causes worldwide.

A major reason for the increased mortality in patients with stomach tumors is late diagnosis. Indicatively, it is worth noting that 80% of patients with a stomach tumor are completely asymptomatic or show non-specific symptoms. This means that half of the patients with such a disease visit their doctor late and are diagnosed at an advanced stage. This fact reduces, as is understood, the chances of a cure and limits the treatment options.

Modern introspection can change the landscape

In recent years, the progress achieved in endoscopy has drastically changed the landscape for the benefit of patients. With the help of high resolution endoscopy, artificial intelligence, conventional and/or digital chromoendoscopy and magnifying endoscopy, we are given the opportunity to identify early and accurate stomach lesions before they develop into malignancy. Specifically, with the latest generation endoscopes, we are able to identify abnormal and suspicious areas in the stomach and therefore take targeted biopsies. A universal mapping of the stomach is achieved in this way. In addition, with sophisticated endoscopic methods and with the help of endoscopic ultrasound, we can predict with more than 90% accuracy whether a tumor in the stomach is simply superficial or has infiltrated the deep layers of it. In other words, modern endoscopy allows not only the early recognition of damage, but also contributes to their early identification and gives us information on how extensive the damage is in the stomach or in the neighboring organs.

Can endoscopy lead to treatment and cure?

The biggest revolution in the treatment of tumors of the stomach and other organs of the digestive system has been performed by endoscopic surgery. It is an innovative method based on the use of minimally invasive techniques aimed at the complete removal of stomach tumors and healing in these patients. Endoscopic submucosal resection (ESD) occupies a prominent place in these techniques.
At this point we must emphasize that endoscopic surgery is only indicated for early lesions, i.e. for incipient stomach cancers.

What are the steps involved in ESD?

Specifically, during the gastroscopy, the gastroenterologist, after identifying the damage he wants to remove, marks its boundaries with special tools. Then, with a special needle, he injects a liquid inside the stomach wall in order to separate its individual layers.

In the next step, the endoscopist uses special knives to cut the two surface layers of the stomach, keeping the muscle layer intact. In this way, the complete and in one piece detachment of the part of the stomach containing the tumor is achieved, while at the same time the integrity of the organ is ensured. It must be understood that this operation requires great precision and delicacy of the surgical movements. This is a time-consuming procedure in which the stomach muscle is protected and the vessels are ligated to prevent perforation and bleeding. An “artificial ulcer” is created after the operation, which heals by itself after a short period of time. Patients enter the hospital for observation and can be discharged in 1 to 2 days.

Are there complications and how are they treated?

Complications of this method are mainly limited to muscle injury with a risk of perforation and bleeding from the area of ​​the created ulcer. It is noteworthy that the rate of complications is very small, of the order of <4% and they can be treated purely endoscopically.
Another advantage of this particular method is the fact that even if the patient needs to be operated on for tumors that are deeper than expected, the surgery can be performed without any time delay.

in conclusion

Advances in modern endoscopy allow not only the early discovery of incipient tumors in the stomach but also their valid identification. With the use of minimally invasive endoscopy we are now able to remove specific tumors from the stomach endoscopically, without surgical incisions. The complication rate is low, the hospital stay is minimized, and patients can heal and avoid an otherwise crippling surgery that will significantly affect their quality of life.