Optimizing the Clarifying Diagnosis of Stomach Cancer: A Review of Literature and Methodology
The problem of treating stomach cancer is extremely urgent. Annually, 798 thousand (9.9%) new cases and 628 thousand (12.1%) deaths from this disease are registered in the world. It is extremely important to study the increase in morbidity over time. Despite the systematic long-term fight to reduce the incidence of stomach cancer and its mortality, this pathology remains among many countries’ most important medical and socio-economic problems. One of the major factors that determine the high mortality from stomach cancer is its incorrect primary and subsequent diagnosis when the prevalence of the process corresponds to stages III-IV. The five-year survival rate in this group of patients is no more than 12%, while in the 1st stage of the process, this index varies between 90-95%. Optimizing the clarifying diagnosis of stomach cancer during both stages of examination can significantly reduce the number of deaths from this disease.
The problem of specifying diagnostics of stomach cancer has been of interest to the scientific community for a long time. Scientists agree that stomach cancer is a multifactorial and multistage process stretched in time. Therefore, clarifying diagnostics in this context is crucial for effective treatment. On the other hand, there is an opinion that the existing methods of diagnosis are not sufficiently effective. Postoperative refining examination may not reveal the signs of a tumor, leading to even more aggravating consequences in the future. Finally, ultrasound and endo-ultrasound are highly informative in diagnosing stomach cancer and its complications. However, the current statistics prove that even these methods have little accuracy. Thus, the scientific community raises the question of optimizing the clarifying diagnostics of stomach cancer.
This research is based on the study of secondary literature on the causes of stomach cancer, the necessary therapy, and the role of diagnosis in the effectiveness of treatment of the disease. For this, the method of comparative analysis of literature was used. Regarding the second part of the study, the method of interviewing was utilized to collect empirical data on the effect of the disease on the family of a person diagnosed with stomach cancer.
Causes of the Stomach Cancer
Three groups of causes facilitate the development of stomach cancer. The first group includes damaging environmental factors. Among them, a certain place belongs to food factors, for example, excess in the diet of animal fats, table salt, nitrites, and nitrates. Important is the lack of natural food antioxidants contained in fresh vegetables and fruits. Professional factors, in particular, woodworking, chemical production, steel making, and gold and tin mining, among other determinants, have a definite effect on the development of the disease. A statistically significant association between smoking and the development of stomach cancer has also been established in the case studies. The relative risk for smokers was 1.69%, and for those who had earlier smoked but quit smoking – 1.48%. Consequently, environmental factors are some of the reasons for developing stomach cancer.
The second group of factors is genetic, meaning there may be a hereditary burden on stomach cancer. The risk of developing stomach cancer is 3 times greater in people whose relatives have had this disease than in the general population. It infracts their gene stability; that is, mutations in the genome of epithelial cells are relevant. Finally, the third group of causes is acquired by catching viral diseases. For example, the Helicobacter pylori bacterium causes the development of inflammatory-dis regenerator changes in the gastric system. Later, within 15-20 years, it can progress and spread in the anthro-cardial direction, affecting the fundus of the stomach with the resultant progression of the total atrophic disease with intestinal metaplasia, epithelial dysplasia, and subsequent transformation into stomach cancer. Thus, the factors of gastric cancer development are provoked by various influences. That is why diagnosing this disease is a rather complex multi-step process.
Diagnostic Methods of Stomach Cancer
As a rule, the diagnosis begins with a general practitioner. He examines the rectum and a blood test. Further diagnosis depends on the verdict of the general practitioner. If he cannot establish the cause or considers that the symptoms can be brought about by cancer, he directs the patient to the appropriate specialist in the hospital.
In order to diagnose stomach cancer, the following tests and procedures can be performed. First, a proctoscopy is conducted to examine the intestinal mucosa, and cell samples are taken (biopsy). Secondly, a colonoscopy during which photography and biopsy of cells are carried out. The bowel should be completely emptied for the procedure to be objective. Similarly, the subsequent diagnosis of cancer is made. Thus, it is possible to conclude that despite the use of computer technology, a significant role is played by the human factor in the diagnosis of stomach cancer. In this case, the diagnosis’s correctness rests on the doctor’s or nurse’s quality of care. One should rely on something other than the subjectivity of the opinion of even an exceptional professional in the field of oncology. That is why the methods of cancer diagnosis require further improvement by minimizing the role of the human factor.
Therapies for the Stomach Cancer
The main treatment methods for stomach cancer are surgery, chemotherapy, and radiation. Often, the best treatment approach can be using two or more methods. The main goal of the treatment is to get rid of the disease completely. If a full cure is not possible, the therapy aims to alleviate the condition’s symptoms, such as eating disorders, pain, or bleeding.
Depending on the type of stomach cancer and the stage of the disease, surgery can be performed to remove the tumor along with a part of the stomach. If possible, the surgeon leaves the unaffected area of the stomach. At the moment, surgery is the only way to cure stomach cancer if diagnosed timely. In the presence of 0, I, II, or III stages of stomach cancer, as well as a relatively satisfactory condition, an attempt is made to completely remove the tumor. An obstacle to this type of treatment is spreading the tumor to other organs through metastases. At the same time, even if the cancer is widespread and cannot be completely removed by the time of the surgical intervention, the operation can help prevent bleeding from the tumor or promote the passage of food through the intestine. This type of surgery is called palliative. It is performed to alleviate or prevent symptoms and not to cure cancer.
By chemotherapy, the use of antitumor drugs to destroy tumor cells is meant. Chemotherapy can be the main method of treating stomach cancer when the tumor has already spread to nearby organs. This method of therapy can be used before or after surgery. Experience has shown that chemotherapy can alleviate symptoms in some patients with stomach cancer, especially in cases where cancer has spread to other areas of the body. The main obstacle is that chemotherapeutic drugs destroy tumor cells and can damage normal cells, leading to side effects.
Radiation therapy is a method of treating gastric cancer of various types using ionizing radiation. The main task of radiotherapy is the blockade and destruction of cancer cells. Even though this method helps minimize possible side effects due to its impact on the specific location, it is practically not used. Side effects of radiation therapy include radiation burns formed from long-term exposure to a certain area and with the contact method – tissue ulceration, which are the main barriers to applying this treatment method. The effectiveness of the above treatment approaches depends on a qualitative and timely diagnosis of the disease.
Psychosocial Aspect of Stomach Cancer
Oncological disease completely changes the life of a person and his or her family. Not only the external state changes but also the internal one, with frequent protracted depressions and other psychological disorders. Therefore, in the treatment of cancer, in addition to classical methods, a major role is played by the correction of the patient’s psycho-emotional state, which is an integral part of the care of cancer.
An important role is played by psychological work with people who survived cancer. Regardless of the treatment results, they can feel depressed, lose interest in the former hobby, and be less driven by professional goals. Patients, who have undergone the removal of organs affected by the tumor, almost always suffer because of the awareness of the changes that have occurred in their body, especially if the result of surgery is scars or other visible aesthetic defects. The same problem is evidenced in patients (particularly women) who have undergone chemotherapy or radiation therapy and have lost their hair. Notably, attempts to entrust the task of psychological rehabilitation of patients to their friends and relatives, as a rule, do not bring significant results. People emotionally involved in the history of the disease are rarely able to engage in constructive dialogue with the patient. They tend to regret it, and it is much more difficult to adequately assess their moods and true desires. In addition, many of them are psychologically depleted by caring for a loved one and fear for their life; therefore, they also need professional help.
Optimizing the clarifying diagnosis of stomach cancer during primary and subsequent examinations can significantly reduce the death rate from this disease. Often, the causes of cancer are the factors that come from the harmful environment around them, viral diseases, and hereditary predisposition. Diagnosis of stomach cancer is a complex process, where the human factor of a doctor or a nurse plays a significant role. Treatment for stomach cancer includes surgery, chemotherapy, and radiation therapy. However, the effectiveness of primary and post-treatment, whichever approach is selected, depends mainly on the success of the disease diagnosis. In this context, the role of the human factor in identifying the disease should be minimized. Cancer is a hard test to take in a person’s life. Therefore, along with traditional treatment, psychotherapy should also be used. This is especially true in the case of an unsuccessful cancer diagnosis, as will be shown in the second part of the work.
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