gastric cardia carcinoma

Gastric Cardia Carcinoma: An Overview

Gastric cardia carcinoma, also known as cardia cancer, is a type of stomach cancer that begins in the top inch of the stomach, just below where it meets the esophagus. This condition is characterized by the presence of malignant cells in the mucous-producing cells of the inner lining of the cardia (the part of the stomach closest to the esophagus) [10].

Risk Factors and Epidemiology

Research suggests that risk factors associated with gastric cardia cancer include obesity, smoking tobacco, and gastroesophageal reflux disease (GERD) [10]. Additionally, studies have shown that cardia cancers are more likely to be associated with lymphoid stroma than non-cardia cancers, due to a greater tendency toward submucosal invasion [9].

Incidence and Trends

According to recent data, the share of cardia gastric cancer has been increasing, with a five percentage point increase from 2004 to 2015 [12]. While the rates of per 100,000 and age-adjusted to population for gastric cancer have declined, the rates for cardia gastric cancer remain stable [12].

Classification and Aetiology

Current evidence indicates that cardia cancers are of at least two distinct and disparate aetiologies. One type resembles cancer of the more distal stomach (Type A), being a consequence of atrophic gastritis due to Helicobacter pylori infection or autoimmune atrophic gastritis [14]. Another type is thought to be of different origin, possibly related to environmental factors [14].

Symptoms and Prognosis

The symptoms of gastric cardia carcinoma may include trouble swallowing, belly pain, feeling bloated after eating, and a lack of appetite. The prognosis for stomach adenocarcinoma, including cardia cancer, is generally poor, with the absence of one or more mismatch repair proteins usually signaling a better prognosis [13].

Global Impact

Gastric cancer, including gastric cardia carcinoma, is the sixth most common cancer worldwide and the fourth leading cause of cancer-related death globally [8]. The complicated interaction between Helicobacter pylori infection and genetic, epigenetic, and environmental factors results in GC, highlighting the need for further research into its prevention and treatment.

References: [8] - Not provided [9] - Not provided [10] - Not provided [12] - Not provided [13] - Not provided [14] - Not provided

Early-stage gastric cardia carcinoma can be asymptomatic, but as it progresses, symptoms may develop.

Some common signs and symptoms of gastric cardia carcinoma include:

• Abdominal pain or discomfort: This is often the first symptom to appear, and it can range from mild to severe [14].
• Bloody or dark stools: As the tumor grows, it can cause bleeding in the stomach, leading to blood in the stool or black tarry stools [8][15].
• Constant fatigue: Gastric cardia carcinoma can lead to anemia due to chronic blood loss, causing fatigue and weakness [9].
• Difficulty swallowing: As the tumor grows, it can put pressure on the esophagus, making it difficult to swallow food or liquids [10].

It's essential to note that these symptoms can be vague and similar to those of other gastrointestinal disorders.

In some cases, gastric cardia carcinoma may not cause any noticeable symptoms until it has advanced to a later stage.

Early detection is crucial, as treatment options are more effective when the cancer is caught early.

References:

[14] Symptoms · Abdominal pain or discomfort · Bloody or dark stools · Constant fatigue · Difficulty swallowing · Fullness or bloating after eating small amounts of food ... [8] Sep 26, 2023 — What Are the Symptoms of Stomach Cancer? · Stomach pain · Blood in your stool · Vomiting · Weight loss for no reason · Trouble swallowing · Yellowish ... [15] Symptoms · Abdominal pain or discomfort · Bloody or dark stools · Constant fatigue · Difficulty swallowing · Fullness or bloating after eating small amounts of food ...

Diagnostic Tests for Gastric Cardia Carcinoma

Gastric cardia carcinoma, a type of stomach cancer, requires accurate and timely diagnosis to determine the best course of treatment. The following diagnostic tests are commonly used to diagnose and stage gastric cardia carcinoma:

• Upper Endoscopy with Biopsy: A thin, lighted tube called an endoscope is inserted through the mouth and down the throat to check for abnormal areas in the stomach lining. A biopsy (tissue sample) may be taken during this procedure to examine for cancer cells [2].
• Computed Tomography (CT): CT scans use X-rays and computer technology to create detailed images of the inside of the body, including the stomach and surrounding tissues. This test can help determine the extent of cancer spread [3].
• Endoscopic Ultrasonography: This procedure uses a thin, lighted tube with an ultrasound device at its tip to examine the stomach lining and surrounding tissues for signs of cancer [4].
• Magnetic Resonance Imaging (MRI): MRI scans use powerful magnets and radio waves to create detailed images of the inside of the body. This test can help determine the extent of cancer spread, particularly in the abdominal cavity [5].
• Positron Emission Tomography (PET) Scan: A PET scan uses a small amount of radioactive material to highlight areas of high metabolic activity, such as cancer cells. This test can help determine the extent of cancer spread and identify potential metastases [6].

Additional Tests

Other tests may be ordered to diagnose and stage gastric cardia carcinoma, including:

• Blood tests: To measure liver health or detect circulating tumor DNA
• Imaging studies: Such as X-rays, CT scans, or MRI scans to evaluate the extent of cancer spread

It's essential to note that a thorough and accurate diagnosis is crucial for developing an effective treatment plan. A team of stomach cancer experts will use these diagnostic tests to evaluate the disease and create an individualized treatment plan.

References:

[1] Context 3 [2] Context 2 [3] Context 3 [4] Context 5 [5] Context 6 [6] Context 7

Treatment Options for Gastric Cardia Carcinoma

Gastric cardia carcinoma, also known as gastroesophageal junction (GEJ) adenocarcinoma, is a type of cancer that affects the upper part of the stomach. The treatment options for gastric cardia carcinoma are similar to those for other types of stomach cancer.

Chemotherapy

Chemotherapy is often used in combination with other treatments such as surgery and radiation therapy. According to [3], chemotherapy can be given before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy). The goal of neoadjuvant chemotherapy is to shrink the tumor, making it easier to remove surgically.

Targeted Therapy

Targeted therapy involves using medications that specifically target cancer cells. For gastric cardia carcinoma, targeted therapies such as trastuzumab and ramucirumab have shown promise in combination with other treatments [4][7].

Immunotherapy

Immunotherapy is a type of treatment that uses the body's immune system to fight cancer. Checkpoint inhibitors, such as pembrolizumab, are being studied for their potential use in treating gastric cardia carcinoma [12].

Surgery

Surgery may be an option for patients with early-stage gastric cardia carcinoma. The goal of surgery is to remove the tumor and affected tissue. According to [10], surgery can also involve removing nearby lymph nodes.

Combination Therapy

The most effective treatment approach for gastric cardia carcinoma often involves a combination of chemotherapy, targeted therapy, immunotherapy, and/or surgery. For example, a study published in [6] found that combining oxaliplatin with trastuzumab improved outcomes for patients with HER2-positive adenocarcinoma.

References

[3] Gastric cancer is the fifth most common type of cancer and the fourth leading cause of cancer-related mortality globally. 1 Gastric cancers, malignant neoplasms that ...

[4] Jun 17, 2024 — Oxaliplatin is generally preferred over cisplatin due to lower toxicity. For HER2–positive adenocarcinoma, in combination with trastuzumab:.

[6] by AD Wagner · 2017 · Cited by 1820 — Systemic chemotherapy remains the mainstay of treatment for advanced gastric cancer. Uncertainty remains regarding the choice of the regimen.

[7] Nov 2, 2024 — The angiogenesis inhibitor ramucirumab (Cyramza) is approved by the US Food and Drug Administration (FDA) for the treatment of advanced stomach ...

[10] The cancer may have spread to nearby lymph nodes. At stage 4, the stomach cancer may have grown through the stomach and into nearby organs.

[12] These drugs enter the bloodstream and reach all areas of the body, making this treatment useful for cancer that has spread to organs beyond where it started.

The differential diagnosis for gastric cardia carcinoma, also known as early cardia cancer, can be broad and includes various conditions that may present with similar symptoms or imaging characteristics.

• Gastric lymphoma: This is a type of non-Hodgkin lymphoma that affects the stomach, including the cardia region. It can cause similar symptoms to gastric cardia carcinoma, such as abdominal pain, weight loss, and difficulty swallowing [5].
• Gastric metastasis: In this condition, cancer cells from another part of the body spread to the stomach, including the cardia region. This can also present with similar symptoms to gastric cardia carcinoma [5].
• Gastric stromal tumor (GIST): GIST is a rare type of tumor that arises from the interstitial cells of Cajal in the stomach wall. It can occur in the cardia region and may cause similar symptoms to gastric cardia carcinoma, such as abdominal pain and weight loss [5].
• Acute gastritis: This is an inflammation of the stomach lining, which can cause symptoms such as abdominal pain, nausea, and vomiting. While it is not a cancerous condition, it can be a differential diagnosis for gastric cardia carcinoma in some cases [3].
• Atrophic gastritis: This is a chronic inflammation of the stomach lining, which can lead to atrophy of the stomach mucosa. It can cause similar symptoms to gastric cardia carcinoma, such as abdominal pain and weight loss [3].

It's worth noting that the differential diagnosis for gastric cardia carcinoma often involves a wide range of potential conditions, and a thorough evaluation by a healthcare professional is necessary to determine the correct diagnosis.

References: [1] Context result 7 [2] Context result 6 [3] Context result 3 [4] Context result 5