Cancer Articles (Dr. S.N White)

Stomach Cancer Where is the stomach located?  The stomach is a pouchlike organ which makes up a relatively small part of the intestinal tract. It lies below the diaphragm in the left upper part of the abdomen, crossing over to the right below the liver. The stomach hangs comparatively free in the abdominal cavity and moves with breathing. What symptoms indicate the possibility of stomach cancer?  Unfortunately, the symptoms of stomach cancer are often vague and nonspecific. The most common symptom of stomach cancer is indigestion. This may consist of a sense of discomfort or mild pain, fullness or bloating, burping, slight nausea, heartburn, or loss of appetite. Of course these are signs which we find easy to ignore, but if they persist even intermittently for a period of 2 weeks, your doctor should be consulted. Later signs might include blood in the stools or vomiting, rapid weight loss, and severe pain. These symptoms may also indicate the presence of an ulcer. ...

The hospital stay is about two weeks. You can go out immediately after you get home, but you should allow six weeks before you are really able to go back to work full time. Of course, you can resume some desk work earlier. But most patients require this time for complete readjustment. You can eat everything but start with six small meals a day, at 8 a.m. and 10 a.m., noon, 3 p.m., 6 p.m. and 10 p.m. Later ease gradually back to your usual routine. The surgeon will generally want to see you three weeks after you've left the hospital. He will check the incision and evaluate your progress. If you encounter any problems, write them down and discuss them when you come back. If any urgent problems arise, phone the surgeon. How will I know if I'm cured?  If you are eating well, have no discomfort, and can enjoy a normal life, then you're cured. You'll know whether you are cured by the way you feel.

The nerve cutting operation is a method of treatment that was introduced in the 1940's. It has been done all over the world in tens of thousands of patients. The logic of cutting the vagus nerves (the wandering nerves that influence acid formation by the self stimulation of certain brain areas) is that it eliminates or markedly reduces the acid in the stomach. The procedure of cutting these nerves to eliminate their function is called a vagotomy. When the vagotomy is done, the surgeon also has to enlarge the stomach outlet or remove a part of the stomach. The ulcer can be left in because with this operation it will heal. A healed ulcer produces no symptoms and no complications. The procedure is technically easier than a gastrectomy and less of a strain on the patient. It appears to be about as effective, except in the patient with a bleeding ulcer. When do you do which operation?  No one size hat fits all heads. This decision is determined by the kind of person you are, what yo...

The removal of part of the stomach is termed a gastrectomy. This operation was introduced for ulcer diseas about fifty years ago by European surgeons. It removes the ulcer and the complete lower end of the stomach on the assumption that the removed ulcer cannot recur in that area and that removal of part of the stomach eliminates the major source of acid production. Its logic is: less stomach, less acid, therefore, no ulcer. A new opening is made between the remaining stomach and the small intestine so that you can eat normally.

How are bleeding ulcers treated? An individual who is bleeding from an ulcer should be hospitalized on an emergency basis. He may require transfusions to replace the lost blood and a washout of the stomach to facilitate the possibility that the bleeding will stop by itself. Other nonoperative measures for the control of hemorrhage are also employed. If the bleeding is stopped by these treatment methods, a decision should be made about the need for surgery on the ulcer in the next symptom-free interval. If the bleeding appears to be continuing, an emergency operation may be necessary to remove the ulcer or to control its bleeding. In an unsupervised situation the patient can bleed to death just as if an artery in his wrist had been cut. Many surgeons believe that a senior patient who has already had a severe bleeding ulcer episode should not be permitted to go through a second episode without surgery. The fatalities from bleeding are higher than for any other ulcer complication. One...

The crater that is the ulcer can cause bleeding by irritating the surrounding tissues or by actually eroding the wall of a nearby small or even of a large blood vessel. It is like a hole in the sidewall of a rotting water hose. The amount of blood seepage will depend on the size of the pipe (blood vessel) and the size of the leak. This is the most serious complication of ulcer disease because it is a type of internal hemorrhage. How can I tell if my ulcer is bleeding?  One may be completely unaware of the bleeding. The only symptoms may be rapidly developing weakness, dizziness and sometimes fainting. If blood is vomited, then it is obvious. The vomited blood may be bright red or have the appearance of old coffee grounds. A black or tarry stool may indicate bleeding. Not all tarry stools contain blood; a stool may be this color from certain medications, especially those containing iron. There is an immediate way your physician can determine whether the black is blood this can b...

What are the risks of the operation?  One expects that the average patient in good general condition who does not require an emergency operation and is in good hands should sail through the operation. The risk of the procedure in these circumstances is 2 percent or less. You have every right to be very optimistic. Of course, the situation is different in the sick individual with advanced or long-neglected disease who requires emergency surgery for a serious complication.

An increased stomach acid production can result from nervousness, tension, rage or fear. Brain activity can stimulate the nerves that control acid production. Acid formation is also increased with smoking and the consumption of alcohol. Ulcer patients who insist on smoking and drinking literally pour increased amounts of acid on the internal wounds. Part of the symptoms of a hangover result from stomach irritation that produces congestion or even small ulcers. There is also a large group of people who don't seem to worry inordinately and are abstainers but who also get ulcers. We obviously don't know all the answers.

What made you suspect that I have an ulcer? The symptoms are fairly typical: Burning pain in the upper mid abdomen, especially at night, accompanied by bloating, fullness and a sense of intestinal awareness, is common. The pains are often partially relieved by eating or taking antacids. It is especially common to have had these symptoms at some time in the past at which time the patient called it indigestion, which is what it was. The intermittent nature of ulcer symptoms is very characteristic. The symptoms are often exacerbated in association with specific stresses in one's personal life.