Understanding Stomach Cancer
- Camilla Row, 45, was diagnosed with an aggressive form of stomach cancer called poorly differentiated gastric adenocarcinoma when she was 39 years old. She’s sharing her story to “make a difference” and spread awareness for stomach cancer, a disease she never suspected she would get.
- Gastric cancer, or stomach cancer, stands as a formidable adversary in the realm of oncology. It arises from the cells lining the stomach, an organ integral to the digestive process. This type of cancer is characterized by its aggressive nature and a tendency to be diagnosed in advanced stages, which poses significant challenges to treatment and management.
- The stomach, nestled within the digestive system, is responsible for breaking down food and initiating the digestive process. However, when cells within the stomach’s lining begin to grow uncontrollably, gastric cancer can develop. The progression of this disease is often silent and insidious, with early symptoms that are easily overlooked or mistaken for common digestive complaints. This stealthy advance is a primary reason why gastric cancer often evades early detection.
- Symptoms of stomach cancer could be: indigestion, heartburn, appetite changes, weight loss, abdominal pain and discomfort, nausea and early satiety, swelling in the abdomen, weakness, and fatigue.
Now 45, the Korean American clinical psychologist is sharing her story to “make a difference” and spread awareness for stomach cancer..
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Instead, her gastroenterologists told her to take medicine to minimize stomach acid. But when the pain worsened and Row feared she could be having a heart attack, she recalled begging her doctor for help.
She told TODAY.com, “I was actually crying. I’m like, ‘This hurts so bad, please don’t send me home.'”
It was then her doctor scheduled her to have an endoscopy, which revealed she had stomach cancer, something she admitted she had no knowledge of—a diagnosis which led her to have her stomach, ovaries, and breasts removed.
Row’s symptoms had begun in 2015, but she didn’t receive her diagnosis until 2018. Her diagnosis came as a shock as she considered herself healthy and has no family history of the disease.
Following her stage one diagnosis, she had her whole stomach and 47 lymph nodes surgically removed. She also underwent chemo and had her esophagus connected to her small intestine.
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After that, she was monitored every six months with CT scans and blood tests to check for cancer recurrence.
In 2021, a blood test that checks for circulating tumor DNA turned out positive and tumors were eventually found on her ovaries, which were due to her gastric cancer.
She then, was diagnosed with stage 4 stomach cancer, and had her ovaries and fallopian tubes removed.
Row, who has remained positive throughout her cancer journey and has underdone seven heated chemo therapies, as well as traditional chemo, told TODAY.com, “I’ve actually just surpassed my expiration date because when I was first diagnosed (with stage 4 cancer), the longest prognosis I got was 24 months.
“So to be here and say I’m still here, I’m still doing extremely well.”
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With no evidence of disease in her scans as of March 6, 2023, and microscopic levels circulating tumor in her blood, Row wants to make the most of her diagnosis and inspire others to know the signs and symptoms of this disease.
“If I have limited time, I’m going to make my time worth it and count. Knowing that I can make a difference really helps me feel like my disease is not in vain,” she added.
To further celebrate her pathology results, Row’s husband Brennan took to Instagram on March 7, 2023, writing, “I wanted to update you all about my wife @camilla_row and her pathology results… which show no cancer!!
“All the biopsies came back negative as well as the fluid. It’s been such an impossible journey but today is a day to rejoice in Gods mercy and grace. From the bottom of my heart, thank you to everyone of you who has prayed for us and encouraged us along the way. I can’t put into words how thankful and grateful we are as a family for your support! I am on cloud nine!!”
Row told City of Hope following the good news last year, “And I hope my story gives other patients hope. You may have to fight for it. Carve your own path.”
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Understanding Gastric Cancer
Gastric cancer, or stomach cancer, stands as a formidable adversary in the realm of oncology. It arises from the cells lining the stomach, an organ integral to the digestive process. This type of cancer is characterized by its aggressive nature and a tendency to be diagnosed in advanced stages, which poses significant challenges to treatment and management.
The stomach, nestled within the digestive system, is responsible for breaking down food and initiating the digestive process. However, when cells within the stomach’s lining begin to grow uncontrollably, gastric cancer can develop. The progression of this disease is often silent and insidious, with early symptoms that are easily overlooked or mistaken for common digestive complaints. This stealthy advance is a primary reason why gastric cancer often evades early detection.
WATCH: Advice on how to handle a cancer diagnosis.
According to the World Health Organization, gastric cancer occupies a grim position as the fifth most common cancer across the globe. More alarmingly, it is the third leading cause of cancer-related mortality. These statistics underscore the global impact of gastric cancer and the critical need for increased awareness, early detection, and more effective therapeutic strategies.
The journey from a healthy stomach lining to cancerous growth is not fully understood, but it is known to involve a combination of genetic, environmental, and lifestyle factors. Infection with Helicobacter pylori, a bacterium linked to ulcers, is a known risk factor, as are diets high in smoked and salted foods and low in fresh fruits and vegetables. Other contributing factors may include chronic gastritis, smoking, and certain genetic predispositions.
Learning About The Symptoms
Gastric cancer, notorious for its silent progression, frequently eludes early detection due to a lack of specific symptoms in its initial stages. This stealthy nature contributes to its reputation as a particularly insidious form of cancer. However, as the disease advances, a constellation of symptoms may begin to manifest, signaling the presence of malignancy within the stomach lining, SurvivorNet experts explain.
Subtle Onset: Indigestion and Heartburn
Often dismissed as common digestive complaints, persistent indigestion, and heartburn can be early harbingers of gastric cancer. These symptoms may be mistaken for benign conditions such as gastroesophageal reflux disease (GERD) but should be evaluated if they persist or worsen.
Appetite Changes and Weight Loss
A noticeable decrease in appetite, termed anorexia in the medical community, can lead to unintentional weight loss, a concerning sign that may indicate the presence of gastric cancer or other serious medical conditions.
Abdominal Pain and Discomfort
As the cancer grows, it may cause pain or a vague discomfort in the abdomen, often in the upper to mid-stomach region. This pain may be intermittent or constant and can be exacerbated by eating.
Nausea and Early Satiety
Nausea and a feeling of undue fullness after eating only small amounts of food, known as early satiety, are symptoms that can arise from the tumor pressing on the stomach, reducing its capacity, or affecting normal gastric motility.
Ascites: Swelling in the Abdomen
In more advanced stages, gastric cancer can lead to the accumulation of fluid in the abdomen, known as ascites. This condition can cause significant swelling and discomfort due to the increased pressure within the abdominal cavity.
Systemic Symptoms: Weakness and Fatigue
Generalized weakness and fatigue are nonspecific but common symptoms that can be associated with advanced gastric cancer. These symptoms result from the body’s systemic response to the cancer and the nutritional deficiencies that it may cause.
It is crucial for individuals, especially those with risk factors for gastric cancer, to remain vigilant for these symptoms. While they can be associated with a variety of non-cancerous conditions, persistent or unexplained symptoms warrant a thorough medical evaluation. Diagnostic tools such as endoscopy, imaging studies, and biopsy can help clarify the cause of these symptoms and facilitate early intervention.
The insidious nature of gastric cancer underscores the importance of recognizing these potential warning signs. Early detection remains a critical challenge but is essential for improving outcomes, as the effectiveness of treatment is greatly enhanced when the disease is identified at an earlier stage.
Treating Stomach Cancer
The treatment of gastric cancer is a complex process that is tailored to the individual’s specific stage of cancer, overall health, and personal treatment goals. It often involves a multidisciplinary team of specialists, including oncologists, surgeons, gastroenterologists, radiologists, and pathologists, to ensure a comprehensive approach to care.
Surgical Treatment
Surgery is the cornerstone of curative treatment for gastric cancer, particularly in the early stages. The extent of surgery depends on the tumor’s location, size, and stage:
- Endoscopic Resection: For very early-stage cancers (T1a) that have not invaded beyond the superficial layers of the stomach lining, endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be performed.
- Partial Gastrectomy: Removal of part of the stomach (subtotal gastrectomy) may be indicated for tumors located in the lower or middle portions of the stomach.
- Total Gastrectomy: For tumors that involve a larger portion of the stomach or are located near the esophagus, the entire stomach may be removed (total gastrectomy).
- Lymph Node Dissection: The removal of surrounding lymph nodes (lymphadenectomy) is typically performed to ensure the cancer has not spread and to aid in staging.
Chemotherapy may be used at different stages of treatment:
- Neoadjuvant Chemotherapy: Administered before surgery to shrink the tumor and make it easier to remove.
- Adjuvant Chemotherapy: Given after surgery to kill any remaining cancer cells and reduce the risk of recurrence.
- Palliative Chemotherapy: Used in advanced stages to relieve symptoms and improve quality of life when curative treatment is not possible.
Radiation therapy may be used in combination with chemotherapy (chemoradiation) either before surgery to shrink the tumor or after surgery to destroy any remaining cancer cells. It can also be a palliative treatment to relieve symptoms such as pain or bleeding.
Targeted therapy drugs focus on specific abnormalities within cancer cells. For example, trastuzumab (Herceptin) may be used for HER2-positive gastric cancers, which have high levels of the HER2 protein.
Immunotherapy is a newer form of treatment that helps the immune system recognize and attack cancer cells. Drugs like pembrolizumab (Keytruda) may be used for advanced gastric cancer, especially when the cancer has a high level of PD-L1 expression or is MSI-H (microsatellite instability-high).
Palliative care is an integral part of treatment at any stage of cancer. It focuses on providing relief from the symptoms and stress of the illness with the goal of improving the quality of life for patients and their families.
Participation in clinical trials may also be an option for some patients, offering access to new and innovative treatments that are not yet widely available.
The Importance of Getting a Second Opinion
After receiving a cancer diagnosis, it’s important to remember that you can and should talk to other cancer specialists about your disease.
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told SurvivorNet in a previous interview. “Because finding a doctor up to the latest information is important.”
RELATED: Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options.
Also, in some instances, the specific course of treatment is not clear-cut. That’s even more why understanding your disease’s potential approaches is crucial.
At the National Cancer Institute, a patient referral service will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you or isn’t giving you sound advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor recommends or are worried about its possible side effects.
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
Be Pushy, Be Your Advocate, Says Leading Expert
The bottom line is that being proactive about your health could be life or death. Learn as much as possible from as many experts as possible so you know you did your best to take control of your health.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.