Stomach cancer emerges years beforehand – these symptoms must be taken seriously

June 7, 2020| Barbara W. Andrade| 0 Comment | 9:29 am

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Stomach cancer is not as common as colon or breast cancer, but its prognosis is less favorable. FOCUS Online explains the reasons why early detection is therefore particularly important, the current therapies and what belongs to prevention.

Stomach cancer is not uncommon, with around 15,000 new cases per year on the list of carcinomas. 9,300 men and 5,600 women are affected. The cause of the gender difference is currently unknown.

Stomach cancer is not one of the most common cancers, but the chances of survival are not good. Two thirds ultimately die of the tumor disease. “We have to assume that three out of four patients will only be diagnosed in a locally extended or even metastatic situation,” reports Michael Stahl, head of the Clinic for Internal Oncology at the Evangelical Clinics Essen-Mitte (KEM).

This late diagnosis means that three quarters of the patients have a poor prognosis and cannot be cured with an operation alone, summarizes the oncologist, who is among other things the author responsible for the German guideline for the diagnosis and treatment of esophageal cancer and a member of the lead group of the working group for internal oncology for carcinomas of the stomach and esophagus.

Cause of stomach cancer unknown but there are risk factors

“The only good relative risk factor for stomach cancer is the stomach germ Helicobacter pylori”, the expert clarifies. That would be risk factor number 1.

However, around a quarter of Germans are infected with this bacterium, but only a fraction of them develop gastric cancer. Why they get sick is not yet fully understood, just as much is still unknown about the causes of stomach cancer.

There is also evidence that smoking increases the risk. And what about alcohol? “However, there is no meaningful evidence that alcohol also increases the risk of stomach cancer,” adds the oncologist. However, it can lead to gastric mucosal inflammation, i.e. gastritis, up to and including gastric ulcer (ulcer).

Chronic gastric mucosal inflammation and reflux disease could in turn increase the risk of stomach cancer at the junction with the esophagus.

Stomach cancer can also develop from previous operations on the stomach.

The reflux of bile is also considered a risk factor. This danger arises from being very overweight.

And on the subject of obesity and nutrition: Scientists assume that a one-sided diet with a lot of processed meat products, heavily salted, but also smoked and grilled foods promote stomach cancer – keyword nitrosamines, which are known to be carcinogenic. Rotten and moldy foods pose a general health risk, also with regard to stomach cancer.

Stomach cancer with certain genetic changes

In addition, there are genetic components in the development of gastric cancer: first-degree relatives (children, siblings) of patients with gastric cancer have an increased risk – i.e. if the father, mother or sibling are ill. In addition, stomach cancer can occur if a certain form of colon cancer is already present (hereditary colorectal cancer) or breast cancer.

These are patients with changes in their genetic makeup, for example what is known as microsatellite instability (MSI). You are at an increased risk of various types of cancer, including cancer of the stomach and intestines. “Doctors should keep this in mind if a patient has a colon cancer with microsatellite instability , or if there are multiple carcinomas in the family,” emphasizes the Essen-based oncologist.

However, all of these are only possible risk factors. “Of most patients who fall ill, we don’t know why, because none of these risk factors apply to them,” summarizes Michael Stahl.

Look out for these warning signs

Besides this, there is the second difficulty in gastric cancer – late diagnosis. This is because the symptoms are rather unspecific, affecting the stomach, but are often dismissed as harmless everyday complaints. Early signs can be:

Feeling of fullness, pressure in the stomach
general upper abdominal discomfort
Eructation
nausea
Vomit
Flatulence
Loss of appetite

“Anyone who has one or more of these complaints for more than three weeks should have them checked out by a doctor,” advises Michael Stahl.

Do not treat persistent stomach problems with acid blockers on your own initiative

However, many sufferers do not take these symptoms seriously and try to relieve them first with self-medication – wasting valuable time on early cancer therapy and thus a high chance of recovery.

They resort to gastric acid blockers that are available over the counter or prescribed by doctors. The pain will actually go away. “Cancer itself does not cause the pain at the beginning of the disease, rather the mucous membrane defect it causes is irritated by stomach acid – and that triggers the pain,” explains the expert.

This pain disappears when the stomach acid is blocked because it no longer irritates the mucous membrane. The cancer growth is not influenced by this, the tumor can spread undisturbed.

The most important diagnostic tool – gastroscopy

The oncologist therefore urgently recommends that the complaints be clarified by a quality-assured endoscopy, i.e. in a gastroenterological practice that carries out these examinations on a daily basis or in an appropriate center.

The gastroscopy only takes a few minutes; the doctor can not only check the condition of the esophagus and stomach up to the duodenum, but can also test whether Helicobacter is present and possibly take additional tissue samples.

Usually no tumor is discovered, but rather the stomach germ or an enlargement or relocation of the area between the stomach and esophagus (hernia), which can cause reflux. A change in diet can help here or medication may be necessary. Sometimes, however, the doctor finds stomach cancer, “and more and more often in the transition area to the esophagus,” reports the expert from the practice.

The reason for this is that there are more and more people who are very overweight. “Being overweight puts pressure on the abdominal cavity, which is why bile acids and stomach acids flow back into the transition area to the esophagus, which is not designed for frequent contact with these acids and is therefore damaged,” says Michael Stahl, summarizing the chain of reactions.

How stomach cancer spreads

The treatment depends on the severity of the disease (grading):

Whether the carcinoma is limited to the mucous membrane,
already affects the underlying muscle
in addition, the outer connective tissue of the stomach
surrounding organs
Lymph nodes
Has metastasized.

In Asian countries, where the risk of stomach cancer is very high and gastric cancer screening is therefore carried out regularly, the cancer can often be detected early. If the diagnosis “stomach cancer” is made in the early stages, i.e. only the mucous membrane is affected, there is a high chance of recovery.

Unfortunately, this is extremely rare in Germany, explains the oncologist. In this country, stomach cancer is usually only discovered when it has worked its way deeper into the tissue or has already broken through the stomach. This is also the reason why the prognosis for stomach cancer in Germany is so unfavorable – the cancer is recognized very late.

Stomach cancer does not depend on age

How long the time span between gastric cancer in its initial stage and the appearance of metastases cannot be answered. However, Michael Stahl points out in this context that it is a cancer myth that the tumor only grows slowly in the elderly. “We also have elderly patients with rapidly growing stomach cancer, and young ones,” he warns. Young people should also take stomach problems seriously and not dismiss them: “I’m only 35, it can’t be something bad, like cancer.”

Treatments for stomach cancer – chemotherapy plus surgery

Only in the early stages, i.e. when stomach cancer is limited to the mucous membrane, surgery alone is the method of choice. Then it is the only way to cure the patient.

Most patients, however, need more than the operation, the scientist reports. For locally advanced tumors (without metastasis), treatment consists of chemotherapy, surgery and renewed chemotherapy. Chemotherapy before the operation is intended to shrink the tumor and combat (invisible) metastases at an early stage.

Antibody therapy for HER2-positive gastric cancer

In addition, chemotherapy plus antibody therapy with so-called HER2 antibodies is used for certain forms of metastatic gastric cancer. In around 20 percent of gastric cancer patients, HER2 receptors (HER2-positive gastric cancer) are found in particularly large numbers on the cancer cells. They are docking points for growth factors. Occupied by the special antibodies, tumor growth can slow down significantly.

By the way, HER2 receptors are also found on breast cancer cells, keyword HER2-positive breast cancer. This is where this antibody therapy, which incidentally does not count among the immunotherapies, was first used.

In addition, attempts are being made in Germany, the scientist reports, to treat HER2-positive gastric cancer with HER2 antibodies plus immunotherapy. Scientists hope that this will enable them to offer equivalent treatment without chemotherapy in the future. However, the effect of this combination of therapies has not yet been proven.

Immunotherapies for gastric cancer do not (yet) meet expectations

In some forms of cancer such as melanoma or lung cancer, immunotherapies, for example with checkpoint inhibitors, are considered particularly successful today. These drugs are also currently being tested in studies for gastric cancer .

“Unfortunately, the first results are sobering,” reports the scientist. He and his colleagues had hoped that immunotherapy could improve the effect of chemo, but this was not confirmed. “If, however, all therapy options have already been exhausted in a patient, more can be achieved with immunotherapy than without further tumor-specific treatment,” reports Michael Stahl about the studies.

The problem with this is that it is currently difficult to predict in which patients the immunotherapy will work and which will not. Only in the few patients (less than ten percent of all patients with gastric cancer) whose tumors show what is known as high microsatellite instability (MSI-H) can one predict that immunotherapy has a high chance of effectiveness. Overall, the risk of severe side effects under immunotherapy is significantly lower than under chemotherapy, namely 20 percent instead of 60 percent.

The prognosis for gastric cancer is poor because the patients are late

How successful are the therapies at a glance? “The chances of a cure for stomach cancer are on average 25 to 30 percent; if stomach cancer is metastatic, the average life expectancy is one year,” reports Michael Stahl. The prognosis is only very good at a very early stage. However, patients with gastric cancer in this easily curable stage would be the exception in practice because many go to the doctor too late.

Prevention of stomach cancer – three measures

This makes provision and prevention all the more important. This includes, on the one hand, having longer stomach complaints clarified by a gastroscopy – and it does not matter how old the person affected is.

On the other hand, everyone should pay attention to the following three factors. Because little is known about the development of stomach cancer, so few are:

Pay attention to food hygiene, do not eat spoiled food, nothing that is moldy
Do not smoke
Avoid being overweight

This can not only protect the stomach, but is known to promote general health – not smoking and maintaining a normal weight are among the most important preventive measures against cardiovascular diseases such as high blood pressure, heart attack and stroke, but also against cancer.

The unknown colon cancer: How to prevent tumors in the small intestineThe unknown colon cancer: How to prevent tumors in the small intestine

June 4, 2020| Barbara W. Andrade| 0 Comment| 9:22 am

When it comes to colon cancer, most people think of colon cancer. What is less well known is that the small intestine can also develop malignant tumors. What you should know about it, about symptoms, treatment and the combination of colon and small bowel cancer.

Small bowel cancer accounts for up to five percent of all bowel cancers; around 2,600 men and women were diagnosed with small bowel cancer in 2016, compared with around 60,000 colon cancer. “It is important to classify a carcinoma on the one hand by localization, i.e. in the case of bowel cancer, small or colon cancer, but also differentiate it on the basis of its biological characteristics,” reports Ulrich Graeven, chief physician at the Clinic for Hematology, Oncology and Gastroenterology at Maria Hilf Mönchengladbach Hospital.

Cancer of the small intestine is usually biologically very different from cancer of the colon

While colon cancer is usually adeno tumors, i.e. growths of the mucous membrane, this affects only a small fraction of small bowel cancer. The most common forms of small bowel cancer, depending on the cells that cause the disease, are:

Neuroendocrine tumors (NET) with around 50 percent, they arise from hormone-producing cells
Gastrointestinal stromal tumors (GIST) make up about ten percent, these tumors originate from the connective tissue in the gastrointestinal tract.

The differing biological characteristics of the two types of colon cancer, colon and small bowel cancer, “make these two diseases so fundamentally different, even though both affect the bowel,” explains the oncologist.

Causes of small bowel cancer and why it is less common than colon cancer

What triggers the fact that the cells in the small intestine no longer act normally, but degenerate and multiply in an uncontrolled manner, is still largely unknown. It is assumed that there is a connection with pollutants in food that come into contact with the small intestine during passage and can thus influence its cells.

It is well known that the small intestine connects directly to the stomach. This first section of the three-part small intestine is called the duodenum, followed by the jejunum and ileum. In addition to transporting the chyme to the large intestine, the task of the five-meter-long small intestine is to break down certain food components and release them into the blood. The most important ones are carbohydrates, which are processed into various sugars, fat, but also vitamins and trace elements.

The chyme is still thin in this section of the intestine and is therefore transported on quickly. The contact time with the intestinal wall is much shorter than later in the large intestine, “which could explain why colon cancer is much more common than small intestine cancer,” the gastroenterologist explains the possible background. In addition, the mucous membrane in the small intestine is less susceptible to certain factors such as pollutants than that in the large intestine.

Risk factor hereditary diseases

However, there is also a familial willingness to develop small bowel cancer: Hereditary polyposis syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome. Genetically, a large number of polyps develop in the large intestine, sometimes also in the small intestine. These are adenocarcinomas, but are very rare in the small intestine compared to NET and GIST.

Small intestinal tumors associated with FAP are usually only discovered when polyps have been detected in the large intestine. In the course of further diagnosis of the familial predisposition, these rare small bowel carcinomas are also identified.

Small bowel cancer symptoms

Small bowel cancer usually grows slowly. Frequently, signs only appear when the disease has progressed and the tumor is taking up space. Depending on you can

Bleeding,
Stomach pain,
nausea
Constipation or diarrhea

occur. If the tumor is large, it can even block the intestines (ileus). The intestinal obstruction manifests itself through massive pain, it is always a medical emergency that is life-threatening and must be treated immediately.

Small bowel cancer prognosis varies

Small bowel cancer is usually only discovered at an advanced stage. In more than 70 percent, the carcinoma is only diagnosed in stage three or four, i.e. later than this applies to this common colon cancer – again the comparison with colon cancer.

The survival rates for small bowel cancer are therefore somewhat lower. “The decisive factor, however, is always the type of cancer of the small intestine,” explains the expert. If a GIST or NET is detected early, the chances of survival are very good. If, on the other hand, it is adenocarcinoma, which is also usually discovered later, the prognosis is not quite as favorable.

Diagnosis of small bowel cancer

The classic examination methods of gastroscopy and colonoscopy only cover the upper or lower part of the small intestine, “the almost five meters in between are not reached with these examination techniques,” explains the expert.

Imaging methods such as magnetic resonance tomography (MRT) or computed tomography (CT) are only used if there are symptoms and suspicion of this intestinal tumor. Capsule endoscopy, which shows images from the small intestine, also provides information.

Only when these examinations reveal an abnormality is it possible to specifically mirror the small intestine. “However, this is very time-consuming and cannot be used as a preventive examination – also because these intestinal tumors are very rare,” emphasizes Ulrich Graeven.

Small intestinal cancer therapies – surgery and its consequences

Overall, the following applies to the various small intestinal tumors: If possible, an operation should be performed. “If the tumor is limited, parts of the small intestine can usually be removed without any problems,” explains the oncologist in more detail.

A stoma, i.e. an artificial anus, is therefore usually not necessary. However, it is crucial which part of the small intestine is missing and which functions it had, which trace elements and vitamins it passed on to the body. This deficiency must then be compensated for through appropriate nutrition or medication.

Treatment for small bowel cancer varies depending on the type of tumor

Parts of the removed tumor are examined histologically. For the therapy plan, it is crucial whether it is NET, GIST or the rare familial adenocarcinoma in the small intestine. “A generally applicable therapy scheme for small bowel cancer is not possible because there is not just one small bowel cancer, but different ones, it always depends on its type,” emphasizes the oncologist.

Accordingly, there are many different therapy options. If a gastrointestinal stromal tumor (GIST) has metastasized, for example, there are very good drugs for further treatment. “This is not the classic chemotherapy, but we use so-called tyrosine kinase inhibitors, with very good results,” reports the expert. These are inhibitors, such as imitanib, that can block certain signaling pathways within the cells. They are sometimes also used before an operation to reduce the size of a tumor that is too large and therefore inoperable, or after an operation to avoid a relapse.

If the cancer of the small intestine is a neuroendocrine tumor (NET), on the other hand, surgery is often the only treatment required. The NET is further subdivided with regard to the need for drug therapy, taking into account its growth rate. This subdivision of the NET is also of crucial importance for planning therapy for metastatic NET.

Ademocarcinoma of the small intestine is treated on the basis of the results from the treatment of colon tumors.

Small bowel cancer prevention

Targeted prevention against these rare tumors is hardly possible – apart from the well-known rules for a healthy life, i.e. without smoking, with a sensible diet, extensive alcohol restriction and sufficient exercise. Because little is known about the possible causes of small bowel cancer, they cannot be influenced.

However, there is an important tip from the expert for everyone in whose families there are genetically determined polyps in the large intestine: Remember to not only limit the preventive measures to the large intestine, but also to extend it to the small intestine. Although this is provided for in the relevant colorectal cancer screening and follow-up programs, it must not be overlooked.

Key Principles of Implant DentistryKey Principles of Implant Dentistry

April 19, 2022| Barbara W. Andrade| 0 Comment| 9:54 am

Before your consultation with your dentist at implant dentistry san diego, you should know what to expect from your procedure. The main points of this article are the importance of soft tissue, bone, and implant placement. Occlusal contact is also a crucial point to consider. All these points should be carefully examined before treatment. The goal of your GP is to protect you and the staff. Before you go in for your appointment, ask yourself if you have any of these risk factors.

Bone

Whether the procedure is a flap-less or traditional surgery, it requires careful planning. In either case, a series of drills gradually enlarges the site of the implant. The final bur is slightly smaller than the implant itself, and it is placed with a torque-controlled wrench to avoid overheating the bone. The bone surrounding the implant is then reshaped to accommodate the new fixture. What is a Dental Implant Same Day Procedure? - Smiles By Julia Fort Lauderdale Florida

Osteointegration occurs when the biomaterial that is used to support dental implants is osteoconductive. This material enables the dental implant to integrate with the bone surface. Histological studies have shown that implant surface contacts the host bone and initiates the healing process. The procedure follows a sequence similar to that of bone regeneration in fractures and small defects. It ends with “restoration ad integrum,” or the absence of scar tissue.

Soft tissue

The success of dental implants depends on the stability of soft tissue surrounding the implants. This stability is best achieved through proper diagnosis and surgical planning. Inadequate soft tissue evaluation can lead to improper placement of dental implants, which is detrimental to both patient and implant health. Soft tissue grafting can be performed to address these soft tissue concerns. Grafting techniques differ according to patient anatomy and morphology. The biotype of the gingival tissues is based on the morphology of the tooth, bone, and gum tissue. An underdeveloped biotype can lead to pocket formation. A biotype with thick, flat tissue may not be suitable for implant placement.

The graft site must provide adequate vascularisation for the graft. It must be rigidly immobilised and provide adequate hemostasis. The donor tissue must be large enough to facilitate immobilization and achieve the desired volume augmentation after secondary contraction. Soft tissue grafting should be performed before the bone grafting procedure. If soft tissue grafting is not possible, connective tissue autografts can be used.

Implant placement

If successful dental implant placement is the ultimate goal, then a modern dentist will implement reproducible treatment protocols, which will ultimately lead to more successful outcomes. There are five key principles of implant dentistry, including past medical history, examination, occlusion, dental imaging, fixed versus removable prosthodontics, and surgery. This article will discuss each of these concepts and their proven contributions to implant dentistry. You should consider implementing these principles into your practice, too.

While successful implant placement is crucial, it’s also the most challenging aspect. Implant placement can go wrong, causing the implant to misalign with the bone. This can lead to unnatural crowns, gum recession, and dark grey metal around the gum. Improper implant placement can result in poor oral health and failure. In order to minimize these risks, patients should follow oral hygiene and care instructions closely for the long-term success of their implants.

Occlusal contact

Occlusal contact is an important component of implant prosthesis and must be accounted for. Ideally, occlusal contact should occur over a flat surface perpendicular to the implant body and be centered over the implant abutment. Secondary occlusal contacts should be placed within one millimeter of the implant body’s periphery to reduce the moment loads. Contacts with the marginal ridges should be avoided, as they are the most susceptible to cantilever forces and should be recontoured to occlude with the central fossa.

When there is an occlusal disparity, the dentist can utilize articulating papers or ribbons to check the occlusion. While these devices leave a contact mark, they are not effective because they are too thick and don’t give enough information to detect an occlusal disparity. Further, the thicknesses of dental marking ribbons vary from 20 microns to 200 microns.

Maintenance

Among other things, the maintenance phase of dental implants entails various parameters and risk factors. During this phase, patients should be informed of the procedures and associated risks. This is because a maintenance procedure involves the continued replacement of a dental implant with a new one. Informed consent is the key to a successful maintenance process. Here are some of the most critical aspects of the maintenance phase. Read on to learn more about the important aspects of this phase of dental implants.

A typical dental implant maintenance visit should last approximately an hour. The dentist will check for any changes to the patient’s medical and dental history. Instrument selection is also important, to avoid trauma to the implant surface or peri-implant tissues. Although an increasing number of patients opt for dental implants, they should understand the challenges of their treatment and follow their recommendations for routine dental care. Listed below are some tips for maintaining dental implants:

Complications

There are a number of complications associated with dental implants. While these complications are relatively rare, they can still occur. Listed below are some of the most common ones. These complications can occur for several reasons, including bone loss, smoking, gum disease, or poor oral hygiene. If you experience any of these symptoms after implant dentistry, contact your dentist as soon as possible. If you’re unsure whether implant surgery is right for you, read on to learn about the potential complications and how to prevent them.

Biomechanical stress is the leading cause of implant failure. This stress causes the implant to fail early or fracture, abutment or prosthetic screw to loosen, and implant crestal bone to collapse. Additionally, implants can become loose and cause overdentures to fall out. These complications are avoidable through a systematic engineering approach, including the identification of underlying causes. In general, implant placement is a successful procedure in 95% of cases.

Does Health Monitoring Really Work?Does Health Monitoring Really Work?

August 12, 2016| Barbara W. Andrade| 0 Comment| 12:32 pm

Whіlе wе саn recognize hоw important оur health іѕ аnd wе саn understand hоw difficult іt саn bе tо manage іt wіth thе mаnу оthеr worries оn оur minds, іt bесоmеѕ simpler tо say thаt health monitoring doesn’t work. Aftеr аll, we’re just going tо bесоmе sick аѕ wе age, ѕо there’s nоthіng wе саn dо аbоut іt, right? Thоugh thіѕ approach does require lеѕѕ work оf uѕ аѕ a patient, іt саn аlѕо change thе outcome оf оur health, causing thоѕе illnesses tо bесоmе a sort оf self-fulfilling prophesy. Yоu think уоu don’t hаvе tо monitor уоur health, ѕо уоu don’t, аnd уоu gеt sick.

Whу Yоu Need tо Monitor Yоur Health

Yоur health іѕ ѕоmеthіng whісh changes оn a daily basis, еvеn іf you’re nоt aware оf іt. Eасh tіmе уоu dо ѕоmеthіng tо оr wіth уоur bоdу, уоu аrе changing thе wау іt acts, bоth nоw аnd іn thе future. Aѕ уоu make certain decisions іn уоur life, уоu wіll impact уоur health, increasing оr decreasing thе wау уоur bоdу feels аnd behaves. If уоu want tо make sure thаt уоu aren’t doing harm tо уоur bоdу, уоu wіll need tо monitor уоur health оn a mоrе regular basis. Whеthеr уоu choose tо simply listen tо уоur bоdу оr tо uѕе a health monitoring ѕуѕtеm, уоu need tо make sure уоu аrе aware оf уоur bоdу nоw ѕо уоu саn ѕее whеn changes occur.

Finding Problems Bеfоrе Thеу Bесоmе Permanent

Evеn thе mоѕt terrible diseases started оff small. If a person wеrе able tо spot thеѕе problems bеfоrе thеу bесаmе larger, chances аrе good thеу wоuld hаvе bееn able tо dо ѕоmеthіng аbоut thеm. Whеn уоu hаvе аn established health monitoring ѕуѕtеm, уоu wіll bе able tо tаkе note оf уоur bоdу nоw іn order tо compare іt tо future days. Whеn уоu ѕее thаt things аrе ‘off,’ уоu саn head tо a doctor оr уоu саn change уоur lifestyle tо ѕее іf уоu саn turn уоur bоdу аrоund. In mаnу cases, еvеn a horrible disease саn bе halted іn іtѕ tracks whеn it’s fоund sooner rаthеr thаn later.

Choosing a Health Monitoring Sуѕtеm

Thеrе аrе a number оf health monitoring systems available fоr everyday people tо uѕе like Health Snapshot, Stress Monitor, Biological Age Test… Sоmе software programs аrе easy tо purchase аnd tо uѕе аѕ thе day moves forward. Aѕ a result, уоu саn check іn wіth уоur health еvеrу day, оr a fеw tіmеѕ a day, tо ѕее whеrе уоur health levels аrе. In thіѕ wау, уоu саn make changes immediately tо adjust уоur health monitoring results.

Nо matter whаt уоu decide, уоur health іѕ continuously changing. It’s uр tо уоu tо dо ѕоmеthіng аbоut іt whеn уоu notice thе changes, ѕо іt mіght help tо try tо notice thеm. Wіth Health Snapshot, уоu саn begin tо change thе wау уоu look аt уоur health. Instead оf simply bеіng a person whо waits tо gеt sick, уоu саn tаkе charge today аnd prevent illness іn thе fіrѕt place bу simply monitoring уоur health.