Stomach cancer is rare in the United States. In 2016, 113,054 people were living with this disease, and the number of new cases every year is just 7.4 per 100,000 Americans. However, because it is usually diagnosed in its later stages, it is one of the deadlier cancers.
95 percent of stomach malignancies are adenocarcinomas. They arise from the glandular tissue in the lining of the stomach. Other types of tumors are lymphomas and leiomyosarcomas. Lymphomas are tumors of the lymphatic system. Leiomyosarcomas affect the smooth muscle tissues. Both can develop in the stomach but account for just five percent of cases.
Part of fighting stomach cancer is finding the right treatment for your particular case. However, there is also the massive financial burden that comes with treating cancer. Stomach cancer may involve surgery or chemotherapy, or chemo and radiation.
Typical Costs of Treating Stomach Cancer
- For patients with health insurance, out-of-pocket costs for stomach cancer treatment typically consist of doctor visit, lab and prescription drug copays as well as coinsurance of 10%-50% for surgery and other procedures, which can easily reach the yearly out-of-pocket maximum. Stomach cancer treatment typically is covered by health insurance, although some plans may not cover certain drugs or treatments.
- For patients without health insurance, stomach cancer treatment typically costs up to $50,000 or more for surgery and tens of thousands for chemotherapy and radiation. Costs can reach $200,000 or more, depending on the case.
- For example, at Saint Elizabeth Regional Medical Center, in Nebraska, surgery for gastric cancer typically costs about $25,000 to more than $40,000, not including the doctor fee.
- According to a study published in the Journal of Gastrointestinal Cancer Research, it costs about$20,100 to add chemoradiotherapy, a combination of chemotherapy and radiation, after surgery for localized gastric cancer.
- According to the American Society of Clinical Oncology, the total mean monthly cost of care for a newly diagnosed gastric cancer patient, for the first year, including hospitalization, doctor visits, lab fees, radiology and drugs, was more than $10,600 per month. This could total almost $130,000 for a year.
What Are the Symptoms of Stomach Cancer?
Stomach cancer produces almost no symptoms until it becomes advanced. Stomach cancer symptoms include:
- Tiredness or weakness
- Feeling full after eating small meals
- Persistently feeling bloated
- Indigestion or heartburn
- Not feeling hungry
- Frequent nausea
- Vomiting blood
- Losing weight without trying
- Pain above the bellybutton
- Fluid in the abdomen
What Are the Risk Factors of Stomach Cancer?
Risk factors are characteristics that increase the likelihood of developing a disease. But, their presence does mean that you will get it. Some of the risk factors for stomach cancer include:
- Gender: Men get stomach cancer more often than women
- Getting older: Most cases are diagnosed in people over the age of 60
- Ethnicity – Stomach cancer is more common in Hispanics, African Americans, Native Americans and Asian /Pacific -Islanders than in Caucasians.
- Helicobacter pylori infection (stomach ulcers)
- Some genes
- Eating a lot of smoked meats and pickled vegetables
- Type A blood
- Autoimmune atrophic gastritis
How Is Stomach Cancer Diagnosed?
Your doctor will perform a medical examination and ask you about your symptoms. She will also likely order some tests to try and find out more about your condition. These tests may include:
- Upper endoscopy – A thin tube called an endoscope with a video camera at the end is passed down the throat. The doctor can see any abnormalities and take tissue samples.
- Upper gastrointestinal (GI) series – X-rays of the esophagus, stomach, and first loops of the small intestine.
- Computed Tomography (CT scan) – A CT scan uses x-rays to create cross-sectional pictures of the body. It is used to confirm the location of the cancer and may show if it has spread.
- Magnetic Resonance Imaging (MRI) – Like a CT scan, an MRI produces detailed images of the body's soft tissues. It uses radio waves and magnets instead of x-rays.
- Positron Emission Tomography (PET scan) – PET scans are whole-body scans used mainly to detect suspected metastases. The doctor Injects the patient with a radioactive sugar that collects in cancer cells resulting in highlighted areas.
- Lab tests – Lab tests commonly done include a Complete Blood Count (CBC) and a fecal occult blood sample. The former can detect anemia, a common effect of the cancer bleeding into the stomach, while the latter checks for hidden blood in the stool.
- Biopsy – A biopsy is the only way to confirm the presence of cancer. The doctor removes a small piece of tissue and sends it for testing in the lab. Biopsies are usually taken during the endoscopic examination.
Financial Planning With Stomach Cancer
Studies show that individuals with cancer often face “financial toxicity,” manifested by a mix of severe economic stress, depression and anxiety that can worsen the underlying health condition.
Even with private health insurance or coverage through Medicare or Medicaid, families are at substantial risk of financial catastrophe. These families experience not only a major increase in daily expenses, but often a significant loss of income due to patients’ and their caregivers’ inability to maintain full-time work.
There are a number of organizations that offer pro-bono financial planning and assistance for people going through cancer treatment. A new study, published this month in The American Journal of Medicine, discovered that 42 percent of patients deplete their life savings during the first two years of treatment.
What Causes Stomach Cancer?
Like most malignancies, there are probably many causes for stomach cancer, which is partly why it is so hard to cure. Research has shown some correlation between the inflammation of the stomach lining and stomach cancer, but the exact mechanism for how it changes the cells remains unknown. Research into its causes continues.
What Are the Stages of Stomach Cancer?
Doctors stage stomach cancer by how far it has progressed and whether it has spread to other parts of the body. It is most curable during its earliest stages.
- Stage 0 – There are precancerous cells in the lining of the stomach. It has not spread to the lymph nodes or other areas of the body
- Stage I –A tumor is present in the stomach lining and may have spread to a few lymph nodes. It has not spread to other organs.
- Stage II – The tumor has invaded multiple layers of the stomach lining and has likely spread to the lymph nodes. It has not spread beyond the stomach.
- Stage III – The tumor has invaded the entire stomach wall and is spreading to other nearby organs. It can also be smaller but with multiple lymph node involvements.
- Stage IV – The cancer has spread to distant areas of the body.
How is Stomach Cancer Treated?
How stomach cancer is treated depends on its stage at the time of diagnosis, and whether the treatment is aimed at a cure or helping the patient remain comfortable.
The most common way it is treated is with surgery to remove as much of the tumor as possible, called tumor debulking. Depending on the extent of the cancer, the cancerous area and a section of the surrounding healthy tissue may be removed, along with some lymph nodes. In later stages, part of or all the stomach may need to be taken out. If the entire stomach is removed, a small bit of the small intestine is formed into a pouch and connected to the esophagus.
Adjuvant therapies such as radiation therapy, chemotherapy, or a combination of the two may be used before and after surgery. The purpose of these treatments is to shrink the tumor, if applied before surgery, and to kill any remaining cancer cells in the body after surgery. Common side effects of these treatments include:
- Nausea and vomiting
- Hair loss
- Weakened immune system
- Low red blood cell count
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