The stomach is a muscular J-shaped sac-like structure, mainly acts as reservoir for the food, located in the upper and left part of abdomen and a crucial part of the digestive organ of gastrointestinal system. It produces enzymes (Substances that create chemical reactions) and acids (digestive juices). This mix of enzymes and digestive juices breaks down food so it can pass to our small intestine(duodenum).
Gastric cancer, also referred to as stomach cancer, can happen anywhere, in any part of the stomach (Fundus, Body, also called proximal stomach and Antrum and Pylorus also called Distal part of stomach)– where abnormal growth of malignant cells, invading the stomach and adjacent and distal organs like Liver Lung, peritoneum and Bone etc.
Symptoms of Gastric Cancer
The prominent symptoms of gastric cancer include: • Difficulty swallowing • Feeling full or bloated even after eating small amounts of food • Heartburn or acidity • Indigestion coupled with nausea and vomiting • Severe pain in the stomach • Unintentional weight loss
Causes of Gastric Cancer
There is no definite reason for what could cause stomach cancer. However, the risk factors that can trigger this ailment include: • Chronic Gastroesophageal Reflux Disease • Overweight • Consumption of low fibre diet • Poor eating habits like intake of food high on salts, deep fries • Family history • Infection with Helicobacter pylori • Chronic gastritis • Smoking • Stomach polyps
Diagnosis
The diagnosis of gastric cancer is made by running various tests, including blood tests, and imaging tests like endoscopic ultrasound, CT, PET-CT, biopsy, or diagnostic laparoscopy. Treatment
Surgery forms the first line of defence while combating gastric cancer (in early stages). In the last decade, the surgical techniques for treating stomach cancer have grown by leaps and bounds, providing significant relief for the patients treating gastric cancer requires the exceptional expertise of Surgical oncologists (gastro intestinal surgeons). Over the last decade or more, the surgical treatment for gastric cancers witnessed unparalleled medical advancements, with the advent of minimally invasive procedures like robotic, laparoscopic procedures that ensure a faster recovery.
What is Gastrectomy?
Gastrectomy is defined as a full or partial removal of stomach for treating various medical conditions mainly for cancer.
Gastrectomy is of four types – Total Gastrectomy, Subtotal Gastrectomy, Distal Gastrectomy extended total gastrectomy (removal of distal food pipe) and Proximal Gastrectomy.
Advantages of Minimally Invasive Robotic, Laparoscopic Gastrectomy Procedures
Open surgery, laparoscopy, or robotic surgery; the principles involve the same – removing cancer and surrounding structures (in case of metastasis) without compromising on the cure. Minimally invasive surgical procedures provide a better outcome than open surgery in patients undergoing gastrectomy to treat gastric cancer. Extensively trained gastrointestinal surgeons adopting either robotic or laparoscopic surgeries to ensure faster, safe and feasible alternatives to conservative open surgery.
Some of the advantages of minimally invasive procedures are:
• Decreased postoperative pain • Shorter hospital stays and quicker recovery • Minimal scarring • Less strain on the immune system • Smaller incisions • Less chance of infection and hernia formation
How is Laparoscopic Gastrectomy performed?
Laparoscopic Gastrectomy is a widely recommended and adopted minimally invasive surgical procedure for eliminating cancer cells, even in the locally advanced stages of gastric cancer.
During the procedure, several small incisions (key holes) are made by the surgeons. Surgical instruments are sent inside for accessing the diseased part for its dissection and removal. The surgery aimed at eliminating the cancer cells, may take a little longer in comparison to open gastrectomy but the patient would recover faster due to less blood loss and pain. It has 2D vision and Ergonomics of instruments are difficult due to straight instruments.
The patient would be able to resume regular duties and eat normally within a week or too.
How is Robotic Gastrectomy performed?
Robotic-assisted gastrectomy is done by making a small incision (key hole) measuring up to 8 to 12mm, at the belly button and three other small incisions for assistant instruments at the upper abdomen. The surgeon sits at the console during the procedure, directing the robotic arms to perform the operation. These robotic arms work like human hands with absolute, accurate dexterity, finger movement, and wrist (done by surgeon hand actions transmitted through instruments with digital interactions). Even while performing the surgery, the surgeon could view a magnified, high-definition 3D view of the organs, enabling the surgeon to execute procedures like dissection, bowel connections, and stapling.
The advantages of Robotic Gastrectomy are aplenty. It is often recommended for removing Gastrointestinal stromal tumours, gastric adenocarcinoma, or even rare form of carcinoid or neuroendocrine tumours.
This procedure has lesser pain when compared to conventional open gastrectomy. Other benefits include:
• Lesser blood loss and less transfusions • Reduced risk of infections • Early starting of feed • Faster return to normalcy
Since its inception, robotic surgeries have been carried out extensively in thousands of procedures across the globe. These techniques have gained widespread popularity for its positive impact on a patient’s recovery, fewer complications, and shorter stays at hospitals. If we focus on cancers in particular, these surgeries are widely used in the treatment of gastrointestinal cancers. To learn more about the benefits of robotic surgeries for gastric cancer care, you can consult an oncologist for further guidance.
By Dr Jagannath Dixit, Surgical Oncologist, HCG Cancer Centre, Bengaluru (DISCLAIMER: The views expressed are solely of the author and ETHealthworld does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person / organisation directly or indirectly)
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
