[GASTRIC CANCER IN THE PRACTICE OF FAMILY PHYSICIAN]

Gastric cancer is the second most common cause of cancer-related death in the world. Gastric cancer mostly affects older people. The incidence increases with age and more than 75% of people are older than 50 years. Due to the relatively late detection, long-term survival is poor, except for patients with localized disease and it remains difficult to cure. There are many known risk factors for stomach cancer, but it is not known exactly how these factors cause cells of the stomach lining to become cancerous. But it is known that a certain kind of diet can contribute to its development such as a diet high in salty and smoked foods and low in fruits and vegetables. Long-term infection with H. pylori increases the risk of gastric cancer and the World Health Organization declared H. pylori as carcinogenic for some types of the gastric cancers. About 90% to 95% of cancers of the stomach are adenocarcinomas, the others are Lymphomas, Gastrointestinal stromal tumor (GIST) and MALT lymphoma. Early gastric cancer has no associated symptoms; however, some patients complain of indigestion, nausea or vomiting, dysphagia or postprandial fullness. When there is a suspicion of the gastric it is necessary to do an endoscopy with multiple biopsies. Many treatments may be used such as surgery, radiation therapy, chemotherapy, targeted drugs or a combination of these methods, and the choice depends on the stage of the disease and the condition of the patient. Family physician should determine all patients who are at increased risk and regularly control them.