Stomach cancer, also known as gastric cancer, begins when cells in the stomach’s lining grow abnormally. While stomach cancer is common globally, with adenocarcinomas accounting for the majority of cases, its incidence has seen a decline in some regions, including the United States.
What Makes a Cancer Aggressive
Cancer is often described as aggressive when it exhibits certain characteristics that indicate a more challenging disease course. These characteristics include a rapid growth rate. Another defining feature is a high potential for metastasis. Cancer cells that are poorly differentiated also signal aggression; these cells appear very different from normal, healthy cells under a microscope. This aggressive behavior frequently leads to diagnosis at more advanced stages, as early symptoms may be subtle or absent.
Identifying the Most Aggressive Stomach Cancers
Diffuse-type gastric adenocarcinoma is frequently considered the most aggressive. This subtype is distinguished by its infiltrative growth pattern, where cancer cells spread throughout the stomach wall without forming a distinct mass. A particularly aggressive form often included within the diffuse type is signet ring cell carcinoma. These cells are characterized by a unique appearance under a microscope, with a large, mucin-filled vacuole pushing the nucleus to the cell’s periphery, resembling a signet ring. In contrast, intestinal-type adenocarcinoma typically presents as a more cohesive mass and is generally less aggressive, while diffuse-type gastric cancers, including signet ring cell carcinoma, tend to spread more quickly and are often harder to treat than the intestinal type.
Understanding Their Aggressive Nature
The aggressive nature of diffuse-type gastric adenocarcinoma, especially signet ring cell carcinoma, stems from its unique features. These cancers often infiltrate the stomach wall in a scattered manner, making it difficult to detect early because they do not form a prominent tumor. This diffuse infiltration can lead to a condition known as linitis plastica, where the stomach wall becomes thickened and rigid, resembling a leather bottle. Such a growth pattern contributes to late diagnosis, as symptoms may not appear until the disease is advanced.
These aggressive types have a high propensity for early metastasis, spreading quickly to regional lymph nodes and distant organs. Genetic factors also play a role in their invasive behavior. Mutations in the CDH1 gene, which encodes the cell adhesion protein E-cadherin, are frequently associated with hereditary diffuse gastric cancer and contribute to the cancer cells’ ability to detach and invade tissues. The lack of clear boundaries and the tendency for microscopic spread make complete surgical removal challenging.
Facing an Aggressive Stomach Cancer Diagnosis
Receiving a diagnosis of aggressive stomach cancer presents challenges. Due to the diffuse growth pattern and vague symptoms in early stages, these cancers are frequently diagnosed at a later stage. Symptoms such as indigestion, abdominal pain, nausea, and unintended weight loss may be present, but they are often non-specific and can be mistaken for less serious conditions.
The advanced stage at diagnosis often means the cancer is more widespread, impacting treatment options and overall prognosis. A comprehensive medical evaluation is important for anyone with persistent stomach-related symptoms. Rapid and thorough assessment is important to determine the extent of the disease and guide appropriate management strategies.