Stomach Cancer in Children

Here are the known risk factors for pediatric gastric carcinomas:

• H. pylori infection in children
  • Affects the stomach
  • Causes persistent active inflammation in the gastric mucosa and atrophy, particularly in the antrum
  • Has been linked to a considerably increased risk of gastric cancer, especially in the presence of a positive family history of gastric cancer
• Familial diffuse gastric cancer
  • Also called hereditary diffuse gastric cancer and is a rare genetic condition that increases the risk of developing diffuse gastric carcinoma, a type of stomach cancer.
  • An inherited disease with mutations in the CDH1 gene.
  • Grows in the stomach lining and may spread to other regions of the body, such as the liver or bones.
  • Women with familial diffuse gastric cancer are more likely to develop breast cancer that develops in the breast’s lobules (milk glands).

The symptoms of stomach cancer in children include:

• Nausea and vomiting
• Persistent abdominal pain
• Indigestion
• Loss of appetite
• Constipation
• Diarrhea
• Unexplained weight loss
• H. pylori infection
• Dizziness
• Heartburn
• Shortness of breath
• Fatigue
• Anemia
• Bloating
• Persistent burping
• Early satiety (feeling of fulness with minimal food)
• Gastrointestinal bleeding
• Black or bloody stools
• Pale skin

During the physical examination, the doctor may identify possible masses depending on the advancement of the cancer. However, in the early stages, swelling, tenderness, or areas with pain could be identified.

• Blood tests: Detect abnormal amounts of chemicals released by the affected organs or tissues.
• Various radiological modalities: Can identify tumors lining the stomach.
• Upper endoscopy:
  • The primary diagnostic test for stomach cancer.
  • Under the influence of a mild sedative, an endoscope is inserted into the mouth, which passes through the esophagus and stomach and reaches the first section of the small intestine.
  • Abnormalities in the abdominal organs, such as tumors, ulcers, blockages, and inflammation, are identified.
  • A biopsy could be done (a small tissue is collected from abnormal regions and suspected areas, which is further evaluated in the laboratory to identify possible cancer).
• Endoscopic ultrasonography:
  • Inspects your stomach and organs, such as the pancreas, liver, gallbladder, and bile duct.
  • Ultrasound waves detect tumors and surrounding lymph nodes where the disease may have spread.
  • Helps determine the progression and stage of cancer to provide appropriate treatment.

The various treatments for stomach cancer in children include:

• Surgery
  • To remove the tumor and part of the gastric tract. Can show a good prognosis, particularly for localized cancer.
• Chemotherapy
  • Administered orally or intravenously to shrink, kill or suppress the growth of the cancer cells.
  • Could be administered before surgery to shrink large tumors.
• Radiation therapy
  • The child is subjected to high-energy X-rays or other forms of radiation to kill the cancer cells or prevent their growth.
  • During external radiation therapy, the high-energy beams are directed toward the cancerous region in the body.
• Targeted therapy
  • Drugs identify specific cancer cells and kill them.
  • Has fewer side effects than chemotherapy.
• Clinical trials
  • Being a rare condition, children who are diagnosed with stomach cancer are advised to participate in various clinical trials to better understand:
    • The progression of the cancer
    • Responses to various treatments
    • Development of better diagnostic modalities

Cancer that develops from the epithelial tissue that lines the stomach is called carcinoma, whereas adenocarcinoma develops from the glands that line the organs in the stomach.

Pediatric gastric adenocarcinoma is rare, accounting for only 0.1 percent of all gastrointestinal cancers. More clinical studies are yet to be done. According to the National Institutes of Health, out of 129,024 gastric adenocarcinoma cases identified, 129 cases are pediatric gastric adenocarcinomas.

The five-year survival rates for stomach cancer are:

• Localized: No evidence of cancer spreading outside the stomach; 69 percent
• Regional: Has spread beyond the stomach to adjacent tissues or lymph nodes; 31 percent
• Distant: Has spread to distant organs, such as the liver; 5 percent

The chance of recovery depends on how far the cancer has spread and how well it responds to the treatment.