A young woman self investigated herself as her close sibling succumbed to a GI cancer. This lady was found to have an incidental early gastric cancer with very poor tumor biology (poorly differentiated signet ring cell cancer). Since tumor was in its early stage without any spread intraabdominally or to any other distant organ like liver, a laparoscopic radical gastrectomy was performed as a curative treatment.
Stomach cancer is often diagnosed in an advanced stage in India as there is no formal screening policy like Japan. A laparoscopic surgery in gastric cancer (radical gastrectomy) is recommended when it is in early stage. However advanced stage cancer are usually treated with chemotherapy first followed by a surgery whenever feasible. Surgery in advanced cancer is often an open surgery as removal of a bulky tumor or a good lymph node clearance is necessary and this is not always possible laparoscopically. An early incidental pick up in our patient enabled us to do the curative surgery laparoscopically.
This patient is being investigated further for a genetic condition (mutation) associated with multiple cancers in the young family members. These family members are at high risk for developing endometrial / uterine, colorectal, stomach cancer and few more. In this condition we advise close family members especially young under fifty to remain under a screening program / check up to diagnose a cancer in its early stage. Along with check ups we often do genetic screening to assess the risk. The best treatment of cancer is when it is diagnosed early as in our patient. We expect complete cure in our patient. However she will remain under close observation for any recurrence as tumor biology is poor. Patient would also remain under observation for other cancers like colorectal and uterine cancer.
