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Stomach cancer at fundus, chronic gastritis, H.Pylori. Treatment ?

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Internal Medicine Specialist
Practicing since : 2007
Answered : 362 Questions
I have removed T1A stomach cancer at fundus by endoscopy on march 25th.--I am 67 years old male from Japan.
I am going to remove Pre- cancer in end of August. I have H.Pylori but H.pylori biopsy results on the cancer cell,pre-cancer cells, randum stomach cells were all negative. i have chronic gastritis. My absolute Eosinophills count was 1455 on September blood test. My vitamin count is 25 on XXXXXXX test. I have been taking Prilosec for 8months. Now I stop taking Prilosec. I am taking digestive enzyme and one table spoon of Vinegar when I eat. I feel fine doing this, but some times between the meal, I feel something in my upper potion of stomach. I drink water or take antacid,or eat XXXXXXX to stop this little stomach pain. My questions are following.
1)cause of stomach cancer located at Fundus 2)cause of my chronic gastritis--H.pylori or Autoimmune disease 3)stomach does not makes enough Acid or enzyme to break down food if gastritis affect upper potion of stomach;and this lead to stomach cancer--I strongly believe this is the cause of my stomach cancer-wrong or right ? 4) if H.pylori was the my chronic gastritis,why all my H.Pylori biopsies were negative on H.Pylori organism ? 5)Prilosec treatment for my fundus cancer is correct ? because I had cancer because my stomach does not make enough Acid and I have H.Pylori. what is the proper treatment for my stomach cancer ? I would like to know gastritis treatment medicine which does not cause stomach to make less acid because my H Pylori and my stomach does not make enough acid. 6)I had one cancer, 4 pre cancer cell, one 2mm ulcer on XXXXXXX endoscopy. I did not have any cancer except one pre cancer (tubular adenoma with high-grade dysplasia) to remove soon( Dr. took random places biopsy ).
Condition of my stomach is good or bad ? my stomach condtion is improving or not ? My Dr. is gastroenterologist with 18 years experience. I am taking endoscopy every 3 month this year and next year,I am going to have endoscopy twice and only once a year after that. I am not taking any medication or treatment other than endoscopy.-is this OK? anything missing ? I must worry something or I do not worry any thing for my stomach condition, treatment. My age -67 height-5.7 weight-150(was 175 last Oct.---medical history-nothing big things

Posted Tue, 17 Apr 2012 in Cancer
Answered by Dr. Kiran Kumar 1 hour later
Thanks for the query,

I acknowledge your concern and appreciate that you have given such complete details. I shall give you answers for questions as yo have asked.

Ans 1. The most common type of cancer is Adenocarcinoma. It can occur anywhere in the stomach. Fundus is the upper part of the stomach and adenocarcinoma can occur there too. The exact cause of carcinoma stomach is not known. Multiple factors contribute to its development. These are, long term ingestion of nitrates in dried, smoked and salted food, Helicobacter pylori infectio (by causing chronic gastritis, loss of gastric aidity and bacterial growth of stomach), Gastric lcers/polyps, Individuals of blood group A.
Some times, no cause can be found.

Ans 2. Most common cause of chronic gastritis is H pylori. If your biopsies are negative, then this could be atrophic gastritis due to autoimmune pathology. You can consider doing H pylori serology. Some times, H pylori can get eradicated from stomach after antibiotics, serology however remains positive.

Ans 3. As i said, its not clear why stomach cancers occur It has been proven that Nitrates in food stuffs are converted to carcinogenic nitrites by bacteria. Now, bacteria grows and thrives in stomach especially in low acid environment. This can occur with atrophic gastritis and with H pylori infection.

Ans 4. As i said, if you have taken any antibiotics, it might eradicate the bacteria. In that case, serology is a better indication of presence o H pylori.

Ans 5. Sorry. Prilosec (Omeprazole) is a proton pump inhibitor and is specifically is an acid suppressing agent and is used for Gastritis/Peptic Ulcer Disease.
Sucralfate coats the surface of the stomach and reduces gastritis. It does not alter gastric acid secretion and therefore the gastric pH is not altered.

Ans 6. Doctor has taken multiple random biopsies because, he identified precancerous lesions. Some times, patient can have multiple site of lesions in stomach which are pre-cancereus. In such situations, early surgical intervention will be required.

Condition of your stomach is good. However, a close observation is required to identify any new lesions if they develop.

Keep your self evaluated with endoscopies as advised by your doctor. he as done a good work till now.

Hope this answers your queries
Please get back if you need an further information

Thanks and Regards

Dr Kiran
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