SAN PEDRO COLLEGE
Bachelor of Science in Medical Laboratory Science
INTERNSHIP PROGRAM
GASTRIC CANCER
A Case Study in
HISTOPATHOLOGY
,OBJECTIVES OF THE STUDY
This study aims to:
1) Define and discuss the terms presented in the case
2) Provide an accurate identification of the patient’s condition
3) Describe the precise diagnosis of the patient’s case and provide factual information
that would support the diagnosis
4) Associate patient’s symptoms with the diagnosis
, Chapter I
Introduction to the Case
Gastric cancer is the third most common cause of cancer-related death in the world
(1,2) and is the fifth most frequently diagnosed malignancy worldwide, with an estimated 1
million new cases annually (1,3). Gastric cancer usually starts with inflammation of the
mucous membrane lining the stomach which is made up of columnar epithelial cells and
glands. These linings are prone to inflammation, known as gastritis, which can lead to peptic
ulcers and ultimately progress to gastric cancer. The formation of a tumor in the inner lining
of the stomach causes this cancer, which develops slowly over years (4).
Globally, the incidence of gastric cancer has decreased over the last few decades. This
may be due to the effect of increased hygiene standards, conscious nutrition, and Helicobacter
pylori control measures, which constitute primary prevention, has resulted in a trend decline
in gastric cancer incidence rates (1,5). In a recent meta-analysis of six randomized controlled
trials (RCT) conducted by Wu et. al., they examined and showed the effectiveness of
controlling H. pylori to reduce gastric cancer incidence by 44% (2).
According to the statistics report of GLOBOCAN last 2018, males, especially older
males, are two times higher at developing this kind of cancer than females in 5 countries, and
there is no country where it is the most diagnosed cancer in females (6). The average
incidence rate in East Asia is 32.1 per 100,000 among males, 5.6 per 100,000 in Northern
America, and the lowest rate is in North and East Africa, with only 4.7 per 100,000 males
annually. The country with the highest incidence rate is the Republic of South Korea, with
almost 60 per 100,000 males annually (7).
Moreover, the mortality rate of gastric cancer is high, making it the third most common
cause of cancer-related death with 784,000 deaths worldwide in 2018 (3). The mortality rate
is still higher among males than females in Eastern and Central Asia and Latin America (7).
The risk factors associated with gastric cancer include: nutritional factors such as high-
salt intake, consuming large amounts of processed foods, smoked foods, lack of vitamin A
and C diet, gastroesophageal reflux, being infected with H. pylori, alcohol consumption and
tobacco use (1,7,8).
The main diagnostic procedure for this kind of disease is upper endoscopy, especially
for those patients manifesting the symptoms. This procedure involves visualizing the stomach
lining with the aid of an inserted specialized tube equipped with a camera to provide the most
specific and sensitive means of diagnosing gastric cancers (1). Prognosis and survival rates
have been improved due to advancements in treatment options and early detection.
Management and treatment of gastric cancer would depend on preoperative staging. Such
treatments are: endoscopic resection, chemotherapy, and radiation therapy. It has been
found that diet and lifestyle modifications are said to be the most effective way of preventing
gastric cancer (7).
, Chapter II
Organized Patient’s Data
Patient’s Profile ● 62 year old Latino Male
Patient’s Complaints ● Persistent weakness
● Fatigue
● Lack of energy
● Experiences heartburn frequently
despite taking GERD medications
Patient’s Medical and Surgical History ● GERD
● Asthma
● Benign Prostatic Hyperplasia
Family History
● Mother is alive at age 82 with type 2
diabetes mellitus and hypertension
● Father died at age 59 from acute
myocardial infarction
● Patient has two sisters (ages 60 and
64) who are alive and well
● Maternal grandmother died from
breast cancer and an aunt passed
away from complications secondary
to colon cancer
Social History ● A widower for six years
● Retired music professor that lives
alone
● Smokes 1 1/2 packs of cigarettes
daily
● Drinks 3-4 Brandy Manhattans daily
● Consumes significant amount of
hamburger and processed meats,
especially weiners
● Does not eat a healthy serving of
grains, fruits and vegetables
● Do not have an exercise program
but does some walking
Medications
● Omeprazole 20 mg po QD
● Ipratropium bromide 2 puffs QID
● Triamcinolone MDI 2 puffs QID
● Albuterol MDI 2 puffs PRN
● Terazosin 1 mg HS QD
Bachelor of Science in Medical Laboratory Science
INTERNSHIP PROGRAM
GASTRIC CANCER
A Case Study in
HISTOPATHOLOGY
,OBJECTIVES OF THE STUDY
This study aims to:
1) Define and discuss the terms presented in the case
2) Provide an accurate identification of the patient’s condition
3) Describe the precise diagnosis of the patient’s case and provide factual information
that would support the diagnosis
4) Associate patient’s symptoms with the diagnosis
, Chapter I
Introduction to the Case
Gastric cancer is the third most common cause of cancer-related death in the world
(1,2) and is the fifth most frequently diagnosed malignancy worldwide, with an estimated 1
million new cases annually (1,3). Gastric cancer usually starts with inflammation of the
mucous membrane lining the stomach which is made up of columnar epithelial cells and
glands. These linings are prone to inflammation, known as gastritis, which can lead to peptic
ulcers and ultimately progress to gastric cancer. The formation of a tumor in the inner lining
of the stomach causes this cancer, which develops slowly over years (4).
Globally, the incidence of gastric cancer has decreased over the last few decades. This
may be due to the effect of increased hygiene standards, conscious nutrition, and Helicobacter
pylori control measures, which constitute primary prevention, has resulted in a trend decline
in gastric cancer incidence rates (1,5). In a recent meta-analysis of six randomized controlled
trials (RCT) conducted by Wu et. al., they examined and showed the effectiveness of
controlling H. pylori to reduce gastric cancer incidence by 44% (2).
According to the statistics report of GLOBOCAN last 2018, males, especially older
males, are two times higher at developing this kind of cancer than females in 5 countries, and
there is no country where it is the most diagnosed cancer in females (6). The average
incidence rate in East Asia is 32.1 per 100,000 among males, 5.6 per 100,000 in Northern
America, and the lowest rate is in North and East Africa, with only 4.7 per 100,000 males
annually. The country with the highest incidence rate is the Republic of South Korea, with
almost 60 per 100,000 males annually (7).
Moreover, the mortality rate of gastric cancer is high, making it the third most common
cause of cancer-related death with 784,000 deaths worldwide in 2018 (3). The mortality rate
is still higher among males than females in Eastern and Central Asia and Latin America (7).
The risk factors associated with gastric cancer include: nutritional factors such as high-
salt intake, consuming large amounts of processed foods, smoked foods, lack of vitamin A
and C diet, gastroesophageal reflux, being infected with H. pylori, alcohol consumption and
tobacco use (1,7,8).
The main diagnostic procedure for this kind of disease is upper endoscopy, especially
for those patients manifesting the symptoms. This procedure involves visualizing the stomach
lining with the aid of an inserted specialized tube equipped with a camera to provide the most
specific and sensitive means of diagnosing gastric cancers (1). Prognosis and survival rates
have been improved due to advancements in treatment options and early detection.
Management and treatment of gastric cancer would depend on preoperative staging. Such
treatments are: endoscopic resection, chemotherapy, and radiation therapy. It has been
found that diet and lifestyle modifications are said to be the most effective way of preventing
gastric cancer (7).
, Chapter II
Organized Patient’s Data
Patient’s Profile ● 62 year old Latino Male
Patient’s Complaints ● Persistent weakness
● Fatigue
● Lack of energy
● Experiences heartburn frequently
despite taking GERD medications
Patient’s Medical and Surgical History ● GERD
● Asthma
● Benign Prostatic Hyperplasia
Family History
● Mother is alive at age 82 with type 2
diabetes mellitus and hypertension
● Father died at age 59 from acute
myocardial infarction
● Patient has two sisters (ages 60 and
64) who are alive and well
● Maternal grandmother died from
breast cancer and an aunt passed
away from complications secondary
to colon cancer
Social History ● A widower for six years
● Retired music professor that lives
alone
● Smokes 1 1/2 packs of cigarettes
daily
● Drinks 3-4 Brandy Manhattans daily
● Consumes significant amount of
hamburger and processed meats,
especially weiners
● Does not eat a healthy serving of
grains, fruits and vegetables
● Do not have an exercise program
but does some walking
Medications
● Omeprazole 20 mg po QD
● Ipratropium bromide 2 puffs QID
● Triamcinolone MDI 2 puffs QID
● Albuterol MDI 2 puffs PRN
● Terazosin 1 mg HS QD
