Evidence of gastric cancer cases, year survival rate and frequent symptoms – A retrospective study at Vlora regional hospital, Albania

The purpose of two stages study was to identify the frequency of distribution of stomach cancer in relation to gender, age and year survival rate after diagnosis as well the identification of common signs and symptoms of diseases for better management of them by nursing staff. The retrospective study was conducted in July-September 2018 at the Vlora Regional Hospital, Albania. The first phase included collecting data from patient records (n=30) in the Palliative Care Unit, and the second phase included data from card files (n=15). The majority of cases of gastric cancer were males (n=22). The average age of female and male patients was respectively 59.87 years, SD±16.63 and 64.27 years, SD±13.98. The average year survival rate (life expectancy) after the diagnosis of the disease was 1.86, SD±1.95. The most frequent signs and symptoms were lack of appetite, abdominal pain, body weakness and vomiting. *Correspondence to: Fatjona Kamberi, Research Center of Public Health, Faculty of Public Health, University of Vlore “Ismail Qemali’’, Albania, E-mail: kamberifatjona@outlook.it Received: October 25, 2018; Accepted: November 13, 2018; Published: November 16, 2018 Introduction Stomach cancer is the fifth most common cancer overall, after cancers of the lung, breast, colorectum, and prostate. In 2012, worldwide, there are estimated to have been 952000 new cases of stomach cancer (6.8% of all incident cancer cases). More than 70% of stomach cancer cases occur in developing countries [1]. In Albania the deaths caused by stomach cancer account 15.9% in males and 13.6% in females of deaths caused by cancer [2]. In addition, stomach cancer is the third leading cause of cancer death in both sexes worldwide. In 2012, stomach cancer were estimated to have affected a total of 951,594 individuals with a male/female ratio of 1.97, and caused 723,073 deaths worldwide [3]. Most of the cases are diagnosed at late stages when the treatment is largely ineffective. Screening for cancer and pre-cancerous lesions could be beneficial, but the currently available methods are not yet readily implementable in organized screening settings. Additional attention should now be paid to early diagnosis [4]. The incidence and mortality of stomach cancer have fallen dramatically over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. The main risk factors for distal gastric cancer include Helicobacter pylori (H pylori) infection and dietary factors, whereas gastroesophageal reflux disease and obesity play important roles in the development of proximal stomach cancer [5]. The development of gastric cancer is a multifactorial process and many conditions influence the likelihood of occurrence. The effects of H. pylori infection on gastric cancer appear multifactorial, involving host and environmental factors as well as differing bacterial strains. Ethnic and geographic factors also play role.There is a higher incidence of gastric cancer in non-Caucasian populations. In addition there are a variety of genes that increase the risk of stomach cancers as well there are many environmental and behavioral factors that affect the development of gastric carcinoma. Smoking is now considered a significant contributor. Alcohol, however, has been identified as a risk factor for disease progression. Diets with high amounts of fresh vegetables and fruit have been shown to have a protective association with stomach cancer. Consumption of high levels of salt and processed meat has been shown to be positively associated with gastric cancer [6]. Early-stage stomach cancer rarely causes symptoms. This is one of the reasons why stomach cancer is so hard to detect early. The signs and symptoms of stomach cancer can include: poor appetite, weight loss (without trying), abdominal (belly) pain, vague discomfort in the abdomen, usually above the navel, a sense of fullness in the upper abdomen after eating a small meal, heartburn or indigestion, nausea, vomiting, with or without blood, swelling or fluid build-up in the abdomen, blood in the stool and low red blood cell count (anemia). Most of these symptoms are more likely to be caused by things other than cancer, such as a stomach virus or an ulcer. Since symptoms of stomach cancer often do not appear until the disease is advanced, only about 1 in 5 stomach cancers is found at an early stage, before it has spread to other areas of the body [7]. The survival of patients with a stomach cancer diagnosis appears to be increasing. During the 1980s, statistically significant improvements were seen in the 2-month, 5-year, and 10-year relative survival of patients with stomach cancer, and in the subgroup with noncardiac cancer. Age at diagnosis was strongly and inversely related to relative survival. The reasons for this are probably Kamberi F (2018) Evidence of gastric cancer cases, year survival rate and frequent symptoms – A retrospective study at Vlora regional hospital, Albania Volume 2(6): 2-4 Cancer Rep Rev, 2018 doi: 10.15761/CRR.1000172 multifactorial and are likely to include improvements in surgical and anesthesiologic management [8]. In addition, the favorable trends may be due to changes in environmental exposure and lifestyle, including decreased Helicobacter pylori prevalence, increased intake of fresh fruits and vegetables, the availability of refrigeration and decreased intake of salted and preserved food and smoking prevalence [9]. In the cases diagnosed in late stage the nurse’s role is very important in the management of symptoms. The nurse’s role in caring for patients with stomach cancer includes knowledge of the pathophysiology, risk factors, detection methods, signs and symptoms, treatments, conventional and integrative holistic nursing interventions, and community resources. In addition, they provide quality care and contribute to improved outcomes for cancer patients [10]. Materials and methods Study design, area and population The two stages retrospective study was conducted in July-September 2018 at the Vlore Regional Hospital, Albania. The first phase included the collection of data from patient records (n=30) in the Palliative Care Unit for the time period 20132018. In the first stage the objective was the identification of the frequency of distribution of stomach cancer in relation to gender, age and year survival rate after diagnosis. In the second stage the objective was the identification of common signs and symptoms of the patients affected by stomach cancer through the analysis of 15 patients medical record files. Any data written in the patients card and related to the objectives of the study was documented. Purpose of the study The purpose of two stages study was to identify the frequency of distribution of stomach cancer in relation to gender, age and years of survival after diagnosis as well the identification of common signs and symptoms of diseases for better management of them by nursing staff. Ethical considerations An approval to conduct the study was obtained from the ethical committee of the research unit at Faculty of Public Health. For data collection were informed the relevant structures of the hospital which gave its approval. In the processing of each patients card, anonymity and ethics for scientific research were respected.