Stomach (Gastric) Cancer
Stomach cancer (also called gastric cancer) starts in the stomach. A majority of the cancers of the stomach are called adenocarcinomas. Less common tumors that can be found are called lymphomas, gastric stromal tumors, and carcinoid tumors.According to the American Cancer Society, over 22,000 new cases of stomach cancer will be diagnosed this year. In addition, two-thirds of the people found to have stomach cancer are older than 65. The risk of a person getting stomach cancer in his/her lifetime is about 1-in-100. Stomach cancer is much more common in some countries other than the United States. Stomach cancer was once a leading cause of cancer deaths in this country, but it is now much less common. The reasons for this decline are not completely understood, but they may be linked to the increased use of refrigeration for food storage and less use of salted and smoked foods. Some doctors think that an important factor is the use of antibiotics to treat infections in children. These drugs can kill the bacteria (Helicobacter pylori) that may be a major cause of this disease.
What are the Major Risk Factors Leading to the Development of Stomach Cancer?
Although there are many risk factors associated with stomach cancer, we do not know exactly how these factors cause stomach cells to become cancerous. The major risk factors, listed alphabetically, are as follows:
- Age – There is a sharp increase in the incidence of stomach cancer after age 50.
- Blood type – People with type A have the highest incidence of stomach cancer.
- Chronic Helicobacter pylori infections
- Diets high in smoked foods, salted fish, meats, and pickled vegetables are more closely associated with stomach cancer.
- Ethnicity – Hispanics and African-Americans have a higher incidence of stomach cancer than do non-Hispanic whites; Asian/Pacific Islanders have the highest rates.
- Family history
- Gender – Males are twice as likely to develop stomach cancer.
- Previous stomach surgery
- Stomach polyps – While most types of polyps (small, mushroom-like growths in the stomach lining) are harmless, the type identified as adenomatous polyps sometimes become cancerous.
- Tobacco and/or alcohol abuse
What are the Symptoms of Stomach Cancer?
People afflicted with stomach cancer rarely display early symptoms, one of the main reasons why stomach cancer in its early stages is so difficult to diagnose. The signs and symptoms of stomach cancer, alphabetically listed, include the following:
- Abdominal pain
- A sense of fullness just below the chest bone after eating a small meal
- Heartburn, indigestion, or ulcer-like symptoms
- Swelling of the abdomen
- Unintended weight loss and lack of appetite
- Vague discomfort in the abdomen, often above the navel
- Vomiting, with or without blood
How is Stomach Cancer Diagnosed?
The only way to confirm stomach cancer is through a procedure called an upper endoscopy. A gastroenterologist passes a tube-like device, called an endoscope, through the throat in order to view the stomach lining. While the appearance of the stomach may suggest cancer, the diagnosis can only be confirmed via small tissue samples (biopsies) taken through the endoscope. The tissue samples are then microscopically examined by a pathologist – a physician who specializes in the diagnosis of disease via the microscopic examination of a tissue sample – to determine the type and state (extent) of the cancer. The pathologist must work accurately and quickly, since this type of cancer has the potential to spread to other organs, such as the regional lymph nodes, liver, pancreas, and lungs. Your physician will recommend any additional testing needed to evaluate the cancer prior to treatment. These additional tests may include one or more of the following:
- Chest x-rays
- Clinical laboratory tests
- Computed tomography scan
- Magnetic resonance imaging
- Positron emission tomography scan
- Upper GI series
Treatment Options for Stomach (Gastric) Cancer
The choice of treatment you receive depends on many factors. The place and stage of the tumor are very important, but other factors include your age, your overall health, and your personal values. There are treatment options for every stage of stomach cancer. The main treatments for stomach cancer are surgery, chemotherapy, and radiation therapy; often the best approach involves the use of more than one of these treatment methods, as discussed below:
- Endoscopic mucosal resection – This procedure entails the excision, via endoscope, of all or part of a tumor; it is reserved for early stage cancer in which the chances of its having spread to the lymph nodes is minimal.
- Subtotal (partial) gastrectomy – This procedure entails the partial excision of the lower stomach, often along with the first part of the small intestine.
- Total gastrectomy – This procedure entails the removal of the entire stomach; it may require the surgical design of a “new stomach” from intestinal tissue.
- Chemotherapy – This is the use of drugs to destroy cancer cells. This type of therapy is systemic because the drugs are sent directly through the bloodstream or are taken orally and travel throughout the entire body. Chemotherapy medication intervals will vary, depending upon the drug used and whether it is administered by injection, pill, or intravenously. Chemotherapy may be used to control a tumor, relieve symptoms, or destroy cancer cells that remain in the body after surgery. It is usually administered cyclically, with alternating treatment and recovery periods. Chemotherapy is currently under study as:
- A stand-alone therapy
- Part of a presurgical, combination therapy to shrink a tumor
- Part of a combined chemotherapy/radiation therapy approach
- Radiation therapy – This is the use of high-energy rays to kill cancer cells and shrink tumors. Similar to surgery (and normally administered in a hospital), radiation therapy is focused directly upon the affected area. Physicians may use radiation therapy to shrink a tumor prior to surgery or to destroy cancer cells that remain in the body after surgery. Radiation may come from an external source or may be implanted into or adjacent to a tumor, i.e., via the use of a radioisotope.
Important Questions to Ask Your Doctor:
- What is the stage of my stomach (gastric) cancer?
- What are my treatment options?
- What are the risks and side effects of these treatment options?
- What can I do to take care of myself during and after treatment?
- How long will the treatment last, and what will be my follow-up?
Sources of Additional Information:
American Cancer Society
American College of Gastroenterology
American Gastroenterological Association
National Institutes of Health
This patient diagnostic fact sheet is provided to you as a service by AmeriPath. It is intended for patient education and information only. It does not constitute advice, nor should it be taken to suggest or replace professional medical care from your physician. Your treatment options may vary, depending upon your medical history and current condition. Only your physician and you can determine your best option.