Stomach Cancer - Summary, Symptoms, Treatments

What is stomach cancer?

Stomach cancer, also known as gastric cancer, begins in the cells lining the stomach. It typically develops slowly over many years and often starts in the mucosa, the innermost layer of the stomach wall.
 
The most common type of stomach cancer is adenocarcinoma, which starts in the glandular cells that produce mucus and stomach acids. Gastrointestinal stromal tumors (GISTs), lymphomas and carcinoid tumors are other, less common types of stomach cancer.
 
Stomach cancer mostly affects older adults. The average age at diagnosis is around 68. The risk increases significantly after age 50. The lifetime risk of developing stomach cancer is higher in men than in women.

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What are the signs and symptoms of stomach cancer?

Pre-cancerous changes in the stomach often go undetected because, early on, they rarely cause any symptoms. Some symptoms may be caused by other conditions.
 
Signs and symptoms of stomach cancer can include:

• Poor appetite or weight loss (without trying)
• Abdominal (belly) pain, discomfort or swelling, usually above the navel
• Feeling full after eating only a small meal
• Heartburn or indigestion
• Nausea or vomiting, with or without blood
• Trouble swallowing
• Blood in the stool
• Feeling tired or weak, as a result of having too few red blood cells (anemia)
• Yellowing of the skin and eyes (jaundice)

If these issues exist for an extended period of time, especially if they don’t go away or get worse, it is recommended to see a doctor.

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How is stomach cancer diagnosed?

Diagnosing stomach cancer begins with a physical examination and review of health history to evaluate the symptoms. An upper endoscopy (EGD) is an important test for diagnosing stomach cancer. A flexible tube with a camera (endoscope) is passed down the throat to view the stomach lining. Suspicious areas can be biopsied (small tissue samples taken) for microscopic examination to confirm cancer cells. Imaging tests such as ultrasound, computed tomography (CT) or positron emission tomography scans (PET) can help to make an accurate diagnosis. Blood tests can assess liver function and anemia.

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What causes stomach cancer?

While the exact cause is not always known, several risk factors have been identified that increase the likelihood of developing stomach cancer. Each person’s risk can be impacted by many factors.
 
Major causes and risk factors include:

• Helicobacter pylori (H. pylori) infection—a common bacterial infection that can cause chronic inflammation and ulcers, which may lead to cancer over time.
• Poor diet—high intake of salted, smoked or pickled foods or processed meats and low intake of fruits and vegetables
• Smoking–roughly doubles the risk.
• Heavy alcohol use
• Family history—having a close relative (parent, sibling) with stomach cancer
• Chronic medical conditions—gastritis, pernicious anemia or stomach polyps
• Obesity

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Is stomach cancer genetic?

Stomach cancer can have a genetic component, but most cases are not directly inherited. It is best to talk with your doctor about possible genetic predisposition, especially if stomach cancer runs in your family.
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Is stomach cancer curable?

Stomach cancer can be curable. Early-stage stomach cancer that is confined to the stomach lining or nearby lymph nodes has a good chance of cure, often through surgery to remove the tumor, sometimes combined with chemotherapy or radiation. When detected early, survival rates can be quite high. Advanced-stage stomach cancer, when cancer has spread beyond the stomach to other organs, is much harder to cure. Treatment focuses more on controlling the disease and symptoms rather than cure.

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How is stomach cancer treated?

Treatment options for stomach cancer depend on a number of factors, including the specific type and stage of cancer, possible side effects, and the patient’s overall health and personal preference. Each patient and each cancer is unique. At FCS, physicians develop a personalized treatment plan in partnership with patients.
 
Treatment options for stomach cancer include:

• Surgery to remove part of the stomach or the entire stomach and possibly nearby lymph nodes.
• Chemotherapy or radiation therapy, sometimes used together, to shrink or destroy cancer cells.
• A growing number of targeted therapies are used to target specific molecules on cancer cells.
• Immunotherapies help the body’s own immune system recognize and attack cancer cells and may be used alone or in combination with other treatments.

Participation in clinical trials for new therapies or combinations of treatments can be an option, especially for advanced stages of cancer.

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Are there screening tests for stomach cancer?

There are no routine screening tests to detect stomach cancer, although research is continuing. For adults who may be at higher risk due to chronic gastric issues, certain genetic syndromes or a family history of stomach cancer, doctors may recommend an endoscopy screening, a procedure that views inside the esophagus, stomach and upper part of the small intestine to check for abnormal areas.
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