What is Stomach Cancer?

Stomach cancer, also known as gastric cancer, often begins in the cells lining the stomach. This type, known as adenocarcinoma, is the most commonly diagnosed form of stomach cancer. Other types of stomach cancer include gastrointestinal carcinoid tumors, gastrointestinal stromal tumors and lymphomas – but these are very rare.

Stomach cancer is uncommon in the United States, and rates are on the decline. It is much more common in countries like Japan and China.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of stomach cancer. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Stomach cancer symptoms can be mild and non-specific or severe. They may include:

• Abdominal mass
• Abdominal pain
• Anemia
• Bloating after eating
• Difficulty swallowing
• Fatigue
• Feeling full after eating a small amount
• Severe and persistent heartburn or indigestion
• Severe and unexplained nausea
• Unintentional weight loss
• Vomiting

Diagnosis

To determine if someone has stomach cancer, we ask about medical history and do a physical exam. We also use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Biopsy: During an endoscopy, the physician may take a small piece of tissue from the stomach and examine it under a microscope for cancer cells.

Blood test: These tests can check for anemia and certain cancer markers in the blood.

Computed tomography (CT) scan: A series of detailed pictures of the abdomen and chest, taken from different angles, are created by a computer linked to an X-ray machine.

Endoscopic Ultrasonography (EUS): During this test, a thin tube with a small ultrasound probe at the end is inserted in the mouth and down into the esophagus, stomach and small intestine. Sound waves are emitted and converted into black and white images.

Endoscopy: During this test, a thin tube with a light and a lens is inserted in the mouth and down into the esophagus, stomach and small intestine to check for inflammation, suspicious growths and other problems.

Staging Laparoscopy: A surgeon may make several small incisions in the abdomen and insert a special camera to see if cancer has spread beyond the stomach within the abdomen.
Positron emission tomography (PET) scan: This imaging test uses a radioactive substance called a tracer to look for cancer cells in the stomach.
Stool test: A physician can check for non-visible blood in the stool, a sign of cancer. 

Causes

Most cases of stomach cancer result from a mutation in cell DNA, and researchers aren’t sure of the cause. There are a number of lifestyle and environmental factors that can lead to the development of stomach cancer. Some of these causes include:

• A diet high in smoked, salted and pickled foods
• Obesity
• Smoking

Risk Factors

Risk factors that can contribute to stomach cancer include:

Age: Most people with stomach cancer are in their late 60s and older.

Gender: Stomach cancer is more common in men than women.

Common variable immune deficiency (CVID): People with this rare condition face frequent infections, gastritis and pernicious anemia – which can all contribute to the development of stomach cancer.

Epstein-Barr virus (EBV) infection: EBV has been found in some stomach cancer cells, but it isn’t yet clear if this virus causes stomach cancer.

Ethnicity: In the United States, stomach cancer is more common in Hispanic Americans, African Americans and Asian/Pacific Islanders than it is in Caucasians.

Gastritis: This chronic inflammation of the stomach lining can lead to cancer.

Genetics: People with first-degree relatives who have had stomach cancer are more likely to develop this disease. Some inherited conditions – like hereditary diffuse gastric cancer, hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, mutated inherited breast cancer genes BRCA1 or BRCA2 and Li-Fraumeni syndrome and Peutz-Jeghers syndrome – also increase a person’s risk.

Helicobacter pylori infection: This bacterial infection is a common cause of stomach cancer.

Occupational exposure: People working in the coal, metal and rubber industries seem to have a higher risk of developing stomach cancer.

Pernicious anemia: People without enough intrinsic factor, a substance that helps the body absorb vitamin B12, can end up with a B12 deficiency which affects red blood cell production. An increased risk of stomach cancer is associated with this condition.

Previous stomach surgery: Stomach cancers are more likely to develop in people who have had part of their stomach removed to treat non-cancerous diseases such as ulcers.

Prior abdominal radiation for cancer: People who have had abdominal radiation to treat Hodgkin’s disease, testicular cancer or childhood cancer are at a higher risk of developing stomach cancer.

Some polyps: Most polyps are harmless. But adenomatous polyps can sometimes develop into cancer.

Type A blood: For unknown reasons, people with type A blood have a higher risk of developing stomach cancer.

Prevention 

While many risk factors cannot be controlled, there are ways you can help prevent some types of stomach cancer:

Ask about your risk: If you have a known risk of stomach cancer, ask your physician about periodic endoscopies.

Don’t smoke: Smoking is a known cause of most cancers.

Eat a healthy diet: Eat a diet that includes plenty of fruit and vegetables, and exercise daily.

Lose weight: People at a healthy weight are less likely to develop many types of cancer.

Reduce the amount of certain foods you eat: Cut back on smoked, salted and pickled foods.

Prognosis

The earlier that stomach cancer is diagnosed, the better the outcome. If curative treatment is not possible, there are multiple treatment measures that can relieve symptoms and improve the quality of life.

Prognosis can be determined by the stage of the cancer. The stage of the cancer is determined by the size of the tumor and extent of local growth, whether lymph nodes are involved and whether the cancer has spread. The cancer stage and the patient’s medical history are used to determine the plan of care.

Treatment and Recovery

Stomach cancer treatment depends upon how far the condition has progressed, a person’s overall health and his or her preferences. Treatment methods may include:

Chemotherapy

Chemotherapy uses special drugs designed to kill cancer cells. Chemotherapy can be administered as a pill or injected into the bloodstream and may be given before surgery to shrink a tumor, after surgery to kill remaining cancer cells and as a means of reducing symptoms.

Radiation Therapy

This treatment uses high-energy radiation to kill cancer cells. Similar to getting an X-ray, the radiation is directed specifically to the stomach. Most often, radiation treatments are given five days a week for several weeks.

Surgery

Surgery is meant to remove all of the stomach cancer and a margin of healthy surrounding tissue. People with early-stage tumors can undergo removal during an endoscopy procedure. Others will need a portion – or all – of the stomach removed. The surgeon may also remove surrounding lymph nodes to see if the cancer has spread.

Targeted Drugs

These therapies attack specific abnormalities in the cancer cells.

Complications

Stomach cancer can recur, so follow-up care after successful treatment is important. In addition, the cancer itself and some treatments can result in complications. These include:

Digestion and nutrition problems: Both the cancer and surgeries to treat the cancer can lead to digestive problems and trouble absorbing vital nutrients.
Gastrointestinal bleeding: This can develop from the tumor itself or as a complication of surgery.
Obstruction: If a tumor blocks the pylorus at the end of the stomach, food cannot pass through.
Spread of the cancer to other areas: Stomach cancer can spread to surrounding lymph nodes, other organs in the abdomen and throughout the body.
Stomach perforation: Tumors and certain drugs can weaken and cause a perforation in the stomach lining, leading to inflammation of the abdominal wall and organs. This is an emergency and can be fatal. 

Related Conditions

Skin changes can include:

• Sudden eruption of pigmented skin lesions
• Dark, velvety discoloration in skin folds and creases

Problems with the blood can include:

• Anemia, caused by the loss of red blood cells
• Vessel inflammation due to blood clot
• Hemorrhage due to blood not clotting

Kidney problems can include:

• Kidney failure