Stomach Cancer
Stomach cancer, also known as gastric cancer, is cancer that starts in any part of the stomach. The stomach is just one of many organs located in the abdomen, the area of the body between the chest and the pelvis. Among other organs found in the abdomen are the liver, pancreas, gallbladder, and colon. It is important to differentiate among these organs, because cancers and other diseases that affect them present different symptoms and are treated differently.
The American Cancer Society estimated that 21,000 Americans would be newly diagnosed with stomach cancer during 2010, and 10,570 deaths were expected.
The exact cause of stomach cancer is not known, although there are many risk factors believed to contribute to cells in the stomach becoming cancerous.
The following are suggested as risk factors for stomach cancer:
- Helicobacter pylori infection
- diet that includes the following:
- large amounts of smoked foods
- salted fish and meat
- pickled vegetables
- foods and beverages that contain nitrates and nitrites, which are commonly found in cured meats
- tobacco use
- alcohol abuse
- previous stomach surgery
- megaloblastic (pernicious) anemia (caused by vitamin B12 deficiency)
- Menetrier's disease
- age (marked increase after age 50 and the average age at time of diagnosis is 70)
- male gender (more men are diagnosed with the disease than women)
- having blood type A
- family history of the following:
- nonpolyposis colon cancer
- familial adenomatous polyposis
- BRCA1 or BRCA2 mutations
- stomach cancer
- history of stomach polyps
- exposure to environmental factors such as dusts and fumes in the workplace, most commonly the coal, metal and rubber industries
- race (more common in Asians, Pacific Islanders, Hispanics, and African Americans than in non-Hispanic Caucasian Americans)
- obesity
The following are the most common symptoms of stomach cancer. However, each individual may experience symptoms differently. Symptoms may include:
- indigestion or heartburn (burning sensation)
- discomfort or pain in the abdomen
- nausea and vomiting
- diarrhea or constipation
- bloating after meals
- loss of appetite
- unexplained weight loss
- weakness and fatigue
- vomiting blood or blood in the stool
The symptoms of stomach cancer may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for stomach cancer may include the following:
- fecal occult blood test - checks for hidden (occult) blood in the stool. It involves placing a very small amount of stool on a special card, which is then tested in the physician's office or sent to a laboratory.
- upper GI (gastrointestinal) series (Also called barium swallow.) - a diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.
- esophagogastroduodenoscopy (Also called EGD or upper endoscopy.) - an EGD (upper endoscopy) is a procedure that allows the physician to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the physician to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).
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- endoscopic ultrasound - this imaging technique uses sound waves to create a computer image of the inside of the esophagus and stomach. A small transducer (which emits sound waves and receives their echos) is placed on the tip of an endoscope. The endoscope is guided into the mouth and throat, then into the esophagus and the stomach. As in standard endoscopy, this allows the physician to view the inside of this area of the body, as well as insert instruments to remove a sample of tissue (biopsy).
Specific treatment for stomach cancer will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Treatment for stomach cancer may include:
- surgery
Surgery may be necessary to remove cancerous tissue, as well as nearby noncancerous tissue. The most common operation is called gastrectomy. If part of the stomach is removed, it is called a subtotal or partial gastrectomy. If the entire stomach is removed, it is called a total gastrectomy. Nearby lymph nodes are usually removed as well.
- external beam radiotherapy (EBRT)
EBRT uses carefully aimed beams of x-rays to kill cancer cells. EBRT is painless and takes a few minutes to deliver. The treatment plan is developed by a doctor called a Radiation Oncologist. Special techniques such as Intensity-Modulated Radiotherapy (IMRT) and Tomotherapy are often used to minimize the dose of radiation to normal tissues to reduce side effects, while still delivering enough radiation to kill tumor cells and shrink tumors. EBRT is often used before or after surgery, in combination with chemotherapy, to reduce the likelihood of tumor recurrence. EBRT is also used after surgery to try to kill any remaining cancer cells or for more advanced stomach cancer to ease symptoms (palliate) such as pain, blockage, or bleeding.
- chemotherapy
Chemotherapy is the use of anticancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell’s ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual.
- targeted therapy
Some newer drugs work differently from standard chemotherapy drugs by targeting certain parts of cancer cells that make them different from normal cells. For example, in some stomach cancers, the cells have too much of a protein called HER2 on their surfaces. A drug called trastuzumab (Herceptin) may be helpful against these cancers. It is usually given along with standard chemotherapy drugs to help treat advanced stomach cancers.
Sometimes, several treatments may be combined to treat stomach cancer.
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Online Resources of Digestive Disorders
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