Stomach Cancer

What is stomach cancer?

Stomach cancer, also known as gastric cancer, is cancer that starts in any part of the stomach.

Illustration of the anatomy of the digestive system, adult

The stomach is just one of many organs located in the abdomen, the area of the body between the chest and the pelvis.

What causes stomach cancer?

The exact cause of stomach cancer is unknown, although there are many risk factors believed to contribute to cells in the stomach becoming cancerous.

What are the risk factors for stomach cancer?

The following are suggested 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

  • 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 the 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:

    • Hereditary nonpolyposis colorectal cancer

    • Familial adenomatous polyposis

    • Breast cancer gene mutations BRCA1 or BRCA2

    • Stomach cancer

  • History of stomach polyps

  • History of stomach lymphoma

  • 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

What are the symptoms of stomach cancer?

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 doctor for a diagnosis.

How is stomach cancer diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for stomach cancer may include the following:

  • Fecal occult blood test. This 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 doctor'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 doctor 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 doctor 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).

Illustration of an esophagogastroduodenoscopy procedure

  • Endoscopic ultrasound. This imaging technique uses sound waves to create a computer image of the wall of the esophagus and stomach, as well as nearby lymph nodes. A small transducer (that emits sound waves and receives their echoes) 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 doctor to view the inside of this area of the body, as well as insert instruments to remove a sample of tissue (biopsy).

  • Computed tomography scan (CT or CAT scan). A noninvasive diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body.  A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

What is the treatment for stomach cancer?

Specific treatment for stomach cancer will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent (stage) 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 radiation (external beam therapy). External radiation precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes. External radiation may be used after surgery to try to kill any remaining cancer cells or for more advanced stomach cancer to ease (palliate) symptoms such as pain or blockage.

  • 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 certain 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. Please consult your doctor with any questions or concerns you may have regarding this condition.