Written by Anton Bilchik, M.D., Professor of Surgery, Chief of General Surgery, and Director of Gastrointestinal and Hepatobiliary Tumors Program at the John Wayne Cancer Institute.
The American Cancer Society estimates that 27,510 cases of stomach cancer will be diagnosed this year. Also known as gastric cancer, it mostly affects people 65 and older and occurs in more men than in women. While new cases of stomach cancer are decreasing in the United States each year, its symptoms are sometimes mistaken for less serious conditions. Therefore, it is important to be aware of the signs and risk factors of gastric cancer, which are summarized below as well as tips for prevention.
What is Stomach Cancer?
Stomach cancer, also called gastric cancer, is a type of cancer that begins in the stomach. In 90 to 95% of cases, the disease starts in the cells that form the lining of the stomach – beginning as an ulcer or polyp. In some people, the lesion may cause no symptoms; in others, it might bleed or cause pain. Stomach cancer is often discovered at an advanced stage.
Often people ask us if you can survive stomach cancer. Survival depends on how advanced the cancer is and if it has traveled to the lymph nodes or other parts of the body. Many patients diagnosed with stomach cancer can be cured.
How is Stomach Cancer Diagnosed?
Stomach cancer is diagnosed with various tests, including the following:
Upper Gastrointestinal (GI) series:
- This test is also known as the barium swallow. Patients drink a special fluid that coats the inside of the digestive system organs, making them visible on x-rays. The x-rays are then evaluated by a doctor.
Esophagogastroduodenoscopy (EGD)/Upper Endoscopy:
- This procedure is done with an endoscope, a lighted, flexible, thin tube. It is first guided through the mouth and throat and then into the esophagus, stomach, and duodenum. Doctors can see the inside of the stomach area and remove a tissue sample for testing (biopsy) if needed.
- This test creates a computer image of the esophagus, stomach, and related lymph nodes. With this technique, doctors can also insert surgical instruments to remove a tissue sample for testing (biopsy).
Computed Tomography Scan (CT or CAT scan):
- This non-invasive test uses x-rays and computer technology to create detailed images of the stomach organs.
Fecal Occult Blood Test:
- This test looks for microscopic droplets of blood in the stool and can be done at home. The patient puts a small stool sample on a card and sends it to a doctor’s office or lab for testing.
Learn more about stomach cancer and how it is diagnosed, by visiting our Center for Gastrointestinal and Hepatobiliary Tumors.
What are the Risk Factors for Stomach Cancer?
The factors below can increase your risk for gastric cancer:
- Helicobacter Pylori: This bacterial Infection inflames the inner stomach layer, which can lead to ulcers or cancer. If found, the infection can be treated with antibiotics.
- Gender and Age: More men than women are diagnosed with stomach cancer. It most commonly affects people over 65.
- Diet: Eating lots of smoked and salted foods, such as bacon and hot dogs, can increase your risk for stomach cancer. A deficiency in selenium, a dietary mineral, might also increase someone’s risk.
- Race: Gastric cancer is more prevalent in Asian, Pacific Island, Hispanic, and African American populations.
- Pernicious Anemia: This rare autoimmune disease causes the stomach to stop producing acid, making it hard for the body to absorb vitamin B12.
- Family Cancer Syndromes: The following hereditary cancers increase the risk of developing stomach cancer: nonpolyopsis colorectal cancer (HNPCC/ Lynch syndrome), Peutz-Jeghers syndrome, and familial adenomatous polyposis.
- Family History: Persons with a family history of gastric cancer, possibly caused by the E-cadherin mutation, have a greater risk for developing the disease. Additionally, those carrying mutations of the inherited genes BRCA1 and BRCA2 (breast cancer genes) have a greater risk for stomach cancer.
- Other Factors: Blood type A, smoking, and obesity also increase a person’s risk for gastric cancer.
What are the Signs and Symptoms of Stomach Cancer?
Sometimes people mistake the symptoms of gastric cancer for the stomach flu. Therefore, it’s important to be aware of the signs and symptoms of gastric cancer, especially since the disease often goes undetected until it’s in an advanced stage. Stomach cancer symptoms are similar to other conditions. However, if you experience one or more of these symptoms for several weeks, you should make an appointment with your doctor.
Symptoms of stomach cancer can include
- Stomach pain or bloating
- Vomiting blood or blood in the stool
- Weight loss or lack of appetite
- Nausea and vomiting
- Weakness and fatigue
- Trouble swallowing or a lot of belching when eating
How is Stomach Cancer Treated?
The John Wayne Cancer Institute treats cancer in a variety of ways, including using the latest advancements in cancer care. Gastric cancer is often managed with a three-prong approach using surgery, chemotherapy, and radiation. When creating your personalized treatment plan, we take several things into account, such as your age, preferences, and medical history, the disease’s stage, and other factors. Below we discuss possible treatment options:
- Surgery for gastric cancer may involve removing a patient’s part of the stomach or the whole stomach .
- This type of surgery is less invasive with shorter recovery time. It uses a small video camera called a laparoscope to project a large image of the abdominal wall on a screen. The laparoscope is inserted through a small incision. Guided by the large image, a surgeon operates using special surgical tools which are also inserted through small incisions. This also includes robotic surgery whereby fine instruments are controlled in 3 D at a console.
- Radiation therapy attacks cancer cells with high-energy rays. It’s similar to having an x-ray but much more powerful.
- With chemotherapy, powerful medicines are injected into a vein to destroy cancer cells that have invaded the stomach wall, lymph nodes, and other organs. It may treat stomach cancer on its own or be combined with surgery and radiation. Chemo is also used to shrink tumors before surgery and kill remaining cancer cells after. In cases that can’t be treated with an operation, chemo can reduce symptoms of stomach cancer and increase a patient’s quality of life.
Intraperitoneal (IP) Therapy
- This procedure releases chemotherapy drugs directly into the internal lining of the abdominal area through a surgically-inserted catheter. This allows a high dose of chemotherapy to reach the cancer, increasing the drug’s effectiveness.It is more effective if heated and given at the time of stomach resection (HIPEC).
- This newer form of chemotherapy is often paired with standard chemo. Targeted therapy drugs aim at certain receptors on cancer cells but not normal cells. For example, in some gastric cancers, the cells contain a high level of the HER2 protein. A drug called trastuzumab (Herceptin) neutralizes the receptors, which kills the cancer cells.
Can Stomach Cancer Be Cured?
Surgery is the best chance for curing stomach cancer. However, surgery may not be an option for all cases of gastric cancer. Visit our treatment options page to learn more about stomach cancer.
Tips for Preventing Stomach Cancer
The American Cancer Society recommends that those looking to reduce their risk for stomach cancer follow these guidelines:
- Maintain a healthy weight
- Eat a diet filled with fruits and vegetables.
- Get frequent exercise.
- Avoid smoking.
- Treat H pylori bacterial infections.
- Ask your doctor about taking aspirin and non-steroidal anti-inflammatory drugs, including ibuprofen and naproxen. These over-the-counter medicines may lower the risk of stomach cancer. However, be sure to ask your doctor as the medications may be a health risk for certain people.
- Are you at an increased risk for stomach cancer due to a family history of the cancer syndromes described above (under “What are the Risk Factors for Stomach Cancer?”)? Talk to your doctor about genetic testing to assess your risk for developing gastric cancer.
If you have concerns or questions about stomach cancer, you can schedule an appointment at our Center for Gastrointestinal and Hepatobiliary Tumors.