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Stomach cancer

Cancer - stomach; Gastric cancer; Gastric carcinoma; Adenocarcinoma of the stomach

 

Stomach cancer is cancer that starts in the stomach.

Causes

 

Several types of cancer can occur in the stomach. The most common type is called adenocarcinoma. It starts from one of the cell types found in the lining of the stomach.

Adenocarcinoma is a common cancer of the digestive tract. It is not very common in the United States. It is diagnosed much more often in people in eastern Asia, parts of South America, and eastern and central Europe. It occurs most often in men over age 40.

The number of people in the United States who develop this cancer has decreased over the years. Experts think this decrease may be in part because people are eating less salted, cured, and smoked foods.

You are more likely to be diagnosed with gastric cancer if you:

  • Have a diet low in fruits and vegetables
  • Have a family history of gastric cancer
  • Have an infection of the stomach by a bacteria called Helicobacter pylori
  • Had a polyp (abnormal growth) larger than 2 centimeters in your stomach
  • Have inflammation and swelling of the stomach for a long time (chronic atrophic gastritis)
  • Have pernicious anemia (low number of red blood cells from intestines not properly absorbing vitamin B12)
  • Smoke

 

Symptoms

 

Symptoms of stomach cancer may include any of the following:

  • Abdominal fullness or pain, which may occur after a small meal
  • Dark stools
  • Difficulty swallowing, which becomes worse over time
  • Excessive belching
  • General decline in health
  • Loss of appetite
  • Nausea
  • Vomiting blood
  • Weakness or fatigue
  • Weight loss

 

Exams and Tests

 

Diagnosis is often delayed because symptoms may not occur in the early stages of the disease. And many of the symptoms do not specifically point to stomach cancer. So, people often self-treat symptoms that gastric cancer has in common with other, less serious, disorders (bloating, gas, heartburn, and fullness).

Tests that can help diagnose gastric cancer include:

  • Complete blood count (CBC) to check for anemia.
  • Esophagogastroduodenoscopy (EGD) with biopsy to examine the stomach tissue. EGD involves putting a tiny camera down the esophagus (food tube) to look at the inside of the stomach.
  • Stool test to check for blood in the stools.

 

Treatment

 

Surgery to remove the stomach (gastrectomy) is the standard treatment that can cure adenocarcinoma of the stomach. Radiation therapy and chemotherapy may help. Chemotherapy and radiation therapy after surgery may improve the chance of a cure.

For people who cannot have surgery, chemotherapy or radiation may improve symptoms and may prolong survival, but may not cure the cancer. For some people, a surgical bypass procedure may relieve symptoms.

 

Support Groups

 

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

 

Outlook (Prognosis)

 

Outlook varies based on how much the cancer has spread by the time of diagnosis. Tumors in the lower stomach are cured more often than those in the higher stomach. Chance of a cure also depends on how far the tumor has invaded the stomach wall and whether lymph nodes are involved.

When the tumor has spread outside the stomach, a cure is less likely. When a cure is not possible, the goal of treatment is to improve symptoms and prolong life.

 

When to Contact a Medical Professional

 

Call your health care provider if symptoms of gastric cancer develop.

 

Prevention

 

Screening programs are successful in detecting disease in the early stages in parts of the world where the risk of stomach cancer is much higher than in the United States. The value of screening in the United States and other countries with much lower rates of stomach cancer is not clear.

The following may help reduce your risk of stomach cancer:

  • DO NOT smoke.
  • Keep a healthy diet rich in fruits and vegetables.
  • Take medicines to treat reflux disease (heartburn), if you have it.
  • Take antibiotics if you are diagnosed with H pylori infection.

 

 

References

Abrams JA, Quante M. Adenocarcinoma of the stomach and other gastric tumors. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 54.

Gunderson LL, Donohue JH, Alberts SR. Ashman JB, Jaroszewski DE, eds. Cancer of the stomach and gastroesophageal junction. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 75.

National Cancer Institute. Gastric cancer treatment (PDQ) - health professional version. Updated June 30, 2016. cancer.gov/cancertopics/pdq/treatment/gastric/HealthProfessional. Accessed December 21, 2016.

 
  • Digestive system

    Digestive system - illustration

    The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

    Digestive system

    illustration

  • Stomach cancer, X-ray

    Stomach cancer, X-ray - illustration

    An upper GI series in a patient with cancer of the stomach (gastric carcinoma).

    Stomach cancer, X-ray

    illustration

  • Stomach

    Stomach - illustration

    The stomach is the portion of the digestive system most responsible for breaking down food. The lower esophageal sphincter at the top of the stomach regulates food passing from the esophagus into the stomach, and prevents the contents of the stomach from reentering the esophagus. The pyloric sphincter at the bottom of the stomach governs the passage of food out of the stomach into the small intestine.

    Stomach

    illustration

  • Gastrectomy  - series

    Gastrectomy - series

    Presentation

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Stomach cancer, X-ray

      Stomach cancer, X-ray - illustration

      An upper GI series in a patient with cancer of the stomach (gastric carcinoma).

      Stomach cancer, X-ray

      illustration

    • Stomach

      Stomach - illustration

      The stomach is the portion of the digestive system most responsible for breaking down food. The lower esophageal sphincter at the top of the stomach regulates food passing from the esophagus into the stomach, and prevents the contents of the stomach from reentering the esophagus. The pyloric sphincter at the bottom of the stomach governs the passage of food out of the stomach into the small intestine.

      Stomach

      illustration

    • Gastrectomy - series

      Presentation

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Stomach cancer

           

           

          Review Date: 11/10/2016

          Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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