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Cancer from A to Z

Types of cancer, how to prevent them, diagnosis and treatment.

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Stomach cancer

Although stomach cancer, known medically as gastric cancer, is common in South America, Eastern Europe and some Middle East countries, but least frequent in Western Europe, United States, Australia and Africa. This variation in the occurrence of stomach cancer is likely due to differences in diet, the rate of infection with Helicobacter pylori and environment.

 

Treatment success and survival rates among stomach cancer patients have been hindered because the presence of stomach cancer most often is not recognized until the disease has spread. This is partly due to the absence of noticeable symptoms during the early stages of cancer development in the stomach. And when symptoms do become evident, they initially may be mistaken for other less serious stomach problems, such as indigestion and heartburn, further delaying diagnosis and treatment.

 

Types

 

Most cancerous stomach tumors are adenocarcinomas, which develop in the cells of the stomach’s lining, often following a precancerous change in this lining.

 

Although stomach cancer usually finds its start within the interior layer of the five-layer stomach, it can develop anywhere in the organ and spread to other parts of the body by growing beyond the stomach wall, entering the bloodstream or reaching the lymphatic system.

 

Because adenocarcinomas make up the vast majority of stomach cancercases, other types of stomach cancer are considered rare, including:

  • Lymphoma: which affects a body’s immune system
  • Gastrointestinal stromal tumors: often called GIST or gastric sarcomas
  • Carcinoid tumors: which affect the hormone-producing cells of the stomach

Because many symptoms of stomach cancer are commonly experienced and may be indicative of a stomach virus or other minor condition, people suffering from them may be hesitant to seek medical advice, opting instead to ignore the symptoms. Even though a stomach cancerdiagnosis is unlikely in most cases, individuals should contact a doctor when they consistently experience the following:

  • Abdominal pain or discomfort
  • Loss of appetite
  • Heartburn
  • Indigestion
  • Nausea and vomiting
  • Bloating
  • Diarrhea or constipation
  • Feeling of fullness after eating small amounts of food
  • Bloody or black stools
  • Fatigue
  • Unintentional weight loss
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A popular explanation for the decrease in the number of stomach cancerdiagnoses in the western countries involves improved nutrition due to the proliferation of refrigeration during the past century, which has fostered an increase in the availability of fresh foods at the expense of the once-common pickled, dried and smoked fare that heads the list of dietary risk factors.

 

Another explanation focuses on the broader use of antibiotics in developed countries, which may play a beneficial role in reducing the stomach-dwelling Helicobacter pylori bacteria, a co-factor in the development of stomach carcinoma and a cause of stomach infection in many developing countries where substandard hygiene conditions exist.

 

Being aware of and/or mitigating the following risk factors may help prevent stomach cancer:

 

Diet: The intake of foods preserved through pickling, salting and drying appears to increase the likelihood of stomach cancer, whereas eating substantial quantities of fruits, vegetables and whole-grain foods likely reduces the risk. Men who are very overweight or obese appear to have a higher risk of cancer in the part of the stomach nearest the esophagus. Scientists are not sure whether obesity increases a woman’s risk of stomach cancer.

 

Helicobacter pylori: Infection of the stomach by H. pylori bacteria, a common cause of ulcers, is believed to significantly increase one’s cancer risk.

 

Tobacco and alcohol abuse: According to the American Cancer Society, tobacco use causes about one-third of all cancer deaths in the United States, and both smoking and drinking excessive amounts of alcohol appear to increase the likelihood of cancer in the upper part of the stomach.

 

Genetic disposition: Immediate family members of those diagnosed with stomach cancer are at increased risk for developing the disease. Other genetic risk factors include hereditary non-polyposis colon cancer(HNPCC) syndrome and Li-Fraumeni syndrome, conditions that result in a predisposition to cancer. Having type A blood appears to slightly increase the risk for stomach cancer.

 

Medical Conditions: People with pernicious anemia are 5 to 10% more likely to develop stomach cancer. Those with chronic stomach inflammation and intestinal polyps are also at increased risk for the disease.

 

Gender: The majority of stomach cancer patients are male.

 

Age: Most individuals who develop stomach cancer are older than 55 years of age.

 

Environment: Because the number of stomach cancer cases varies dramatically from one part of the world to another, there may be an environmental component to stomach cancer risk that goes beyond nutrition. It is known that workers in the rubber, metal, coal and timber industries, as well as those who have been exposed to asbestos fibers, have a higher risk for stomach cancer.

Preliminary diagnostic tests for stomach cancer may include: 

  • Determining the patient’s medical history
  • X-rays of the gastrointestinal tract
  • Obtaining a stool sample to test for traces of blood

For patients at increased risk for stomach cancer, additional tests may be ordered. These may include endoscopic examination, which is performed using a thin tube inserted via the mouth and esophagus into the stomach. The instrument can illuminate the stomach’s interior and provide images that can be analyzed by doctors, and it can also collect cell samples from the stomach for lab analysis. Additionally, doctors can use the endoscopy tube to perform ultrasonic scans of the stomach.

 

Beyond endoscopy, doctors have other diagnostic tools at their disposal, several of which feature imaging techniques that make use of new and enhanced technology. Included are CT (computed tomography) scans that augment traditional X-rays by obtaining numerous images and combining them via computer to provide doctors a more complete view of their subject, which aids them in treating the disease.

Treatments for gastric cancer include surgery, chemotherapy and radiation therapy. These treatments may be given alone or in combination with one another. Treatment for gastric cancer depends on the size, location and stage of the cancer, along with your general health.

Common treatment options include:

  • Surgery: often involves removal of tumors, portions of the stomach and neighboring lymph nodes
  • Chemotherapy: aims to shrink tumors and eliminate cancer cells
  • Radiation therapy: aims to stop cancer growth by targeting cancer cells with radiation

Surgery
 

Surgery is a common treatment for early stage gastric cancer. Types of stomach cancer surgery include: 

 

Gastrectomy: involves part or all of the stomach being removed.

 

Subtotal Gastrectomy: includes removing the cancerous part of the stomach, nearby lymph nodes (tissues that filter infection and disease) and parts of other organs near the tumor.

 

Total Gastrectomy: involves removing the entire stomach, nearby lymph nodes and parts of the esophagus and small intestine. The esophagus is reconnected to the small intestine so the patient can continue to eat and swallow.

 

Chemotherapy
 

Chemotherapy uses drugs to kill cancer cells. Your doctor may use one drug or a combination of drugs to treat your cancer. These drugs enter the blood and reach all areas of the body, making this treatment useful for cancer that has spread beyond the stomach. Chemotherapy can be given several ways, such as intravenously or by mouth. A common method is through a central venous catheter, a flexible tube that is placed in a large vein to deliver fluids and medications.

 

Since chemotherapy medications may affect some healthy cells as well as cancer cells, side effects may occur. Medications are available that can reduce the severity of side effects. Common side effects of chemotherapy include nausea, diarrhea, fatigue, hair loss and low blood counts that may increase the risk of infections and bleeding. You will receive detailed information and instruction about the chemotherapymedications your doctor has prescribed.

 

Radiation Therapy
Radiation therapy uses X-rays or other high-energy rays to kill cancer cells and shrink tumors. The radiation can only affect cancer cells in the treated area. External beam radiation therapy is radiation delivered from a machine outside the body.

The following technological means and radiation therapy are used with this disease:

  • Virtual CT simulation
  • Intensity modulated radiation therapy (IMRT)
  • Volumetric modulated arc therapy (VMAT)
  • Stereotactic body radiation therapy (SBRT)
     

Chemoradiation
Chemoradiation for stomach cancer combines radiation therapy and chemotherapy to prevent tumor growth and to reduce symptoms resulting from the tumor.

 

Clinical Trials 
Clinical trials are in progress to find the best ways to use chemotherapyto treat gastric cancer. New chemotherapy drugs are being studied in clinical trials as a treatment for cancer that has spread and as a way to relieve symptoms of the disease.