Stomach cancer, also called gastric cancer, is a disease in which the cells in the stomach divide without control or order and take on an abnormal appearance. These cancerous cells often spread to nearby organs and to other parts of the body.
The stomach is the pouch-like organ located in the upper abdomen, under the ribs, that plays a role in the digestion of food. It connects the esophagus (e-SOF-a-gus), the tube that carries swallowed food, with the small intestine, which absorbs the nutrients needed by the body. When food enters the stomach, the muscles in its wall create a rippling motion that mixes and mashes the food. The glands in the lining of the stomach release juices that begin to digest the mixture. After a few hours, the food becomes a liquid and moves into the small intestine, which makes it easier for the intestine to continue the process of digestion and absorb the substances that the body needs for energy.
Stomach cancer begins when some of its cells take on an abnormal appearance and begin to divide without control or order. If left untreated, these cancer cells can grow through the stomach wall, and they can spread to nearby organs or to nearby lymph nodes *
About 95 percent of all stomach cancers are adenocarcinomas (ah-DEE-no-kar-si-NOH-mas), which start in the glandular cells of the stomach. Other types of stomach cancer include malignant * transformation of the immune * tissue of the stomach wall, which causes lymphoma * of the stomach wall; cancer affecting the hormone-producing cells in the stomach that causes a condition called carcinoid tumor; and gastrointestinal stromal (gas-tro-in-TES-tih-nuhl STRO-mal) tumor, a rare form of stomach cancer that affects nervous system tissue within the stomach.
Each year, about 24,600 people in the United States learn that they have cancer of the stomach, and more than 10,000 will die as a result of the disease. Like most other forms of cancer, stomach cancer occurs most frequently in older people, usually 65 years of age or older. Fortunately, for reasons that scientists cannot fully explain, the number of people who get this disease dropped steadily between the 1940s and the early 2000s.
Stomach cancer is much more common in other countries, especially Japan, Chile, and Iceland. Researchers think the reason may be that people in these countries eat many foods that are preserved by drying, smoking, salting, or pickling. Eating foods preserved in this way may raise someone's risk of developing stomach cancer. People who smoke cigarettes may also be at higher risk of developing stomach cancer. Stomach cancer is a leading cause of cancer-related deaths in the world.
At first, stomach cancer does not cause any symptoms. When it eventually causes symptoms, they often are mistaken for less serious stomach problems, such as indigestion, heartburn, or a virus. Therefore, it is hard to find stomach cancer early, which makes it more difficult to treat. Possible symptoms include:
When people report these symptoms to their family doctor, they may be referred to a gastroenterologist (gas-tro-en-ter-OL-o-jist), a doctor who specializes in diagnosing and treating digestive problems. The gastroenterologist may order additional diagnostic tests to figure out what is wrong.
One of the most common procedures is called endoscopy (en-DOS-ko-pee), which involves passing a very thin, lighted tube down the esophagus and into the stomach. This tube allows doctors to look directly at the inside of the stomach. If an abnormal area is seen, doctors can remove some tissue from it through the tube and have the tissue examined under a microscope. This process, called a biopsy (BY-op-see), determines whether cancer cells are present.
A person might also have an upper GI series, which is a series of x-rays of the upper gastrointestinal (gas-tro-in-TES-ti-nal) tract, including the esophagus and stomach. These pictures are taken after the person drinks a thick chalky liquid called barium (BA-ree-um). The barium outlines the stomach on the x-rays, helping doctors locate tumors or other abnormal areas.
The doctor might also want to test for blood in the feces * , the solid waste that people produce when they go to the bathroom. This test involves placing a small amount of feces (stool) on a slide and having it tested in the laboratory. Sometimes, blood in the stool is a sign of stomach cancer or other cancers of the digestive tract.
The most common treatment is an operation called gastrectomy (gas-TREK-to-mee), during which surgeons remove part or all of the stomach and some of the surrounding tissue. If all of the stomach needs to be removed, then surgeons connect the esophagus directly to the small intestine. The nearby lymph nodes usually are removed as well.
People with stomach cancer may also be treated with radiation therapy or chemotherapy * , either in an attempt to destroy some of the cancer cells or to ease some of their pain and other symptoms. Radiation therapy focuses high-energy rays on the body to destroy cancer cells and to stop or slow their growth. During chemotherapy, anticancer drugs are given by mouth or by injection into a muscle or blood vessel.
Because stomach cancer is so difficult to cure, researchers have looked at other ways to treat this disease. Studies called clinical trials have been conducted to evaluate some new treatments in cancer patients. One example is biological therapy, which triggers the body's own immune system to attack and destroy cancer cells.
Because people with stomach cancer often have part or all of the stomach removed, they need time to readjust to eating after the surgery. At first, patients are fed intravenously (in-tra-VEE-nus-lee) through a vein in the hand or arm. Within several days, they usually can start taking in liquids, then soft foods, and then more solid foods. Often they need to follow a special diet until they can adjust to having a smaller stomach or none at all. People with stomach cancer need to work with dietitians and nutritionists to make sure that they are getting the nutrients their body needs.
See also Cancer: Overview • Colorectal Cancer • Tumor
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* lymph nodes (LIMF) are small bean-shaped masses of tissue containing immune system cells that fight harmful microorganisms. Lymph nodes may swell during infections.
* malignant (ma-LIG-nant) refers to a condition that is severe and progressively worsening.
* immune (ih-MYOON) means resistant to or not susceptible to a disease.
* lymphoma (lim-FO-muh) is a cancerous tumor of the lymphocytes, cells that normally help the body fight infection
* feces (FEE-seez) is the excreted waste from the gastrointestinal tract.
* CT scans is the shortened name for computed tomography (to-MOG-ra-fee), which uses computers to view structures inside the body. Formerly called computerized axial tomography (CAT).
* ultrasound, also called a sonogram, is a diagnostic test in which sound waves passing through the body create images on a computer screen.
* chemotherapy (KEE-mo-THER-a-pee) is the treatment of cancer with powerful drugs that kill cancer cells.