Stomach or gastric cancer is a disease in which malignant (cancer) cells form in the lining of the stomach. It is the 13th most common cause of cancer-related death in the US which has been steadily declining. View Our Stomach Cancer Providers
Stomach cancer has several known risk factors. Your diet and lifestyle choices can play a role in the risk for developing this cancer. Consuming fresh fruits and vegetables can help prevent unwanted changes in the lining of your stomach. Using tobacco and drinking a lot of alcohol can increase your risk, as can a diet high in salted, smoked, or pickled foods. Family history of gastric cancer as well as being of certain ethnic background (South and Central America, Eastern Europe, Asia) is known to play a part. Infection with H. pylori bacteria is also a risk factor for gastric cancer.
Individuals with some of the signs and symptoms of stomach cancer should see their doctor as soon as possible. The physician will ask the patient about his/her symptoms, family history, and medical history, as well as lifestyle choices, such as eating habits or smoking. He/she will also carry out a physical examination to check for stomach tenderness or masses. If the doctor suspects possible stomach cancer, the patient will be referred to a specialist for tests, these include:
The specialist looks at the inside of the patient’s stomach with a video camera (endoscope). Some tissue samples may be taken if the doctor suspects cancer. This is called a biopsy.
In a barium swallow study, the patient swallows a liquid which contains barium. This helps identify the stomach during an X-ray.
The specialist may want to look inside the abdomen in more detail to determine how much the cancer has spread. In a procedure called a laparoscopy, the patient is placed under a general anesthetic, and a laparoscope, a thin tube with a camera at the end, is inserted through a small incision in the lower part of the stomach.
CT scan or PET scan
These scans take a series of radiographic pictures of the inside of the body. The images help the specialist determine how advanced the cancer is, and where in the body it has spread to. These types of scans also help the doctor decide on the most appropriate treatment.
Endoscopic Ultrasound (EUS)
This is a procedure that is used with a CT scan and PET scan to help determine how advanced the cancer is. It is a gastroscopy with an ultrasound probe at its tip, allowing the specialist to evaluate the depth of invasion of the main tumor, as well as to look for and sample lymph nodes around the stomach.
The stages of stomach cancer include:
Your treatment options for stomach cancer depend on the stage of your cancer, your overall health and your preferences.
If the cancer has not spread beyond the stomach and local lymph nodes, then surgery may be performed to remove the part of the stomach where the tumor is located. The goal of surgery is to remove all of the cancer and a margin of healthy tissue, when possible. Nearby lymph nodes are typically removed as well. Surgery options include:
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs travel throughout your body, killing cancer cells that may have spread beyond the stomach. It can be given before surgery to help shrink a tumor so that it can be more easily removed. It is also used after surgery to kill any cancer cells that might remain in the body. Chemotherapy may be combined with radiation therapy before or after surgery as well. In stomach cancer that is not amenable to surgery or radiation, chemotherapy may be used alone or with targeted therapy to help prolong survival and improve quality of life.
Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. In gastric cancer cases, radiation therapy can be used before surgery to shrink a tumor so that it’s more easily removed; or after surgery to kill any cancer cells that might remain in the area around the esophagus or stomach. In cancer of the gastroesophageal junction, radiation and chemotherapy can sometimes be administered at the same time (chemoradiotherapy), most often before surgery. In cases of advanced cancer, radiation therapy may be used to relieve side effects caused by a large tumor.
Targeted and Immune Therapy
Targeted therapy uses drugs that attack specific abnormalities within cancer cells and can be helpful in certain types of gastric cancer. Immunotherapy that directs your immune system to kill cancer cells may also be used in certain types of stomach cancer.