Overview
Gastric cancer, also known as stomach cancer, develops when abnormal cells in the lining of the stomach grow uncontrollably. Symptoms of gastric cancer can include abdominal pain, bloating, heartburn, trouble swallowing, unintentional weight loss, fatigue and vomiting blood. While the exact cause of gastric cancer is not fully known; certain factors increase the risk, including previous infection in the stomach, smoking, family history of the stomach cancer, certain genetic conditions, ongoing GERD and gastritis, a diet low in fruit and vegetables and high in salty and smoked foods
There are a few different types of stomach cancer, based on where the cancer began.
- Adenocarcinoma: the most common type of stomach cancer that starts in the cells that produce mucus.
- Gastrointestinal stromal tumors (GIST): this type of cancer starts in the nerve cells that are found in the wall of the stomach.
- Carcinoid tumors: Carcinoid tumors begin in the neuroendocrine cells and are a type of neuroendocrine tumor.
- Lymphoma: Lymphoma begins in the immune system cells and most lymphomas that begin in the stomach are a type of non-Hodgkin’s lymphoma.
How is it diagnosed?
Diagnosing gastric cancer often involves an upper endoscopy (EGD) or endoscopic ultrasound (EUS). During an EGD, the physician inserts a tube down your throat to look at your stomach and a EUS is similar but uses ultrasound attached to the tube to take pictures. Biopsy samples from the procedures can confirm the location, size and extent of the cancer, as well as its stage. Imaging tests like CT scans, MRI and barium swallows can also be used to find tumors or if it has spread to other organs. Stomach cancer isn’t very common in the United States so screening is rare. If you have a family history or other risk factors, speak with your physician about recommendations.
How is it treated?
Treatment for gastric cancer depends on the stage of the disease and may include surgery, chemotherapy, radiation therapy, targeted therapy, or immunotherapy. Surgery aims to remove the cancerous tissue and may involve partial or total removal of the stomach (gastrectomy) and nearby lymph nodes. Other treatments like chemotherapy, radiation therapy, targeted therapy, and immunotherapy may be used before or after surgery to shrink tumors, kill remaining cancer cells, or prevent recurrence. When surgery is not possible, endoscopic options like stents can be placed to help alleviate blockages in the stomach and allow for passage of food. Often, close coordination between a gastroenterologist, surgeon, oncologist and primary care physician are required for appropriate management of the condition.
References
Mayo Clinic. 2023. Stomach Cancer. https://www.mayoclinic.org/diseases-conditions/stomach-cancer/symptoms-causes/syc-20352438
Cleveland Clinic. 2022. Stomach Cancer. https://my.clevelandclinic.org/health/diseases/15812-stomach-cancer
