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Stomach (Gastric) Cancer

Definition

Stomach cancer, also called gastric cancer, is the growth of abnormal cells in the lining and wall of the stomach. It occurs mainly in men over 40 years of age.

Stomach cancer is difficult to detect in its early stages because it causes few or no symptoms.

Getting Diagnosed / Treatment

Stomach cancer is treated in the U-M Comprehensive Cancer Center's Gastrointestinal (GI) Cancer Clinic.

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How does it occur?

Several conditions may be precancerous and may increase the risk of stomach cancer. They include:

• atrophic gastritis, chronic gastritis (inflammation of the stomach lining), and infection by a certain type of bacteria
• pernicious anemia: a chronic vitamin-B12 deficiency anemia that occurs in older adults characterized by numbness and tingling in the extremities
• achlorhydria: low levels or absence of hydrochloric acid in gastric juice.

The four stages of stomach cancer progression are:

• Stage 1: Cancer cells are confined to the inner stomach lining. They are absent from the wall of the stomach or from lymph nodes.
• Stage 2: Cancer cells exist in the tissue of the gastric wall, and may or may not exist in the lymph nodes. There are no metastases (tumors that have spread from the original site).
• Stage 3: Cancer cells have spread (metastasized) to other areas adjacent to the stomach.
• Stage 4: Cancer cells exist in distant areas of the body.

What are the symptoms?

Symptoms of stomach cancer include:

• heartburn or indigestion
• stomach pain
• nausea
• sensation of pressure in the stomach
• loss of appetite (and decreased stomach capacity)
• weight loss.

How is it diagnosed?

Your health care provider will review your symptoms and examine you. Initial diagnostic studies may include an "upper GI" x-ray, where you swallow barium which shows up on x-ray and outlines any abnormality in the stomach. You may also have a procedure called an endoscopy, where a slim, flexible, lighted tube is passed through your mouth and throat into your esophagus and then your stomach. This telescopelike tube allows your health care provider to see any abnormalities. The endoscopy also enables your provider to take a piece of any abnormal tissue and send it for tests to determine if it is cancerous.

Your health care provider may also order:

• blood count and blood chemistry tests, including liver tests
• chest x-rays
• CT scan of the abdomen, if there is concern about possible spread of the cancer.

What is the treatment?

Surgical removal of the entire tumor and surrounding lymph nodes may cure some people, especially if the tumor is detected early.

Partial gastrectomies (partial stomach removal) are more often performed for lower-end tumors (closer to the small intestine); near-total gastrectomies are commonly done for tumors closer to the esophagus.

Radiation therapy does not offer a cure, but it may be used to help lessen pain.

The use of chemotherapy is still under investigation.

How long will the effects last?

The cancer may be curable in 85% of people whose early cancers have not spread through the stomach lining tissues. The cancer may not be curable, however, if it has spread beyond the stomach lining. People with disease in an early stage account for just 10% to 20% of all cases of gastric cancer. Ask your health care provider for survival rates for gastric cancer in your stage of disease.

How can I take care of myself?

• Follow the full course of treatment prescribed by your health care provider.
• Consult a dietitian to maximize your nutrition and therefore your strength within the limits of your dietary restrictions.
• Get plenty of rest.
• Ask your health care provider to recommend appropriate exercise and activities.
• Join a cancer support group.
• Be candid with your family and your health care providers about your concerns.
• Seek professional counseling help to deal with difficult issues.
• Identify those individuals and activities which you enjoy and enjoy them.

For more information, contact:

• American Cancer Society, Inc.
  1599 Clifton Road, NE
  Atlanta, Georgia 30329
  800-ACS-2345 (800-227-2345)
  http://www.cancer.org
• AMC Cancer Research Center and Foundation
  800-321-1557
  http://www.amc.org
• Cancer Information Service
  800-4-CANCER (800-422-6237)
  http://cis.nci.nih.gov

How can I help prevent stomach cancer?

Follow these suggestions:

• Have regular examinations if you are diagnosed with achlorhydria (lack of hydrochloric acid in stomach secretions).
• Follow your health care provider's recommendation if you have been diagnosed with pernicious anemia.
• Contact your health care provider right away if symptoms recur.

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