Stomach cancer

 

Alternative Names

Cancer - stomach; Gastric cancer; Gastric carcinoma; Adenocarcinoma of the stomach

Definition

Stomach cancer is cancer that starts in the stomach.

Causes

Several types of cancer can occur in the stomach. The most common type is called adenocarcinoma. It starts from one of the common cell types found in the lining of the stomach.

Adenocarcinoma is a common cancer of the digestive tract. It is not common in the United States. But it is common in eastern Asia, parts of South America, and eastern and central Europe. It occurs most often in men over age 40.

The number of people in the United States who develop this cancer has decreased over the years. Experts think this decrease may be in part because people are eating less salted, cured, and smoked foods.

You are more likely to get diagnosed with gastric cancer if you:

  • Have a diet low in fruits and vegetables
  • Have a family history of gastric cancer
  • Have an infection of the stomach by bacteria called Helicobacter pylori
  • Had a polyp larger than 2 centimeters in your stomach
  • Have inflammation and swelling of the stomach for a long time (chronic atrophic gastritis)
  • Have pernicious anemia
  • Smoke

Symptoms

Symptoms of stomach cancer may include any of the following:

  • Abdominal fullness or pain, which may occur after a small meal
  • Dark stools
  • Difficulty swallowing, which becomes worse over time
  • Excessive belching
  • General decline in health
  • Loss of appetite
  • Nausea
  • Vomiting blood
  • Weakness or fatigue
  • Weight loss

Exams and Tests

Diagnosis is often delayed because symptoms may not occur in the early stages of the disease. Or, patients may self-treat symptoms that gastric cancer has in common with other, less serious disorders (such as bloating, gas, heartburn, and fullness).

Tests that can help diagnose gastric cancer include:

Treatment

Surgery to remove the stomach (gastrectomy) is the only treatment that can cure adenocarcinoma of the stomach. Radiation therapy and chemotherapy may help. Chemotherapy and radiation therapy after surgery may improve the chance of a cure.

For persons who cannot have surgery, chemotherapy or radiation may improve symptoms and may prolong survival, but will likely not cure the cancer. For some patients, a surgical bypass procedure may relieve symptoms.

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

 

Outlook (Prognosis)

Outlook varies based on how much the cancer has spread by the time of diagnosis. Tumors in the lower stomach are cured more often than those in the higher stomach. Chance of a cure also depends on how far the tumor has invaded the stomach wall and whether lymph nodes are involved.

When the tumor has spread outside the stomach, a cure is not possible. In this case, the goal of treatment is to improve symptoms.

When to Contact a Medical Professional

Call your health care provider if symptoms of gastric cancer develop.

Prevention

Screening programs are successful in detecting disease in the early stages in parts of the world where the risk of stomach cancer is much higher than in the United States. The value of screening in the United States and other countries with lower rates of stomach cancer is not clear.

The following may help reduce your risk of stomach cancer:

  • Do not smoke.
  • Eat a healthy foods rich in fruits and vegetables.
  • Take medicines to treat reflux disease (heartburn), if you have it.
  • Take antibiotics if you are diagnosed with H. pylori infection.

References

Abrams JA, Wang TC. Adenocarcinoma and other tumors of the stomach. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease Pathophysiology/Diagnosis/Management. 9th ed. Philadelphia, Pa: Elsevier Saunders; 2010:chap 54.

Gunderson LL, Donohue JH, Alberts SR, et al. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2013:chap 75.

National Cancer Institute: PDQ Gastric Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified 02/15/2013. Available at: http://cancer.gov/cancertopics/pdq/treatment/gastric/HealthProfessional. Accessed November 8, 2013.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): gastric cancer. Version 2.2013. Available at: http://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf. Accessed November 8, 2013. 

Review Date: 10/30/2013
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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